Background: Maintaining good oral health and metabolic control is crucial for living a long and fulfilling life. Many developing and disadvantaged nations are experiencing a rise in oral disorders. As a developing country, Bangladesh faces significant challenges in meeting the oral health care needs of its population, as well as other health sector demands. Preventive measures are always a better approach to avoiding oral diseases. Good metabolic control and proper oral hygiene practices can help prevent oral diseases and unhealthy oral conditions. Method: A cross-sectional observational study was conducted between December 2022 and May 2023 using convenience sampling, involving 44 patients with diabetes mellitus. The study consisted of two phases: 1) a questionnaire survey and 2) an intraoral clinical examination. Descriptive statistics were used to analyze the data. Data screening and entry were performed using SPSS version 25.00, with all analyses conducted through the SPSS software. Results: A total of 44 participants made up the analyzable sample, with 51% male and 49% female. The largest proportions were in the 18 - 36 years and 51 - 70 years age groups. A substantial 77.3% of individuals reported a family history of diabetes mellitus, while 15.9% did not. The dataset includes information from these participants, revealing diverse demographics and health-related variables. It highlights a significant proportion of individuals with strong oral health awareness, regular blood sugar monitoring, and concerns about oral complications related to diabetes. However, there is room for improvement in diabetes management, as a notable percentage exhibited poor metabolic control in the oral health evaluation. Conclusions: A population-based cross-sectional study exploring the association between glycemic control in diabetes mellitus and severe oral lesions and periodontal diseases in adults aged 25 and older found that individuals with poorly controlled diabetes mellitus have a significantly higher prevalence of severe oral lesions and periodontitis than those without diabetes, after controlling for age, education, smoking status, and calculus.
References
[1]
Abiko, Y., & Selimovic, D. (2010). The Mechanism of Protracted Wound Healing on Oral Mucosa in Diabetes. Review. Bosnian Journal of Basic Medical Sciences, 10, 186-191. https://doi.org/10.17305/bjbms.2010.2683
[2]
Abikshyeet, P., Ramesh, V., & Oza, N. (2012). Glucose Estimation in the Salivary Secretion of Diabetes Mellitus Patients. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 5, 149-154. https://doi.org/10.2147/dmso.s32112
[3]
Ahmad, R., & Haque, M. (2021). Oral Health Messiers: Diabetes Mellitus Relevance. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 3001-3015. https://doi.org/10.2147/dmso.s318972
[4]
Akpan, A., & Morgan, R. (2002). Oral candidiasis. Postgraduate Medical Journal, 78, 455-459. https://doi.org/10.1136/pmj.78.922.455
[5]
Al Amassi, B. Y., & Al Dakheel, R. S. (2020). Oral Hygiene Practice of Adult Diabetic Pa-tients and Their Awareness about Oral Health Problems Related to Diabetes. Journal of Dentistry and Oral Hygiene, 9, 8-14. https://academicjournals.org/journal/JDOH/article-full-text/690084763721
[6]
Al Mubarak, S., Robert, A. A., Baskaradoss, J. K., Al-Zoman, K., Al Sohail, A., Alsuwyed, A. et al. (2013). The Prevalence of Oral Candida Infections in Periodontitis Patients with Type 2 Diabetes Mellitus. Journal of Infection and Public Health, 6, 296-301. https://doi.org/10.1016/j.jiph.2012.12.007
