ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Patients with Type I or Type II Diabetes Exhibit More Dry Mouth Symptoms and Xerostomia Compared to Non-Diabetics
Clinical Question In patients with Type I or Type II diabetes, is there an increased incidence of xerostomia, compared to non-diabetics?
Clinical Bottom Line There is a clear relationship between diabetes and the presence of xerostomia.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21969888Al-Maskari/2011Adults with diabetes mellitus.Narrative Review
Key resultsDiabetic patients reported low saliva flow symptoms and had Xerostomia when compared to non-diabetic controls, especially those with parotid gland dysfunction after developing diabetic neuropathy.
#2) 21883355Bustao/2011Adolescents with and without diabetes mellitus.Case Control
Key resultsIn this study, the prevalence of xerostomia was 53% (n=27) in adolescents with Diabetes Mellitus. Bivariate (P = 0.00) and logistic regression (P = 0.01) analysis showed a significant association between DM1 and xerostomia (n=102).
#3) 11552145Moore/2001406 subjects with Type 1 diabetes and 268 control subjects.Case Control
Key resultsSubjects with diabetes were found to have lower mean salivary flow rates (resting flow rates 0.22 +/- 0.014 mL/min compared to 0.28 +/- 0.016 mL/min for control subjects, P= .005) and higher prevalence of hyposalivation (stimulated salivary flow rates of 0.89 +/- 0.047 mL/min for diabetics compared to 1.02 +/-0.054 mL/min for control subjects, P= .071). The diabetic subjects reported a lower (<0.01 mL/min) resting salivary flow rate (11.8% vs. 2.7%) and lower stimulated salivary flow rates, or hyposalivation, (<0.10 mL/min) compared to control subjects (12.4% vs. 5.5%). The analysis of salivary dysfunction factors indicated a relationship between peripheral neuropathy due to diabetes and xerostomia and hyposalivation.
#4) 24086848Prathibha/201330 Diabetic subjects and 30 non-diabetic subjects 40-55 years of age.Case Control
Key resultsDiabetics had a pronounces decrease in flow rate (0.46 +/-0.02 mL/min) compared to the non-diabetics (0.67+/-0.07 mL/min), p<001.
Evidence Search ("diabetes mellitus"[MeSH Terms] OR ("diabetes"[All Fields] AND "mellitus"[All Fields]) OR "diabetes mellitus"[All Fields]) AND salivary[All Fields] AND ("physiopathology"[Subheading] OR "physiopathology"[All Fields] OR "dysfunction"[All Fields])
Comments on
The Evidence
Validity: All of these articles provided valid evidence with corroborating references. Perspective: The insight provided in these articles can elucidate the causes and measures needed to treat diabetic patients who may not only suffer from decreased salivary flow, but also other symptoms that can emanate from xerostomia, such as dysesthesia, periodontitis and increased risk for caries. In particular, the article by Moore/2001 addresses the possibility that xerostomia in diabetics may be due to correlative issues relating to consumption of prescription drugs as opposed to diabetes being a direct cause of dry mouth symptoms.
Applicability Because of the high prevalence of diabetes in the South Texas area, it is important to inform diabetic patients of oral complications such as xerostomia. Saliva stimulation counseling can be provided to diabetic patients who exhibit signs and symptoms of xerostomia, to help them manage the symptoms and prevent additional oral complications, such as caries, in the future.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry)
Keywords Xerostomia, Diabetes, Salivary flow, general practice
ID# 2668
Date of submission: 04/01/2014spacer
E-mail ruizf3@uthscsa.edu
Author Florestella Ruiz
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Juanita Lozano Pineda, DDS
Faculty mentor/Co-author e-mail pinedaj@uthscsa.edu
Basic Science Rationale
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