CC BY-NC-ND 4.0 · European Journal of General Dentistry 2019; 8(03): 55-62
DOI: 10.4103/ejgd.ejgd_28_19
Review Article

Repercussions of diabetes mellitus on the oral cavity

Paras Ahmad
Oral Medicine Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Germany
,
Usman Akhtar
1   LIMES and Pharmaceutical Institute, University of Bonn, Bonn, Germany
,
Ahmed Chaudhry
2   Department of Periodontology, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Germany
,
Usman Rahid
2   Department of Periodontology, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Germany
,
Sarmad Saif
2   Department of Periodontology, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Germany
,
Jawaad Ahmed Asif
3   Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Germany
› Author Affiliations

Abstract

Oral health is a cardinal element of nutritional as well as systemic well-being and plays a substantial part in sustaining optimum general health condition. Various factors influence oral health including metabolic diseases such as endocrine (diabetes mellitus [DM]), hematological, gastrointestinal, cutaneous, and neurological diseases. The intent of this review is to accentuate the correlation between DM and oral disorders, like those upsetting oral mucosa and supporting tissues. A review of literature was performed using relevant key words (“Oral Manifestations of Diabetes” OR “Oral Complications of Diabetes” OR “Oral Impacts of Diabetes” OR “Oral Repercussions of Diabetes“) in prominent journals pertaining to Endocrinology and Dentistry (Journal of Periodontology, Periodontology 2000, British Dental Journal, The Lancet Diabetes and Endocrinology, PloS ONE, and Nature Reviews Genetics). The most frequently witnessed diabetic manifestations in oral cavity include gingivitis and periodontitis leading to premature tooth loss, salivary dysfunctions, dental caries, delayed wound healing, bacterial and fungal infections, lichen planus, taste impairment, tongue abnormalities, neurosensory oral disorders, halitosis, and dry socket. In the end, I have comprehensively described the role of antidiabetic drugs in the management of DM and eventually leading to prevention of its oral complications. In this review, etiopathophysiology of each oral complication has been prudently analyzed to contemplate the establishment of a possible preventive and treatment approach.

Financial support and sponsorship

Nil.




