Non-Periodontal Oral Manifestations of Diabetes: A Framework for Medical Care Providers

Gandara, Beatrice K.; Morton, Thomas Hellman

doi:10.2337/diaspect.24.4.199

Cited by 28 publications

(38 citation statements)

References 45 publications

(25 reference statements)

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“…Studies by Wang et al have shown abnormal subcellular localization of AQP5 as well as downregulation of AQP5 protein in parotid glands of STZ‐induced diabetic rats 23 . Previous research in humans has shown that salivary flow rate is reduced in the onset of DM 3 , 4 . In the current study, the authors also found that the salivary volume and weights of all three salivary glands (P, SM, SL) were less in the DB rats compared with controls.…”

Section: Discussionsupporting

confidence: 71%

“…DM‐induced oral health problems are highly prevalent in minority populations, particularly African Americans, Hispanics, and American Indians 2 . DM is thought to promote xerostomia, a qualitative or quantitative absence of saliva in the oral cavity 3 , 4 . Decreased salivary flow can cause complications in the oral cavity by allowing excessive accumulation of bacteria, leading to numerous oral infections, extreme thirst (especially at night), alteration in the taste of food, rampant tooth decay, and halitosis 3 .…”

mentioning

confidence: 99%

“…DM is thought to promote xerostomia, a qualitative or quantitative absence of saliva in the oral cavity 3 , 4 . Decreased salivary flow can cause complications in the oral cavity by allowing excessive accumulation of bacteria, leading to numerous oral infections, extreme thirst (especially at night), alteration in the taste of food, rampant tooth decay, and halitosis 3 . Decreased salivary production can be caused by a number of other factors, such as medications, 5 radiotherapy involving the salivary glands, 6 and autoimmune diseases 7 .…”

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confidence: 99%

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Effects of Diabetes on Salivary Gland Protein Expression of Tetrahydrobiopterin and Nitric Oxide Synthesis and Function

Stewart

Obi

Epane

et al. 2016

Journal of Periodontology

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Background Xerostomia is defined as dry mouth resulting from a change in the amount and/or composition of saliva and often a major oral health complication associated with diabetes. Studies have shown that xerostomia is more common in females in the onset of diabetes. Evidence suggests that nitric oxide (NO) plays a critical role in healthy salivary gland function. However, the specific mechanisms by which NO regulates salivary gland function at the onset of diabetes have yet to be determined. This study had two aims: 1. To determine whether protein expression and/or dimerization of NO synthase enzymes (nNOS, eNOS) are altered in the onset of diabetic xerostomia and 2. To determine whether the changes in nNOS/eNOS protein expression/dimerization are correlated with changes in NO cofactor, tetrahydrobiopterin (BH4) biosynthetic enzymes (GTP Cyclohydrolase-1, Dihydrofolate reductase). Methods Functional and western blot studies were performed in streptozotocin-induced diabetic (type 1 diabetes) and control Sprague Dawley female rats using standardized protocols. Confirmation of xerostomia was determined by increased water intake and decreased salivary flow rate. Results In diabetic female rats, salivary hypofunction is correlated with decreased submandibular and parotid gland sizes. Furthermore, our results show a decrease in NOS and BH4 biosynthetic enzyme in submandibular glands. Conclusion Our results indicate that a decrease in submandibular NO-BH4 protein expression may provide insight pertaining to mechanisms for the development of hyposalivation in diabetes-induced xerostomia. Furthermore, understanding the role of NO-BH4 pathway may give insight to possible treatment options for the diabetic patient experiencing xerostomia.

