Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
Dental Caries and Salivary Alterations in Patients With Type 2 Diabetes
TAKE-HOME MESSAGE
-
Type 2 diabetes (T2D), along with medications for T2D and other comorbidities, may impair saliva production and composition, increasing the patient's susceptibility to dental caries. This systematic review examined the relationship among dental caries, salivary alterations, and T2D in adults. A meta-analysis of 39 observational studies indicated that individuals with T2D had higher DMFT scores, reduced salivary flow rates, a lower salivary pH, and a decreased buffering capacity than those without T2D. No significant differences in DMFT scores or salivary buffering capacity were observed between patients with well-controlled T2D and those with poorly controlled T2D. However, this study did not explore changes in salivary proteins and metabolites that may be influenced by T2D, medications for T2D, or other systemic conditions.
- Given the heightened risk of dental caries in individuals with T2D, likely due to salivary dysfunction, clinicians should prioritize and enhance preventive strategies to safeguard oral health in this population.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersINTRODUCTION
The association between dental caries, salivary alterations, and type 2 diabetes (T2D) is inconclusive. This systematic review evaluated the caries status and salivary alterations in adults with T2D.
DATA
Observational studies (cross-sectional, case-control, or cohort studies) that evaluated the association between type 2 diabetes and dental caries and/or salivary changes were included.
SOURCES
Systematic searches of PubMed/Medline, Web of Science, Embase, and the Cochrane Library for relevant literature published up to January 2024 were performed.
STUDY SELECTION
Ninety-eight studies were selected from the 1981 records obtained after screening the databases. Thirty-nine studies that met the eligibility criteria were included in the qualitative synthesis, and twenty-eight of the included studies were suitable for the quantitative synthesis (meta-analysis).
RESULTS
The meta-analysis showed that compared to non-diabetic individuals, type 2 diabetic individuals had higher DMFT (mean difference: 2.27; 95 % CI, 1.31 to 3.22; P < 0.00001). Moreover, type 2 diabetic individuals had lower salivary flow rate (standardized mean difference: -2.62; 95 % CI, -4.38 to -0.86; P = 0.003), salivary pH (standardized mean difference: -1.35; 95 % CI, -1.89 to -0.80; P < 0.00001) and salivary buffering capacity (standardized mean difference: -0.60; 95 % CI, -0.93 to -0.27; P = 0.0004). Whereas DMFT (mean difference: -2.15; 95 % CI, -6.47 to 2.17; P = 0.33) and salivary buffering capacity (standardized mean difference: -0.05; 95 % CI, -0.48 to 0.37; P = 0.80) were not significantly different between individuals with well-controlled diabetes and those with poorly-controlled diabetes.
CONCLUSIONS
Type 2 diabetes may lead to an increased index of dental caries and a reduction in salivary flow rate, salivary pH, and salivary buffering capacity in adults.
CLINICAL SIGNIFICANCE
Individuals with type 2 diabetes exhibit an elevated risk of dental caries and salivary alterations that facilitate the progression of dental caries. It is recommended that dentists and endocrinologists focus their attention on the oral health of this population.
Additional Info
Disclosure statements are available on the authors' profiles:
Dental caries and salivary alterations in patients with type 2 diabetes: A systematic review and meta-analysis
J Dent 2024 Aug 30;150(xx)105321, G Zhou, X Shu, Y Long, Y Cao, J Wang, G Liao, L ZouFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This systematic review and meta-analysis focused on studies that evaluated the associations among dental caries, salivary alterations (eg, salivary flow rate), and the presence of type 2 diabetes (T2D). Following a well-conducted systematic search with an appropriate methodology and including a range of article types reporting on research conducted around the world, the authors identified 39 studies that met the inclusion criteria, of which 28 were suitable for the quantitative synthesis (ie, meta-analysis, in which the data from similar studies are combined together to generate a greater statistical power).
The analysis showed that individuals with T2D had more carious teeth, as measured using the DMFT (decayed, missing, filled teeth) index, than those without T2D (mean difference of 2.27 — indicating, on average, the presence of just over two more decayed, missing, or filled teeth in people with T2D). Interestingly, those with T2D also had lower salivary flow rates, salivary pH, and salivary buffering capacity. Clearly, all these elements of reduced salivary function increase the risk of dental caries.
As we know, diabetes is a disease that has multiple impacts on body systems and organs, and the mouth is no different. For example, we are well aware of the increased risk of periodontitis in people with diabetes. With regards to saliva, chronic hyperglycemia can lead to the dysfunction of salivary glands and decreases in salivary secretion, potentially increasing the caries risk. As clearly shown in this research, individuals with T2D have increased risk not only for dental caries but also for alterations in saliva that can facilitate the progression of caries. Although further research is needed to elucidate the mechanisms that underpin the increased caries risk in more detail, it is clear that dental and medical healthcare professionals should be aware of these links and work together to apply appropriate preventive and therapeutic approaches.