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 Table of Contents  
EXPERT COMMENTARY
Year : 2013  |  Volume : 5  |  Issue : 5  |  Page : 337-338

Diabetes weds oral infection: An unhappy marriage


Department of Periodontology and Oral Implantology, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana, India

Date of Web Publication27-May-2013

Correspondence Address:
Preetinder Singh
Department of Periodontology and Oral Implantology, Swami Devi Dyal Hospital and Dental College, Barwala, Haryana
India
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Source of Support: None, Conflict of Interest: None


PMID: 23814768

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How to cite this article:
Singh P. Diabetes weds oral infection: An unhappy marriage. North Am J Med Sci 2013;5:337-8

How to cite this URL:
Singh P. Diabetes weds oral infection: An unhappy marriage. North Am J Med Sci [serial online] 2013 [cited 2019 Sep 16];5:337-8. Available from: http://www.najms.org/text.asp?2013/5/5/337/112492

Dear Editor,

On reading various articles related to diabetes in your esteemed journal, [1],[2],[3] I would like to add the importance of oral infections associated with diabetes.

Diabetes mellitus (DM) is a chronic disease with serious long-term debilitating complications and no known permanent cure. The relationship between oral health and diabetes has been extensively studied, particularly with respect to periodontal disease and to a lesser extent, dental caries. Diabetes affects 18 million individuals in the United States and about 171 million individuals worldwide, and has reached epidemic status. [4]

The onset of symptoms is rapid in type 1 diabetes; and includes the classic triad of polyphagia, polydipsia, and polyuria; as well as weight loss, irritability, drowsiness, and fatigue. Symptoms of type 2 diabetes develop more slowly and frequently without the classic triad; rather, these patients may be obese and may have pruritus, peripheral neuropathy, and blurred vision. Opportunistic infections, including oral and vaginal candidiasis, can be present. Adults with long-standing diabetes, especially those with poorly controlled hyperglycemia, may develop microvascular and macrovascular conditions that can produce irreversible damage to the eyes (retinopathy and cataracts), kidneys (nephropathy), nervous system (neuropathy and paresthesias), and heart (accelerated atherosclerosis), as well as recurrent infections and impaired wound healing. The most common oral health problems associated with diabetes are tooth decay (caries), periodontal (gum) disease, salivary gland dysfunction, fungal infections, lichen planus and lichenoid reactions (inflammatory skin disease), infection and delayed healing, and taste impairment. Other pathology associated with diabetes includes oral infections other than those responsible for dental caries and periodontal destruction. Case reports on life-threatening deep neck infection from a periodontal abscess [5] and fatal palatal ulcers [6] exemplify theseverity of these conditions. There are also indications that patients with elevated salivary glucose levels carry candida intraorally more often than those with lower glucose levels. [7] More to add, a study of 40 patients with lichen planus found that 11 patients had overt or latent diabetes, compared with none of the control group, the implication being that diabetes may be related to the pathogenesis of lichen planus. [8]

Dental professionals must be aware of the various methods of treating effectively the oral complications of DM. Many treatments are no different from those recommended for patients without diabetes. However, managing patients with diabetes does require more effective follow-up, more aggressive interventional therapy rather than observation, regular communication with physicians/endocrinologists, and greater attention to prevention.

 
  References Top

1.Pendyala G, Thomas B, Joshi SR. Evaluation of total antioxidant capacity of saliva in type 2 diabetic patients with and without periodontal disease: A case-control study. N Am J Med Sci 2013;5:51-7.  Back to cited text no. 1
    
2.Ewing GW, Parvez SH. The multi-systemic nature of diabetes mellitus: Genotype or phenotype? N Am J Med Sci 2010;2:444-56.  Back to cited text no. 2
    
3.Magon N, Chauhan M. Pregnancy in type 1 diabetes mellitus: How special are special issues? N Am J Med Sci 2012;4:250-6.  Back to cited text no. 3
    
4.Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047-53.  Back to cited text no. 4
    
5.Harrison GA, Schultz TA, Schaberg SJ. Deep neck infection complicated by diabetes mellitus. Report of a case. Oral Surg Oral Med Oral Pathol 1983;55:133-7.  Back to cited text no. 5
    
6.Van der Westhuijzen AJ, Grotepass FW, Wyma G, Padayachee A. A rapidly fatal palatal ulcer: Rhinocerebral mucormycosis. Oral Surg Oral Med Oral Pathol 1989;68:32-6.  Back to cited text no. 6
    
7.Darwazeh AM, MacFarlane TW, McCuish A, Lamey PJ. Mixed salivary glucose levels and candidal carriage in patients with diabetes mellitus. J Oral Pathol Med 1991;20:280-3.  Back to cited text no. 7
    
8.Lundström IM. Incidence of diabetes mellitus in patients with oral lichen planus. Int J Oral Surg 1983;12:147-52.  Back to cited text no. 8
    




 

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