Oral alterations in diabetes mellitus

Abstract

SummaryDiabetes mellitus is one of the most common chronic diseases which continue to increase in number and significance. It presents the third most prevalent condition among medically compromised patients referring for dental treatment. Diabetes mellitus has been defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Hyperglycemia leads to widespread multisystem damage which has an effect on oral tissue. The present article summarizes current knowledge regarding the association between diabetes mellitus and oral and dental health.

Oral manifestations in patients with diabetes mellitus

“…People with diabetes experience salivary dysfunction, which can lead to decreased salivary flow and change in saliva composition. The estimated universal prevalence of xerostomia among diabetic patients ranges between 34% and 51%[1,2]. Xerostomia can lead to numerous problems such as difficulty in eating, swallowing, and speaking.…”

“…Reduced cleansing and buffering capacity of the saliva, increase of carbohydrate in the saliva, and increased level of oral yeasts, mutans streptococci and lactobacilli can lead to an increase in the incidence of tooth decay. In addition, chronic hyperglycemia may cause irreversible pulpitis leading to pulp necrosis[1,2,5,7,8]. Some studies have shown that apical periodon-titis and radiolucent periapical lesions are more common in diabetic compared to nondiabetic individuals[1,5,9].…”

“…The elimination of pathogens by treatment leads to a decrease of inflammation, which in turn reduces insulin resistance; this in turn decreases glucose levels. Therefore, there is a two-way relationship between periodontal disease and diabetes[1,3,5,10]. In adults, periodontal disease is the main reason for tooth mobility and consequently, loss of it.…”

“…Diabetes mellitus (DM) is a chronic metabolic disease characterized by hyperglycemia due to either a deficiency of insulin secretion or resistance to the action of insulin or both[1-3]. Chronic hyperglycemia leads to different complications in various regions of the body including the oral cavity, so blood glucose control is very critical[4].…”

“…The oral manifestations and complications related to DM include dry mouth (xerostomia), tooth decay (including root caries), periapical lesions, gingivitis, periodontal disease, oral candidiasis, burning mouth (especially glossodynia), altered taste, geographic tongue, coated and fissured tongue, oral lichen planus (OLP), recurrent aphthous stomatitis, increased tendency to infections, and defective wound healing[1-8]. The intensity of diabetic complications is usually proportional to the degree and duration of hyperglycemia[5].…”