Publication History

Article published online:
01 November 2021

© 2019. European Journal of General Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Kerner W, Brückel J. German Diabetes Association. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes 2014;122:384-6.
  • 2 Mack LR, Tomich PG. Gestational diabetes: Diagnosis, classification, and clinical care. Obstet Gynecol Clin North Am 2017;44:207-17.
  • 3 Wu YY, Xiao E, Graves DT. Diabetes mellitus related bone metabolism and periodontal disease. Int J Oral Sci 2015;7:63-72.
  • 4 Baltzis D, Eleftheriadou I, Veves A. Pathogenesis and treatment of impaired wound healing in diabetes mellitus: New insights. Adv Ther 2014;31:817-36.
  • 5 Aitken-Saavedra J, Rojas-Alcayaga G, Maturana-Ramírez A, Escobar-Álvarez A, Cortes-Coloma A, Reyes-Rojas M, et al. Salivary gland dysfunction markers in type 2 diabetes mellitus patients. J Clin Exp Dent 2015;7:e501-5.
  • 6 Leite RS, Marlow NM, Fernandes JK, Hermayer K. Oral health and type 2 diabetes. Am J Med Sci 2013;345:271-3.
  • 7 Al Mubarak S, Robert AA, Baskaradoss JK, Al-Zoman K, Al Sohail A, Alsuwyed A, et al. The prevalence of oral Candida infections in periodontitis patients with type 2 diabetes mellitus. J Infect Public Health 2013;6:296-301.
  • 8 Riddell MC, Gallen IW, Smart CE, Taplin CE, Adolfsson P, Lumb AN, et al. Exercise management in type 1 diabetes: A consensus statement. Lancet Diabetes Endocrinol 2017;5:377-90.
  • 9 Ranjan R, Rajan S. Oral health manifestations in diabetic patients – A review. Int J Community Health Med Res 2016;2:58-62.
  • 10 Su N, Ching V, Grushka M. Taste disorders: A review. J Can Dent Assoc 2013;79:d86.
  • 11 Gupta S, Jawanda MK. Oral lichen planus: An update on etiology, pathogenesis, clinical presentation, diagnosis and management. Indian J Dermatol 2015;60:222-9.
  • 12 Akinbami BO, Godspower T. Dry socket: Incidence, clinical features, and predisposing factors. Int J Dent 2014;2014:796102.
  • 13 Grushka M, Epstein JB, Gorsky M. Burning mouth syndrome and other oral sensory disorders: a unifying hypothesis. Pain Res Manag 2003;8:133-5.
  • 14 Meenawat A, Punn K, Srivastava V, Meenawat AS, Dolas RS, Govila V. Periodontal disease and type I diabetes mellitus: Associations with glycemic control and complications. J Indian Soc Periodontol 2013;17:597-600.
  • 15 Mohanty S, Mohanty N, Rath S. Analysis of oral health complications in diabetic patients – A diagnostic perspective. J Oral Res 2018;7:278-81.
  • 16 Llambés F, Arias-Herrera S, Caffesse R. Relationship between diabetes and periodontal infection. World J Diabetes 2015;6:927-35.
  • 17 Campus G, Salem A, Uzzau S, Baldoni E, Tonolo G. Diabetes and periodontal disease: A case-control study. J Periodontol 2005;76:418-25.
  • 18 Ryan ME, Raja V. Diet, obesity, diabetes, and periodontitis: A syndemic approach to management. Curr Oral Health Rep 2016;3:14-27.
  • 19 Indurkar MS, Maurya AS, Indurkar S. Oral manifestations of diabetes. Clin Diabetes 2016;34:54-7.
  • 20 Mahapatra DK, Asati V, Bharti SK. Chalcones and their therapeutic targets for the management of diabetes: Structural and pharmacological perspectives. Eur J Med Chem 2015;92:839-65.
  • 21 Zhang A, Lieber CM. Nano-bioelectronics. Chem Rev 2016;116:215-57.
  • 22 Annibali S, Pranno N, Cristalli MP, La Monaca G, Polimeni A. Survival analysis of implant in patients with diabetes mellitus: A systematic review. Implant Dent 2016;25:663-74.
  • 23 Costa KL, Taboza ZA, Angelino GB, Silveira VR, Montenegro R Jr. Haas AN, et al. Influence of periodontal disease on changes of glycated hemoglobin levels in patients with type 2 diabetes mellitus: A retrospective cohort study. J Periodontol 2017;88:17-25.
  • 24 Souto ML, Rovai ES, Ganhito JA, Holzhausen M, Chambrone L, Pannuti CM. Efficacy of systemic antibiotics in nonsurgical periodontal therapy for diabetic subjects: A systematic review and meta-analysis. Int Dent J 2018;68:207-20.
  • 25 Knight ET, Liu J, Seymour GJ, Faggion CM Jr., Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016;71:22-51.
  • 26 Joshi D, Garg T, Goyal AK, Rath G. Advanced drug delivery approaches against periodontitis. Drug Deliv 2016;23:363-77.
  • 27 Jha R, Kalyani P, Bavishi R. Oral manifestations of diabetes. J Res Med Dent Sci 2017;2:6-8.
  • 28 Sasaki H, Hirai K, Martins CM, Furusho H, Battaglino R, Hashimoto K. Interrelationship between periapical lesion and systemic metabolic disorders. Curr Pharm Des 2016;22:2204-15.
  • 29 Buranasin P, Mizutani K, Iwasaki K, Pawaputanon Na Mahasarakham C, Kido D, Takeda K, et al. High glucose-induced oxidative stress impairs proliferation and migration of human gingival fibroblasts. PLoS One 2018;13:e0201855.
  • 30 Vitali C, Del Papa N. Classification criteria for Sjögren’s syndrome. Sjögren’s Syndrome: Elsevier; 2016. p. 47-60.
  • 31 Ouanounou A. Xerostomia in the geriatric patient: Causes, oral manifestations, and treatment. Compend Contin Educ Dent 2016;37:306-11.
  • 32 Han P, Suarez-Durall P, Mulligan R. Dry mouth: A critical topic for older adult patients. J Prosthodont Res 2015;59:6-19.