[7]
Al-Maskari, A. Y., Al-Maskari, M. Y., & Al-Sudairy, S. (2011). Oral Manifestations and Complications of Diabetes Mellitus: A Review. Sultan Qaboos University Medical Journal, 11, 179-186. https://pubmed.ncbi.nlm.nih.gov/21969888/
[8]
American Diabetes Association (ADA) (2013). Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 37, S81-S90. https://doi.org/10.2337/dc14-s081
[9]
Atefi, N., Majedi, M., Peyghambari, S., & Ghourchian, S. (2012). Prevalence of Diabetes Mellitus and Impaired Fasting Blood Glucose in Patients with Lichen Planus. Medical Journal of the Islamic Republic of Iran, 26, 22-26. https://pubmed.ncbi.nlm.nih.gov/23482842/
[10]
Berlin, I. (2008). Smoking-Induced Metabolic Disorders: A Review. Diabetes & Metabolism, 34, 307-314. https://doi.org/10.1016/j.diabet.2008.01.008
Bihari, M., Srivastava, R., Jyoti, B., Mehrotra, V., Gupta, M., & Pradhan, S. (2014). Median Rhomboid Glossitis with Palatal ‘Kissing Lesion’—A Case Report. Bangladesh Journal of Dental Research & Education, 4, 94-97. https://doi.org/10.3329/bjdre.v4i2.20273
[13]
Buranasin, P., Mizutani, K., Iwasaki, K., Pawaputanon Na Mahasarakham, C., Kido, D., Takeda, K. et al. (2018). High Glucose-Induced Oxidative Stress Impairs Proliferation and Migration of Human Gingival Fibroblasts. PLOS ONE, 13, e0201855. https://doi.org/10.1371/journal.pone.0201855
[14]
Calsina, G., Ramon, J. M., & Echeverría, J. J. (2002). Effects of Smoking on Periodontal Tissues. Journal of Clinical Periodontology, 29, 771-776. https://doi.org/10.1034/j.1600-051x.2002.290815.x
[15]
Chestnutt, I. G. (2010). Tobacco Usage: The Role of the Dental Team in Smoking Cessation. Dental Update, 37, 55-62. https://doi.org/10.12968/denu.2010.37.1.55
[16]
Cicmil, A., Govedarica, O., Lečić, J., Mališ, S., Cicmil, S., & Čakić, S. (2017). Oral Symptoms and Mucosal Lesions in Patients with Diabetes Mellitus Type 2. Balkan Journal of Dental Medicine, 21, 50-54. https://doi.org/10.1515/bjdm-2017-0007
[17]
Cicmil, S., Mladenović, I., Krunić, J., Ivanović, D., & Stojanović, N. (2018). Oral Alterations in Diabetes Mellitus. Balkan Journal of Dental Medicine, 22, 7-14. https://doi.org/10.2478/bjdm-2018-0002
[18]
Cleveland Clinic (2020). Oral Health Problems and Diabetes. https://my.clevelandclinic.org/health/diseases/11263-oral-health-problems-and-diabetes
[19]
Colak, H. (2013). Halitosis: From diagnosis to management. Journal of Natural Science, Biology and Medicine, 4, 14-23. https://doi.org/10.4103/0976-9668.107255
[20]
Costa, Y. M., Karlsson, P., Bonjardim, L. R., Conti, P. C. R., Tankisi, H., Jensen, T. S. et al. (2019). Trigeminal Nociceptive Function and Oral Somatosensory Functional and Structural Assessment in Patients with Diabetic Peripheral Neuropathy. Scientific Reports, 9, Article No. 169. https://doi.org/10.1038/s41598-018-37041-4
[21]
D'Aiuto, F., Gable, D., Syed, Z., Allen, Y., Wanyonyi, K. L., White, S. et al. (2017). Evidence Summary: The Relationship between Oral Diseases and Diabetes. British Dental Journal, 222, 944-948. https://doi.org/10.1038/sj.bdj.2017.544
[22]
Darr, L., Vergnes, J. N., Gourdy, P., & Sixou, M. (2008). Efficacy of Periodontal Treatment on Glycaemic Control in Diabetic Patients: A Meta-Analysis of Interventional Studies. Diabetes & Metabolism, 34, 497-506. https://doi.org/10.1016/j.diabet.2008.03.006
[23]
