Sir, diabetes mellitus afflicts 3.3 million people in the UK with perhaps a further one million as yet undiagnosed.1 As HbA1c rises, the risk of periodontal disease increases dramatically.2 The combination of increased inflammatory mediators, advanced glycation end products and impaired immunity in diabetes may all play a role.3 But this is by no means a one-way street. Indeed, the bidirectional relationship between poor glycaemic control and periodontal disease is long established.3 One would assume therefore that, between dentists and physicians, information regarding these diseases is both easily accessible and eagerly sought...

As doctors, we are fortunate to know several practising dentists from whom we can seek insight into current practices. 'We just ask how well controlled it is... and some do a BM' was the first response we garnered after asking a dental colleague. Another explained, 'dentists don't really talk to GPs or diabetic specialists. We just tell patients with periodontal disease to make sure they get their glucose tested and make sure it's well controlled with [medications] and diet'. A third colleague reported, 'it's usually a case of taking the patient's word for it'. Indeed, more often than not we can trust that our patients will give us a truthful insight into the control of their condition. However, both denial and lack of insight are certainly not devoid in such patient groups.4,5 Needless to say, as doctors we are guilty of much of the same. I cannot recall a single instance where I, or one of my peers, had thought to consult a patient's dental records!

We would like to invite our dental colleagues to work more closely with us to increase awareness and curb the incidence of diabetic periodontal disease. Awareness of poor oral health amongst doctors may prompt early investigation for diabetes, whilst awareness of poor glycaemic control amongst dentists may encourage targeted dental assessment and aid diagnosis. Just as the once estranged medical specialties have irrevocably come to realise, multidisciplinary teamwork may well be the key in breaking such vicious cycles.