A Comparative Study on Oral Manifestations of Controlled and Uncontrolled Type 2 Diabetes Mellitus in South Indian Patients

Diabetes mellitus is a metabolic disease characterized by dysregulation of carbohydrate, lipid and protein metabolism. The primary feature of this disorder is elevation in blood glucose levels (hyperglycemia), resulting from either a defect in insulin secretion from the pancreas, a change in insulin action or both.1 It is a, ‘good disease with bad companions’. Untreated diabetes leads to significant complications of multiple organ systems, including the eyes, nerves, kidneys and blood vessels.2 These complications are responsible for high degree of morbidity and mortality when a disease with its resultant devastating effects become so widespread it becomes the duty of oral diagnostician to combine their knowledge for the following reasons: 1. To search for the increasing number of unknown or uncontrolled diabetics so as to give them the benefit of adequate medical care. 2. To provide adequate medical care to the known controlled diabetics. Whatever may be the type of diabetes, the oral tissues reacts and produce characteristic manifestations. Oral manifestations include advanced periodontal disease,3,4 high rate of dental caries, sialosis, xerostomia, abnormal taste, prolonged or recurrent fungal infections, burning mouth syndrome.5,6 All these manifestations not only destroy the oral and dental structures but also appear as pathognomonic to oral diagnostician in routine examination and screening program of oral cavity in detection of oral diseases.3,4 With such insight and background, the study was carried out with an aim to investigate oral manifestations of type 2 diabetes mellitus and identification of oral complications in controlled and uncontrolled diabetic patient groups in South Indian patients. The four-fold objectives that helped in comparing the various oral manifestations in patients with controlled diabetes to those newly diagnosed diabetics or uncontrolled diabetes were: (1) To study whether type 2 diabetes mellitus patients have abnormally advanced periodontitis, (2) to know the prevalence of any specific oral mucous membrane lesion in diabetes mellitus patients, in response to an injury to the oral mucosa, (3) to study the prevalence of opportunistic infections in the oral cavity of diabetes mellitus patients, (4) to know whether any oral reactionary changes are present in such patients.