Type 2 Diabetes Mellitus and Oral Health: Understanding the Bidirectional Relationship: A Narrative Review

Diabetes mellitus, a common endocrine disorder, has critical systemic impacts and welldocumented consequences for oral health. This review analyzes studies from 2020 to 2025 that demonstrated the complex bidirectional relationship between Type 2 Diabetes Mellitus (T2DM) and oral disease. Evidence confirms that poor glycemic control leads to higher incidence and severity of periodontitis, tooth decay, candidiasis, dry mouth, burning mouth syndrome, impaired wound healing, among other oral complications. These conditions can also contribute to worsening diabetic management, creating a self-perpetuating cycle. Integrated patient care is therefore essential to break this cycle and reduce its effects on patients, which must include targeted education among diabetic patients about their increased oral health risks, alongside management strategies that emphasize both metabolic control and regular professional dental care. This review also highlights the urgent need for context-specific strategies in the Arab world, a region with a high prevalence of T2DM, exemplified by an estimated number of 85 million affected adults in the Middle East and North Africa (MENA) region Translating the firm evidence on the oral-systemic relationship into routine practice requires closing the gap between existing research and clinical application. Addressing this gap is fundamental to developing clinical guidelines that are effective healthcare protocols specific to the region. Keywords: Diabetes mellitus, Type 2, Periodontitis, Bidirectional relationship, Glycemic control, Oral health, Xerostomia.