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Section: Discussionsupporting

confidence: 71%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of Diabetes on Salivary Gland Protein Expression of Tetrahydrobiopterin and Nitric Oxide Synthesis and Function

Stewart

Obi

Epane

et al. 2016

Journal of Periodontology

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“…Subjective oral dryness may not be associated with hyposalivation (López-Pintor et al, 2016). It may be due to thirst, dehydration, side effects of concomitant drug therapy that is commonly used by diabetic patients as antihypertensive drugs and diuretics (Gandara and Morton, 2011).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Burning Mouth Syndrome in A sample of Egyptian Patients with Diabetic Neuropathy: A Cross Sectional Hospital-Based Study

Nada

Moneim

Fakhr

et al. 2020

Advanced Dental Journal

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Background: Diabetes Mellitus is one of the systemic causes of secondary burning mouth syndrome. Burning sensation in diabetic patients has been attributed to poor glycemic control and regional neuropathy. Diabetic peripheral neuropathy is the most common microvascular chronic complication of diabetes, affecting almost half of the diabetic population. Aim: To assess the frequency of burning mouth syndrome in type 2 diabetic patients with peripheral neuropathy. Methods: A total number of 250 patients with type 2 diabetes mellitus diagnosed clinically with peripheral neuropathy were recruited. Clinical examination was done to exclude any oral lesions. Oral complaints related to burning mouth syndrome including burning sensation, altered taste sensation, and xerostomia were recorded using dichotomous method. Results: The prevalence of burning mouth syndrome in type 2 diabetic patients with peripheral neuropathy was 18.8%. About half of the of the participants (53.2%) had contributing local factors as fissured tongue, oral lichen planus and chronic candidiasis. There is a positive correlation between local factors and burning mouth syndrome, also there is a positive correlation between local factors and metabolic control (p.value<0.05). Conclusion: Burning mouth syndrome in patients with diabetic neuropathy is complicated. The contributing oral factors are associated with poor metabolic control. Good metabolic control should be achieved to prevent effects of hyperglycemia on oral mucosa, also to prevent further deterioration in neuropathic mechanism.

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“…Interestingly periodontal infections are more commonly observed in diabetic individuals [2]. Diabetes negatively affects the salivary gland function and immune function which further increases the risk of oral infections in these individuals [3,4]. Oral infections including hyposalivation or xerostomia which is associated with burning sensation of mouth, loss of sensation of taste, enlargement of salivary glands, candida infections, and few autoimmune lesion such as lichen planus are reported [1].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study in the Diabetes Mellitus Patients for Oral Manifestation at Tertiary Care Hospital in North Karnataka

Nimbal¹,

Desai²,

Rathod³

2016

Asian J Pharm Clin Res

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Objective: Diabetes mellitus is the leading health problem across the world. It is associated with several complications such as retinopathy, neuropathy, oral manifestations, chronic macrovascular and microvascular complications. Our objective is to compare these oral manifestations in controlled and uncontrolled diabetic patients. Methods:A study was conducted on total of 100 diabetic patients. The patients were divided into two groups: Group I (n=50) consists of controlled diabetic patients and Group II (n=50) consists of uncontrolled diabetic patients. Before, the start of the study proper oral examination was done for both the groups. Samples were collected and were subjected to microbial examination. Comparison between both the groups was done for oral manifestations.Results: It showed that uncontrolled diabetic patients had a higher incidence of oral manifestations such as hyposalivation, parotid enlargement, burning sensation of mouth, taste alterations, sialorrhea, dental carries, and microbial lesions than controlled diabetes patients. Conclusion:Uncontrolled diabetic patients had higher risk of oral manifestations than controlled diabetic individuals.

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Non-Periodontal Oral Manifestations of Diabetes: A Framework for Medical Care Providers

Cited by 28 publications

References 45 publications

Effects of Diabetes on Salivary Gland Protein Expression of Tetrahydrobiopterin and Nitric Oxide Synthesis and Function

Effects of Diabetes on Salivary Gland Protein Expression of Tetrahydrobiopterin and Nitric Oxide Synthesis and Function

Prevalence of Burning Mouth Syndrome in A sample of Egyptian Patients with Diabetic Neuropathy: A Cross Sectional Hospital-Based Study

A Comparative Study in the Diabetes Mellitus Patients for Oral Manifestation at Tertiary Care Hospital in North Karnataka

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