Root caries and diabetes: risk assessing to improve oral and systemic health outcomes

Abstract

This report reviews the current understanding of the relationship between diabetes and root caries, and investigates the evidence for dental chairside testing of gingival crevicular blood (GCB) glucose levels to assess risk for type 2 diabetes mellitus. Diabetes is linked with the progression of periodontal disease and a greater number of exposed root surfaces at risk for root caries. The rapidly increasing prevalence of type 2 diabetes coupled with a general trend towards retention of teeth means that the number of patients with increased risk for root caries is expanding significantly. Many patients with diabetes or abnormal blood glucose levels are unaware of their condition or that they are at increased risk for oral disease. Systemic blood glucose concentrations are comparable to those found in GCB and therefore may be a useful adjunctive clinical aid in determining appropriate care for patients and providing timely referrals to general medical practitioners. Use of GCB testing within the dental clinic is described. It is proposed that future studies be undertaken to provide clinicians with improved risk assessment strategies and to evaluate GCB glucose screening models.

Dental caries,diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta‐analysis

“…However, it failed to prove these differences regarding type 2 diabetics. A higher risk of root caries is described for type 2 diabetics, which may be related to the increasing susceptibility to periodontal disease, but few studies aimed at evaluating this condition …”

Potential risk factors for dental caries in Type 2 diabetic patients

“…In 2015, 3.4 million people in Saudi Arabia were diagnosed with diabetes . Besides several complications of diabetes such as neuropathy, retinopathy and nephropathy, it is also linked with the progression of periodontal disease and a greater number of exposed root surfaces at risk for root caries . The rapidly increasing prevalence of type 2 diabetes (T2D) coupled with a general trend towards retention of teeth means that the number of patients at increased risk for dental caries is increasing significantly .…”

“…Besides several complications of diabetes such as neuropathy, retinopathy and nephropathy, it is also linked with the progression of periodontal disease and a greater number of exposed root surfaces at risk for root caries . The rapidly increasing prevalence of type 2 diabetes (T2D) coupled with a general trend towards retention of teeth means that the number of patients at increased risk for dental caries is increasing significantly . Findings of the third National Health and Nutrition Examination Survey (NHANES‐III) demonstrated that dental caries occurs with substantial frequency and represents a burden of unmet treatment needs in older adults …”

Association between History of Dental Amalgam Fillings and Risk of Parkinson’s Disease: A Population-Based Retrospective Cohort Study in Taiwan

“…As we know, impaired glucose regulation, hypertension, and dyslipidemia are main components of metabolic syndrome, which is a low-grade inflammatory condition associated with increased risk for diabetes and cardiovascular disease [30]. Studies have revealed that root caries is highly prevalent in patients with diabetes owing to periodontal attachment loss and gingival recession, compounded by reductions in salivary flow and elevated glucose level in their gingival crevicular fluid [31–35]. A study has also revealed that hyperglycemia and insulin resistance were in strong relation to dental caries [30].…”