Title: Oral Manifestations in Type 2 Diabetes Mellitus and Its Association with Diabetic Complications

Authors: Dr Noorul Ameen, Dr Udayashankar, Dr Baghya Madhivanan, Prof. Rajasekaran

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i10.26

Abstract

Background:  Diabetes Mellitus is a metabolic disorder characterised by hyperglycemia due to reduced insulin secretion or insulin sensitivity. The incidence of this disease is increasing worldwide. The onus is on early diagnosis and early identification of diabetic complications. Oral cavity examination may provide clues to the presence of these complications.

Aim: To find out the prevalence of oral manifestations in diabetes mellitus patients and to analyze the relationship between the oral manifestations and complications of diabetes mellitus.

Study design: Prospective study from April 2014 to December 2014

Material and Methods: All diabetic patients attending the medicine OP during the study period were included after obtaining their consent. These patients were subjected to complete dental examination and evaluated for end organ damage. i.e. diabetic nephropathy, retinopathy and ischemic heart disease.

Results: During the study period, a total of 101 diabetic patients were examined for oral manifestations such as periodontitis, dental caries, glossitis and oral submucosal fibrosis. Oral manifestations were present in more than 90% of all the diabetic patients. The prevalence of periodontitis was 55.4%, dental caries - 46.5%, Xerostomia - 5.9%, Glossitis - 9.9%, Oral submucosal fibrosis - 4%. Of the 101 patients, 55 of them were screened for ischemic heart disease and 19 of them had coronary artery disease (p value -0. 001). In addition  89 patients were evaluated for  renal complications and 58 patients had diabetic nephropathy (p value- 0.001).Further 39 patients were evaluated for diabetic retinopathy out of which 14 had fundal changes suggestive of retinopathy ( p value – 0.001). Also all the three complications were associated more with periodontitis.

Conclusion: The complications of diabetes are life threatening if not detected early. Oral examination in a diabetic patient can be a diagnostic clue to these complications. Especially, presence of periodontitis can suggest the presence of complications like nephropathy, retinopathy and ischemic heart disease in diabetic patients.

Keywords: Diabetes Mellitus, periodontitis, diabetic retinopathy , diabetic nephropathy.

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