Oral Health Implications in Diabetes Mellitus

Diabetes mellitus exerts profound effects on oral health through a confluence of metabolic, vascular and immunological disturbances. Chronic hyperglycaemia promotes the formation of advanced glycation end products and oxidative stress, which impair collagen synthesis and compromise microvascular integrity in gingival tissues. Immune dysfunction in diabetes alters neutrophil chemotaxis and phagocytic activity, fostering a dysbiotic oral microbiome and increasing susceptibility to periodontal inflammation. Reduced salivary flow and altered salivary composition—manifesting as xerostomia—further diminish the oral cavity’s natural defence mechanisms, facilitating cariogenic biofilm accumulation. Beyond caries and periodontitis, individuals with poorly controlled diabetes face delayed wound healing following extractions or implant placement, increased prevalence of mucosal lesions, taste disturbances and a higher risk of opportunistic fungal infections. Effective glycaemic control and interprofessional collaboration between dental and medical practitioners are crucial to mitigate these complications, underscoring the need for routine oral screening and personalised preventive strategies in diabetic care pathways.

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Oral Health Implications in Diabetes Mellitus publication trend

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Technical terms

Hyperglycaemia: Prolonged elevation of blood glucose levels that promotes tissue damage and inflammation.

Periodontitis: Chronic inflammatory destruction of the supporting structures of the teeth, including gingiva, periodontal ligament and alveolar bone.

DMF index: A quantitative measure of dental caries experience, reporting the number of decayed, missing and filled teeth or surfaces.

Xerostomia: Subjective sensation of oral dryness, often due to reduced salivary flow (hyposalivation).

Glycated haemoglobin (HbA1c): A biomarker reflecting average blood glucose control over the preceding two to three months, used to guide diabetes management.

References

1. Evaluating All Potential Oral Complications of Diabetes Mellitus. Frontiers in Endocrinology (2019).
2. Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients. Journal of Diabetes Research (2016).
3. DMF scores in patients with diabetes mellitus: A systematic review and meta-analysis of observational studies. Journal of Dentistry (2023).
4. Oral Microbiota in Children and Adolescents with Type 1 Diabetes Mellitus: Novel Insights into the Pathogenesis of Dental and Periodontal Disease. Microorganisms (2023).
5. Preoperative HbA1c and Blood Glucose Measurements in Diabetes Mellitus before Oral Surgery and Implantology Treatments. International Journal of Environmental Research and Public Health (2023).