Patients with type 2 diabetes may have a heightened risk of salivary alterations, leading to higher decayed, missing, and filled teeth, regardless of glucose control.
Saliva helps protect dental hard tissues from cavities through its cleansing, buffering, and antimicrobial functions. Additionally, it supports tooth remineralization and neutralizes acids in the mouth, helping to maintain a balanced pH. When salivary flow or pH is disrupted, it can lead to imbalances in the oral microbiome, increasing the risk of dental caries.
Type 2 diabetes can also increase the risk of dry mouth, gingivitis, periodontal disease, oral infections, burning mouth syndrome, taste disorders, and poor wound healing. However, the current understanding of the connection between type 2 diabetes and oral changes is inconclusive.
In a systematic review and meta-analysis, published in the Journal of Dentistry, investigators identified 98 observational studies—including cross-sectional, case-control, and cohort studies—that were published until January 2024 and explored the link between type 2 diabetes and dental caries and/or salivary alterations. They noted that 28 of the studies met the inclusion criteria and were suitable for both qualitative and quantitative synthesis.
Patients with type 2 diabetes had higher decayed-missing-filled teeth scores (mean difference 2.27), decreased salivary flow rates (standardized mean difference –2.62), lower salivary pH values (standardized mean difference –1.35), and reduced salivary buffering capacity (standardized mean difference –0.60).
There were no statistically significant differences in decayed-missing-filled teeth scores and salivary buffering capacity between the patients with well and poorly controlled diabetes, according to investigators.
The investigators emphasized the need for oral health policies designed to improve the rate of dental caries in this patient population.
No conflicts of interest were disclosed.