De Silva, N. T., Preshaw, P. M., Taylor, J. J., Jayaratne, S. D., Heasman, P. A., & Fernando, D. J. S. (2006). Periodontitis: A Complication of Type 2 Diabetes in Sri Lankans. Diabetes Research and Clinical Practice, 74, 209-210. https://doi.org/10.1016/j.diabres.2006.06.001
[24]
Dietrich, T., Maserejian, N. N., Joshipura, K. J., Krall, E. A., & Garcia, R. I. (2007). Tobacco Use and Incidence of Tooth Loss among US Male Health Professionals. Journal of Dental Research, 86, 373-377. https://doi.org/10.1177/154405910708600414
[25]
Dotiwala, A. K., & Samra, N. S. (2021). Anatomy, Head and Neck, Tongue. Stat Pearls. https://www.ncbi.nlm.nih.gov/books/NBK507782/
[26]
Erriu, M., Pili, F. M. G., Cadoni, S., & Garau, V. (2016). Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review. The Open Dentistry Journal, 10, 619-635. https://doi.org/10.2174/1874210601610010619
[27]
Fowler, M. J. (2008). Microvascular and Macrovascular Complications of Diabetes. Clinical Diabetes, 26, 77-82. https://doi.org/10.2337/diaclin.26.2.77
[28]
Gupta, S., & Jawanda, M. (2015). Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management. Indian Journal of Dermatology, 60, 222-229. https://doi.org/10.4103/0019-5154.156315
[29]
Hariharavel, V. P., Rao, A. P. V., Venugopal, R. N., & Peter, J. (2017). Diabetes, diet and dental caries. International Journal of Diabetes in Developing Countries, 37, 94-94. https://doi.org/10.1007/s13410-015-0400-6
[30]
Hill, L. V., Tan, M. H., Pereira, L. H., & Embil, J. A. (1989). Association of Oral Candidiasis with Diabetic Control. Journal of Clinical Pathology, 42, 502-505. https://doi.org/10.1136/jcp.42.5.502
[31]
Hsu, P., Wu, H., Huang, Y., Chang, H., Lee, T., Chen, Y. et al. (2019). The Tongue Features Associated with Type 2 Diabetes Mellitus. Medicine, 98, e15567. https://doi.org/10.1097/md.0000000000015567
[32]
Huang, T., Tseng, F., Liu, T., Hsu, C., & Chen, Y. (2005). Deep Neck Infection in Diabetic Patients: Comparison of Clinical Picture and Outcomes with Nondiabetic Patients. Otolaryngology—Head and Neck Surgery, 132, 943-947. https://doi.org/10.1016/j.otohns.2005.01.035
[33]
Iqbal, M. A., Yesmin, S., Maaisha, F., Ibrahim, S., & Gotame, P. (2020). Oral Lichen Planus and Its Recent Management: A Review. Update Dental College Journal, 10, 29-34. https://doi.org/10.3329/updcj.v10i2.50179
[34]
Irwin, C., Mullally, B., Ziada, H., Allen, E., & Byrne, P. J. (2007). Periodontics: 2. Risk Factors and Susceptibility in Periodontitis. Dental Update, 34, 270-276. https://doi.org/10.12968/denu.2007.34.5.270
[35]
Jeong, I. H., & Park, M. J. (2017). The Association between Diabetes Mellitus and Community Periodontal Index. International Journal of Applied Engineering Research, 12, 2277-2281. https://www.ripublication.com/ijaer17/ijaerv12n10_21.pdf
[36]
Kamala, K., Sankethguddad, S., Sujith, S., & Tantradi, P. (2016). Burning Mouth Syndrome. Indian Journal of Palliative Care, 22, 74-79. https://doi.org/10.4103/0973-1075.173942
[37]
Katz, P. P., Wirthlin, M. R., Szpunar, S. M., Selby, J. V., Sepe, S. J., & Showstack, J. A. (1991). Epidemiology and Prevention of Periodontal Disease in Individuals with Diabetes. Diabetes Care, 14, 375-385. https://doi.org/10.2337/diacare.14.5.375
[38]
Khan, T. (2018). Oral Manifestations and Complications of Diabetes Mellitus: A Review. International Journal of Medical Health Research, 4, 50-52. https://www.medicalsciencejournal.com/assets/archives/2018/vol4issue2/4-2-26-589.pdf
[39]
Khandelwal, V., Nayak, P. A., Nayak, U. A., & Gupta, A. (2013). Oral Lichen Planus in a Young Indian Child. BMJ Case Reports, 2013, bcr2013010516.
