The increased morbidity and mortality associated with diabetes are well known to health care providers. Retinopathy, nephropathy, macrovascular disease, neuropathy, and poor wound healing can have a major impact on the lives of patients with diabetes. These complications take an enormous personal and financial toll.
The increased morbidity and mortality associated with diabetes are well known to health care providers. Retinopathy, nephropathy, macrovascular disease, neuropathy, and poor wound healing can have a major impact on the lives of patients with diabetes. These complications take an enormous personal and financial toll.
In addition to these recognized complications, the oral cavity and contiguous structures can be dramatically affected by diabetes. These oral complications are not widely recognized by non-dental health care providers, but can have important effects on quality of life of patients with diabetes, and can also directly and indirectly effect glycemic control.
There are a wide range of oral manifestations that have been reported in patients with diabetes. These include increased extent and severity of periodontal disease, changes in the prevalence of dental caries, burning mouth syndrome, Candida infection, xerostomia, altered taste sensation, altered tooth eruption, and hypertrophy of the parotid glands. Non-dental health care providers and patients need to be aware of the changes in the oral cavity associated with diabetes, emphasize the importance of an oral/dental evaluation when the diagnosis of diabetes is first made, and make appropriate referral if the patient reports a problem. Dental professionals must be familiar with the range of oral disorders observed in patients with diabetes, and how these problems should be managed in patients with the disease. This review will focus on the two most common oral diseases (periodontal disease and caries), how these disorders are modified in patients with diabetes, and how they can affect patient management.
Periodontal Disease
The most common oral complication of diabetes is periodontal disease. The periodontal diseases are a group of inflammatory disorders of the supporting tissues of the teeth, which includes the gingiva (mucosal tissue about the teeth), cementum (covering the roots of the teeth), the periodontal ligament, and the alveolar bone into which the teeth are anchored. The pathology of periodontal disease is an inflammatory lesion induced by the dental plaque biofilm found at the opening of and within the gingival crevice. Beginning as an inflammation of the gingiva, the inflammatory lesion can extend to involve the alveolar bone.
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