Dental caries and bacterial load in saliva and dental biofilm of type 1 diabetics on continuous subcutaneous insulin infusion

Abstract

Objectives Since most of the studies evaluates diabetics on multiple daily injections therapy and continuous subcutaneous insulin infusion may help gain better metabolic control and prevent complications, the objective of this study was to evaluate the prevalence of dental caries, the unstimulated salivary flow rate and the total bacteria load, Streptococcus spp. levels and Lactobacillus spp. levels in saliva and supragingival dental biofilm of type 1 diabetics on insulin pump.Material and Methods Sixty patients with type 1 diabetes on insulin pump and 60 nondiabetic individuals were included. The dental caries evaluation was performed using ICDAS and the oral hygiene was assessed according to Greene and Vermillion Simplified Oral Hygiene Index. Unstimulated saliva and supragingival dental biofilm were collected. Total bacteria, Streptococcus spp. and Lactobacillus spp. was quantified by qPCR.Results Patients with type 1 diabetes had a higher prevalence of dental caries and filled and missing teeth when compared with the control group. These patients were associated with more risk factors for the development of dental caries, namely a lower unstimulated salivary flow rate and a higher bacterial load in saliva and dental biofilm.Conclusion Some risk factors related to dental caries were associated with type 1 diabetics. An early diagnosis combined with the evaluation of the risk profile of the diabetic patient is imperative, allowing the dental caries to be analyzed through a perspective of prevention and the patient to be integrated into an individualized oral health program.

Dental caries, diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta‐analysis

“…Forty‐five articles regarding caries experience among type 1 diabetics were analyzed (Table ). Regarding type 2 diabetes 17 studies were included (Table ).…”

“…Twelve of the studies were conducted in India, eight in the United States, six in Brazil, five in Finland, four each in Portugal, Sweden, and Turkey, two in Lithuania, one each in Belgium, Bosnia and Herzegovina, China, Egypt, Germany, Hungary, Iraq, Jordan, Republic of Kosovo, Kuwait, Libya, Malaysia, Mexico, Spain, Sudan, Thailand, and Uruguay…”

“…Salivary pH has been studied and proven to reach lower values in diabetic patients compared to healthy individuals . Several factors contribute to this decrease: the low concentration of bicarbonate, the greater accumulation of dental plaque and saliva with high cariogenic load and an increased concentration of salivary glucose, possibly related to microvascular complications (damage to the basal membrane of salivary glands leads to an endothelial dysfunction and the glucose molecule is easily released to the existing saliva) …”

The Oral Microbiota Is Modified by Systemic Diseases

“… RA, rheumatoid arthritis; SLE, systemic lupus erythematosus. a Ganesan et al (2017). b de Groot et al (2017). c Xiao et al (2017). d Anbalagan et al (2017). e Coelho et al (2018). f Zhou et al (2013). g Corrêa et al (2017). h Corrêa et al (2018, unpublished results). i Queiroz-Junior et al (2011). j Zhang et al (2015). k Corrêa et al (2016). …”

Prevalence of dental caries in children and adolescents with type 1 diabetes: a systematic review and meta-analysis

“…Screening and preventive treatment are necessary to avoid dental caries before they become incurable in the high-risk population. However, the exact prevalence of dental caries remains controversial in children and adolescents with type 1 diabetes [14–17], especially in those with poor metabolic control [18]. Previous studies reported that the prevalence of dental caries in children and adolescents varies between 36% in Iran [19] and 92% in Chile [20].…”