Evidence to support a bidirectional relationship between diabetes and periodontal disease has been emerging for more than 15 years. In 1993, Löe proposed that severe peridontitis was the sixth complication of diabetes; in 1996, Taylor and colleagues reported other compelling findings that severe periodontitis at baseline is associated with worsening glycemic control over time in a population-based study of Pima Indians with diabetes who were noninsulin dependent.

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