  • 33 Ashley EA. Towards precision medicine. Nat Rev Genet 2016;17:507-22.
  • 34 Spielmann N, Wong DT. Saliva: diagnostics and therapeutic perspectives. Oral Dis 2011;17:345-54.
  • 35 Cornec D, Saraux A, Jousse-Joulin S, Pers JO, Boisramé-Gastrin S, Renaudineau Y, et al. The differential diagnosis of dry eyes, dry mouth, and parotidomegaly: A comprehensive review. Clin Rev Allergy Immunol 2015;49:278-87.
  • 36 Bharateesh JV, Ahmed M, Kokila G. Diabetes and oral health: A case-control study. Int J Prev Med 2012;3:806-9.
  • 37 López-Pintor RM, Casañas E, González-Serrano J, Serrano J, Ramírez L, de Arriba L, et al. Xerostomia, hyposalivation, and salivary flow in diabetes patients. J Diabetes Res 2016;2016:4372852.
  • 38 Jagtap SV, Aramani SS, Mane A, Bonde V. Sialosis: Cytomorphological significance in the diagnosis of an uncommon entity. J Cytol 2017;34:51-2.
  • 39 Bag AK, Curé JK, Chapman PR, Singhal A, Haneef Mohamed AW. Imaging of inflammatory disorders of salivary glands. Neuroimaging Clin N Am 2018;28:255-72.
  • 40 Kakkad A, Bhasin N. Diabetes and oral diseases: A review. Indian J Stomatol 2015;6:71-5.
  • 41 Verhulst MJ, Loos BG, Gerdes VE, Teeuw WJ. Evaluating all potential oral complications of diabetes mellitus. Front Endocrinol 2019;10:56. Doi: https://doi.org/10.3389/fendo.2019.00056.
  • 42 D’’Aiuto F, Gable D, Syed Z, Allen Y, Wanyonyi KL, White S, et al. Evidence summary: The relationship between oral diseases and diabetes. Br Dent J 2017;222:944-8.
  • 43 Jeong I-H, Park M-J. The Association between diabetes mellitus and community periodontal index. Int J Appl Eng Res 2017;12:2277-81.
  • 44 Lima DL, Carneiro SD, Barbosa FT, Saintrain MV, Moizan JA, Doucet J. Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PLoS One 2017;12:e0180891.
  • 45 Sampaio N, Mello S, Alves C. Dental caries-associated risk factors and type 1 diabetes mellitus. Pediatr Endocrinol Diabetes Metab 2011;17:152-7.
  • 46 Ismail AF, McGrath CP, Yiu CK. Oral health of children with type 1 diabetes mellitus: A systematic review. Diabetes Res Clin Pract 2015;108:369-81.
  • 47 Hariharavel V, Rao AP, Venugopal RN, Peter J. Diabetes, diet and dental caries. Int J Diabetes Dev Ctries 2017;37:94.
  • 48 Akhtar N, Saleem M, Mian FA, Shareef MJ, Hussain F. Head and neck infections; secondary to dental causes; diagnosis and treatment. Prof Med J 2015;22:787-92.
  • 49 Rao DD, Desai A, Kulkarni RD, Gopalkrishnan K, Rao CB. Comparison of maxillofacial space infection in diabetic and nondiabetic patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e7-12.
  • 50 Mauri-Obradors E, Estrugo-Devesa A, Jané-Salas E, Viñas M, López-López J. Oral manifestations of diabetes mellitus. A systematic review. Med Oral Patol Oral Cir Bucal 2017;22:e586-94.
  • 51 Negrato CA, Tarzia O. Buccal alterations in diabetes mellitus. Diabetol Metab Syndr 2010;2:3.
  • 52 Vernillo AT. Dental considerations for the treatment of patients with diabetes mellitus. J Am Dent Assoc 2003;134:24S-33S.
  • 53 Beikler T, Flemmig TF. Implants in the medically compromised patient. Crit Rev Oral Biol Med 2003;14:305-16.
  • 54 Guggenheimer J, Moore PA, Rossie K, Myers D, Mongelluzzo MB, Block HM, et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies: II. Prevalence and characteristics of Candida and candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:570-6.
  • 55 Gandara BK, Morton TH. Non-periodontal oral manifestations of diabetes: A framework for medical care providers. Diabetes Spectr 2011;24:199-205.
  • 56 Bastos AS, Leite AR, Spin-Neto R, Nassar PO, Massucato EM, Orrico SR. Diabetes mellitus and oral mucosa alterations: Prevalence and risk factors. Diabetes Res Clin Pract 2011;92:100-5.
  • 57 Khan S, Shah SAH, Ishaq M. Benign migratory glossitis: Case report and literature review. Int J Clin Oral Maxillofac Surg 2018;4:1-4.
  • 58 Najmi MA, Sadiq MS, Khalid A. Median rhomboid glossitis reported in diabetic patient – An enigmatic pathological finding. J Bahria Uni Med Dent Coll 2018;8:197-8.
  • 59 De Carli L, Gambino R, Lubrano C, Rosato R, Bongiovanni D, Lanfranco F, et al. Impaired taste sensation in type 2 diabetic patients without chronic complications: A case – Control study. J Endocrinol Invest 2018;41:765-72.
  • 60 Rasmussen VF, Vestergaard ET, Hejlesen O, Andersson CU, Cichosz SL. Prevalence of taste and smell impairment in adults with diabetes: A cross-sectional analysis of data from the national health and nutrition examination survey (NHANES). Prim Care Diabetes 2018;12:453-9.
  • 61 Neiers F, Canivenc-Lavier M-C, Briand L. What does diabetes “taste” like? Curr Diabetes Rep 2016;16:49-55.
  • 62 Otero Rey EM, Yáñez-Busto A, Rosa Henriques IF, López-López J, Blanco-Carrión A. Lichen planus and diabetes mellitus: Systematic review and meta-analysis. Oral Dis 2019;25:1253-64.
  • 63 Parthasarathi K, Smith A, Chandu A. Factors affecting incidence of dry socket: a prospective community-based study. J Oral Maxillofac Surg 2011;69:1880-4.