Abstract
Objective: The Oral Health Science Institute at the University of Pittsburgh has completed a
cross-sectional epidemiologic study of 406 subjects with type 1 diabetes and 268 control
subjects without diabetes that assessed the associations between oral health and diabetes.
This report describes the prevalence of dry-mouth symptoms (xerostomia), the prevalence
of hyposalivation in this population, and the possible interrelationships between
salivary dysfunction and diabetic complications. Study Design: The subjects with diabetes were participants in the Pittsburgh Epidemiology of Diabetes
Complications study who were enrolled in an oral health substudy. Control subjects
were spouses or best friends of participants or persons recruited from the community
through advertisements in local newspapers. Assessments of salivary function included
self-reported xerostomia measures and quantification of resting and stimulated whole
saliva flow rates. Results: Subjects with diabetes reported symptoms of dry mouth more frequently than did control
subjects. Salivary flow rates were also impaired in the subjects with diabetes. Regression
models of potential predictor variables were created for the 3 self-reported xerostomia
measures and 4 salivary flow rate variables. Of the medical diabetic complications
studied (ie, retinopathy, peripheral and autonomic neuropathy, nephropathy, and peripheral
vascular disease), only neuropathy was found to be associated with xerostomia and
decreased salivary flow measures. A report of dry-mouth symptoms was associated with
current use of cigarettes, dysgeusia (report of a bad taste), and more frequent snacking
behavior. Xerogenic medications and elevated fasting blood glucose concentrations
were significantly associated with decreased salivary flow. Resting salivary flow
rates less than 0.01 mL/min were associated with a slightly higher prevalence of dental
caries. Subjects who reported higher levels of alcohol consumption were less likely
to have lower rates of stimulated salivary flow. Conclusions: Subjects with type 1 diabetes who had developed neuropathy more often reported symptoms
of dry mouth as well as symptoms of decreased salivary flow rates. Because of the
importance of saliva in the maintenance and the preservation of oral health, management
of oral diseases in diabetic patients should include a comprehensive evaluation of
salivary function. (ORAL Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:281-91)
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Article info
Publication history
Accepted:
May 31,
2001
Received in revised form:
May 3,
2001
Received:
March 23,
2001
Footnotes
*Supported by the National Institute for Health grants NIH-NIDR-1-91-R4 (P. A. Moore, PI) and R01-DK34818 (T. Orchard, PI).
**Reprint requests: Paul A. Moore, DMD, PhD, MPH, University of Pittsburgh, School of Dental Medicine, 380 Salk Hall, Department of Dental Public Health, Pittsburgh, PA 15261, [email protected]
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