[40]
Khosravi, A. R., Yarahmadi, S., Baiat, M., Shokri, H., & Pourkabireh, M. (2008). Factors Affecting the Prevalence of Yeasts in the Oral Cavity of Patients with Diabetes Mellitus. Journal de MycologieMédicale, 18, 83-88. https://doi.org/10.1016/j.mycmed.2008.04.002
[41]
Kibayashi, M., Tanaka, M., Nishida, N., Kuboniwa, M., Kataoka, K., Nagata, H. et al. (2007). Longitudinal Study of the Association between Smoking as a Periodontitis Risk and Salivary Biomarkers Related to Periodontitis. Journal of Periodontology, 78, 859-867. https://doi.org/10.1902/jop.2007.060292
[42]
Kuo, L., Polson, A. M., & Kang, T. (2008). Associations between Periodontal Diseases and Systemic Diseases: A Review of the Inter-Relationships and Interactions with Diabetes, Respiratory Diseases, Cardiovascular Diseases and Osteoporosis. Public Health, 122, 417-433. https://doi.org/10.1016/j.puhe.2007.07.004
[43]
Lalla, R. V., & D’Ambrosio, J. A. (2001). Dental Management Considerations for the Patient with Diabetes Mellitus. The Journal of the American Dental Association, 132, 1425-1432. https://doi.org/10.14219/jada.archive.2001.0059
[44]
Lamey, P. J., Darwaza, A., Fisher, B. M., Samaranayake, L. P., Macfarlane, T. W., & Frier, B. M. (1988). Secretor Status, Candidal Carriage and Candidal Infection in Patients with Diabetes Mellitus. Journal of Oral Pathology & Medicine, 17, 354-357. https://doi.org/10.1111/j.1600-0714.1988.tb01549.x
[45]
Lamster, I. B., Lalla, E., Borgnakke, W. S., & Taylor, G. W. (2008). The Relationship between Oral Health and Diabetes Mellitus. The Journal of the American Dental Association, 139, 19S-24S. https://doi.org/10.14219/jada.archive.2008.0363
[46]
Lang, N. P., & Bartold, P. M. (2018). Periodontal Health. Journal of Periodontology, 89, S9-S16. https://doi.org/10.1002/jper.16-0517
[47]
Latti, R., Kalburge, J., Birajdar, B., & Latti, G. (2018). Evaluation of Relationship between Dental Caries, Diabetes Mellitus and Oral Microbiota in Diabetics. Journal of Oral and Maxillofacial Pathology, 22, 282. https://doi.org/10.4103/jomfp.jomfp_163_16
[48]
Lima, D. L. F., Carneiro, S. D. R. M., Barbosa, F. T. D. S., Saintrain, M. V. D. L., Moizan, J. A. H., & Doucet, J. (2017). Salivary Flow and Xerostomia in Older Patients with Type 2 Diabetes Mellitus. PLOS ONE, 12, e0180891. https://doi.org/10.1371/journal.pone.0180891
[49]
Lin, C., Sun, S., Kao, A., & Lee, C. (2002). Impaired Salivary Function in Patients with Noninsulin-Dependent Diabetes Mellitus with Xerostomia. Journal of Diabetes and Its Complications, 16, 176-179. https://doi.org/10.1016/s1056-8727(01)00174-x
[50]
López-López, J., Jané-Salas, E., Estrugo-Devesa, A., Velasco-Ortega, E., Martín-González, J., & Segura-Egea, J. J. (2011). Periapical and Endodontic Status of Type 2 Diabetic Patients in Catalonia, Spain: A Cross-Sectional Study. Journal of Endodontics, 37, 598-601. https://doi.org/10.1016/j.joen.2011.01.002
[51]
McIntyre, G. T. (2001). Oral Candidosis. Dental Update, 28, 132-139. https://doi.org/10.12968/denu.2001.28.3.132
[52]
Moin, M., & Malik, A. (2015). Frequency of Dental Caries and Level of Risk among Type II Diabetics. Dentistry, 5, Article ID: 1000334. https://doi.org/10.4172/2161-1122.1000334
