Oral Manifestations of Diabetes Mellitus

Fania Triwidyanti1, Rahma Amelia2, Shiva Yolanda3, Lidya Wati Anggraini4, Andi Merry
Andani4
Fakultas Kedokteran Universitas Mulawarman
Samarinda, Kalimantan Timur, Indonesia
Email Correspondence: faniasubagio@gmail.com , shivayolanda3@gmail.com

Abstract
The purpose of this article is to increase knowledge about oral manifestations and complications associated with
diabetes mellitus. In this article we use descriptive method and case studies from several sources that we get.
Diabetes Mellitus is a chronic disease that affects the majority of patients worldwide. Diabetes mellitus is a
global health problem, within 20 years the number of diabetics has increased to 642 million people. Diabetes
mellitus has a huge impact on sufferers, especially in the oral cavity which has a higher prevalence. Clinical
manifestations related to diabetes mellitus include dental caries, periodontal disease, taste disturbances, burning
mouth, xerostomia. Oral complications in diabetics are considered as the biggest complications and can affect
the patient's quality of life. There is evidence that oral complications in these patients have a chronic negative
effect on glycemic control, so preventing and controlling oral complications is very important.

Keywords: Diabetes Mellitus; Oral Manifestasion

 INTRODUCTION

Deficiency of insulin secretion or resistance to insulin action or both. Chronic

hyperglycemia causes various complications in various parts of the body, for example in the
oral cavity, so blood glucose control is very important. Mechanisms that may be associated
with complications of oral diabetes include impaired neutrophil function, increased
collagenase activity, and decreased collagen synthesis, microangiopathy, and neuropathy.
Oral manifestations and related complications of Diabetes mellitus include dry mouth
(xerostomia), dental caries, periodontal disease, taste disturbances, burning mouth. The
intensity of diabetic complications is usually proportional to the degree and duration of
hyperglycemia. In this study, we briefly review DM and its oral manifestations and
complications in a recent scientific paper that is credible and easy to understand.

LITERATURE
From the several sources and data we got, we found several oral manifestations in the oral
cavity related to diabetes mellitus. This article was made using a descriptive method and
several case studies that we found from data and sources that we read and studied. From
some source and data that we studied, clinical manifestations related to diabetes mellitus
include dental caries, periodontal disease, taste disturbances, burning mouth, xerostomia.

FINDING AND DISCUSSION

XEROSTOMIA

Xerostomia is caused by reduced salivary secretion which can cause discomfort in the oral
cavity, pain, increased levels of dental caries and oral infections, and difficulty speaking and
swallowing food. Complaints that arise can affect the health of the teeth and oral cavity
which later is estimated to affect the level of quality of life.

DENTAL CARIES
Diabetics tend to experience new and repeated tooth decay. Reduced cleansing and buffering
capacity of saliva can lead to an increase in carbohydrates in saliva and an increase in mutant
streptococci and lactobacilli, leading to increased tooth decay.

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Oral Manifestasions of Diabetes Mellitus

Fania Triwidyanti, Rahma Amelia, Shiva Yolanda, Lidya Wati, Andi Merry A

PERIODONTAL DISEASE
Periodontal disease is a risk factor for people with diabetes mellitus. Some people at a young
age develop periodontal disease, but in adults with diabetes periodontal disease is more
common. In diabetics and non-diabetics subgingival plaque with composition of Prevotella
intermedia and Porphyromonas gingivalis is higher in diabetic periodontal patients. increased
glucose content and decreased cAMP in the sulcular fluid may contribute. In type diabetes 1
with gingivitis or periodontitis, there is an increase in the levels of Prostaglandin E2 (PGE2)
and interleukin 1 beta (IL -1 beta). Type 2 diabetes patients with HbA1c >8% have higher
IL1B levels compared to patients with HbA1c <8%. Changes in neutrophil response as
indicated by Decreased chemotaxis, phagocytosis, and microbial function are hallmarks of
diabetes mellitus.

TASTE DISTURBANCES

Taste disturbances could be a significant pointer to diabetes in at risk patients. Taste

disturbances like ageusia (taste loss), hypogeusia (decrease in taste) and dysgeusia (abnormal
taste) have been associated with DM. Disturbance of taste is mostly transient and does not
often appear in daily practice. Also patients do not associate taste disturbance with chronic
diseases like diabetes or hypertension. A taste disturbance helped us to diagnose a case of
DM before the complications could set in. It is very essential that we specifically ask patients
for history of altered taste whenever other risk factors for diabetes are present. Also it is
important to give attention to complaints related to taste by any vigilant patient.

BURNING MOUTH

Burning oral syndrome (burning mouth) can cause the mouth of a person with diabetes to
develop a major symptom of moderate levels of burning sensation. Burning mouth syndrome
may also cause symptoms of dry mouth (xerostomia) and the appearance of a metallic
sensation in the tongue. This condition can cause the extremities of the mouth and the tongue
to tingle or become numb. Most of these burning sensations can occur in the morning and can
both rise and subside at night but can also result in constant pain.

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 CONCLUSION AND PROPOSED SOLUTION

Diabetes mellitus is a group of metabolic diseases associated with abnormalities in

glucose, lipid, and protein metabolism caused by inadequate insulin secretion and/or
decreased insulin sensitivity. Diabetes mellitus has various complications, especially in the
oral cavity include dry mouth (xerostomia), dental caries, periodontal disease, taste
disturbances, and burning mouth. Patients with diabetes mellitus typically experience taste
changes prior to problems. Additionally, patients with diabetes mellitus may experience oral
manifestations like xerostomia, which causes patients to become dehydrated, burning mouth
syndrome, which can also cause symptoms like xerostomia and the development of a metallic
taste on the tongue, decreased salivary cleansing and buffering capacity which can lead to
tooth decay from the development of bacteria, and burning mouth syndrome, which can be
the primary symptom in diabetics. Management of patients with diabetes mellitus requires
cooperation between patients and doctors in order to reduce symptoms in the oral cavity so as
to improve the patient's quality of life and self-awareness of a healthy lifestyle is needed.

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Oral Manifestasions of Diabetes Mellitus

Fania Triwidyanti, Rahma Amelia, Shiva Yolanda, Lidya Wati, Andi Merry A

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