[53]
Moore, P. A., Orchard, T., Guggenheimer, J., & Weyant, R. J. (2000). Diabetes and Oral Health Promotion: A Survey of Disease Prevention Behaviors. The Journal of the American Dental Association, 131, 1333-1341. https://doi.org/10.14219/jada.archive.2000.0388
[54]
Moore, P. A., Weyant, R. J., Mongelluzzo, M. B., Myers, D. E., Rossie, K., Guggenheimer, J. et al. (1999). Type 1 Diabetes Mellitus and Oral Health: Assessment of Periodontal Disease. Journal of Periodontology, 70, 409-417. https://doi.org/10.1902/jop.1999.70.4.409
[55]
Nada, A., Abdel Moneim, W., Fakhr, M., & El Sawy, S. (2020). Prevalence of Burning Mouth Syndrome in a Sample of Egyptian Patients with Diabetic Neuropathy: A Cross Sectional Hospital-Based Study. Advanced Dental Journal, 2, 34-42. https://doi.org/10.21608/adjc.2020.23213.1050
[56]
Nazir, M. A., AlGhamdi, L., AlKadi, M., AlBeajan, N., AlRashoudi, L., & AlHussan, M. (2018). The Burden of Diabetes, Its Oral Complications and Their Prevention and Management. Open Access Macedonian Journal of Medical Sciences, 6, 1545-1553. https://doi.org/10.3889/oamjms.2018.294
[57]
Pihlstrom, B. L., Michalowicz, B. S., & Johnson, N. W. (2005). Periodontal Diseases. The Lancet, 366, 1809-1820. https://doi.org/10.1016/s0140-6736(05)67728-8
[58]
Poudel, P., Griffiths, R., Wong, V. W., Arora, A., Flack, J. R., Khoo, C. L. et al. (2018). Perceptions and Practices of Diabetes Educators in Providing Oral Health Care: A Qualitative Study. The Diabetes Educator, 44, 454-464. https://doi.org/10.1177/0145721718796055
[59]
Poul, E. P. (2005). Priorities for Research for Oral Health in the 21st Century—The Approach of the WHO Global Oral Health Programme. Community Dental Health, 22, 71-74. https://pubmed.ncbi.nlm.nih.gov/15984131/
[60]
Preshaw, P. M. (2009). Periodontal Disease and Diabetes. Journal of Dentistry, 37, S575-S577. https://doi.org/10.1016/j.jdent.2009.05.019
[61]
Rao, D. D., Desai, A., Kulkarni, R. D., Gopalkrishnan, K., & Rao, C. B. (2010). Comparison of Maxillofacial Space Infection in Diabetic and Nondiabetic Patients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 110, e7-e12. https://doi.org/10.1016/j.tripleo.2010.04.016
[62]
Rathee, M., & Sapra, A. (2021). Dental Caries. Stat Pearls. https://www.ncbi.nlm.nih.gov/books/NBK551699/
[63]
Ritchie, C. S. (2009). Mechanistic Links between Type 2 Diabetes and Periodontitis. Journal of Dentistry, 37, S578-S579. https://doi.org/10.1016/j.jdent.2009.05.015
[64]
Rohani, B. (2019). Oral Manifestations in Patients with Diabetes Mellitus. World Journal of Diabetes, 10, 485-489. https://doi.org/10.4239/wjd.v10.i9.485
[65]
Samaranayake, L. P. (1990). Host Factors and Oral Candidiasis. In L. P. Samaranayake & T. W. MacFarlane (Eds.), Oral Candidosis (2nd ed., pp. 145-147). Butterworth & Co. Ltd. https://core.ac.uk/download/pdf/37889818.pdf
[66]
Sampaio, N., Mello, S., & Alves, C. (2011). Dental Caries-Associated Risk Factors and Type 1 Diabetes Mellitus. Pediatric Endocrinology, Diabetes, and Metabolism, 17, 152-157. https://pubmed.ncbi.nlm.nih.gov/22027069/
[67]
Seetha Lakshmi, C., Reddy, R. C., Asifa, N., & Prabhu, S. (2016). Correlation of Salivary Ph, Incidence of Dental Caries and Periodontal Status in Diabetes Mellitus Patients: A Cross-Sectional Study. Journal of Clinical and Diagnostic Research, 10, ZC12-ZC14. https://doi.org/10.7860/jcdr/2016/16310.7351
[68]
Ship, J. A. (2003). Diabetes and Oral Health. The Journal of the American Dental Association, 134, 4S-10S. https://doi.org/10.14219/jada.archive.2003.0367
[69]
Soysa, N. S., Samaranayake, L. P., & Ellepola, A. N. B. (2006). Diabetes Mellitus as a Contributory Factor in Oral Candidosis. Diabetic Medicine, 23, 455-459. https://doi.org/10.1111/j.1464-5491.2005.01701.x
[70]
Sudarshan, R., Sree Vijayabala, G., Samata, Y., & Ravikiran, A. (2015). Newer Classification System for Fissured Tongue: An Epidemiological Approach. Journal of Tropical Medicine, 2015, Article ID: 262079. https://doi.org/10.1155/2015/262079
[71]
Teeuw, W. J., Gerdes, V. E. A., & Loos, B. G. (2008). Effect of Periodontal Treatment on Glycemic Control of Diabetic Patients. Diabetes Care, 33, 421-427. https://doi.org/10.2337/dc09-1378
[72]
Tsai, C., Hayes, C., & Taylor, G. W. (2002). Glycemic Control of Type 2 Diabetes and Severe Periodontal Disease in the US Adult Population. Community Dentistry and Oral Epidemiology, 30, 182-192. https://doi.org/10.1034/j.1600-0528.2002.300304.x
[73]
Tsujimoto, T., Imai, K., Kanda, S., Kakei, M., Kajio, H., & Sugiyama, T. (2016). Sweet Taste Disorder and Vascular Complications in Patients with Abnormal Glucose Tolerance. International Journal of Cardiology, 221, 637-641. https://doi.org/10.1016/j.ijcard.2016.07.062
[74]
Uma Maheswari, T., & Chaudhary, M. (2020). Management of Oral Lichen Planus Based on the Existing Clinical Practice Guidelines. Journal of Indian Academy of Oral Medicine and Radiology, 32, 284-292. https://doi.org/10.4103/jiaomr.jiaomr_55_20
[75]
Utkarsh, L., & Srinath, N. (2007). Diabetic Challenge in Maxillofacial Infection. International Journal of Oral and Maxillofacial Surgery, 36, 1040. https://doi.org/10.1016/j.ijom.2007.08.287
[76]
Vernillo, A. T. (2003). Dental Considerations for the Treatment of Patients with Diabetes Mellitus. The Journal of the American Dental Association, 134, 24S-33S. https://doi.org/10.14219/jada.archive.2003.0366
[77]
Villa, A., Connell, C., & Abati, S. (2014). Diagnosis and Management of Xerostomia and Hyposalivation. Therapeutics and Clinical Risk Management, 11, 45-51. https://doi.org/10.2147/tcrm.s76282
[78]
Willis, A. M., Coulter, W. A., Fulton, C. R., Hayes, J. R., Bell, P. M., & Lamey, P. J. (1999). Oral Candidal Carriage and Infection in Insulin-Treated Diabetic Patients. Diabetic Medicine, 16, 675-679. https://doi.org/10.1046/j.1464-5491.1999.00134.x
[79]
World Health Organization (WHO) (2014). Global Status Report on Noncommunicable Diseases 2014: Attaining the Nine Global Noncommunicable Diseases Targets; A Shared Responsibility. https://www.who.int/publications/i/item/9789241564854
[80]
World Health Organization (WHO) (2016a). Global Health Estimates 2015: Deaths by Cause, Age, Sex by Country and by Region 2000-2015. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death
