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Other Oral Complications
Xerostomia, Candidiasis, Burning Mouth Syndrome, Oral Neuropathies and Enlargement of the Parotid Gland
Complaints of xerostomia are common among diabetics. A study (43) assessing salivary gland function in diabetics, individuals with IGT and a control group found no significant difference in salivary output. The study excluded individuals taking medication. It has been postulated that other diseases or medication use may influence diminished salivary flow. Individuals with poor glycemic control may also experience dry mouth, possibly due to hypovolemia. Xerostomia may predispose diabetic individuals to oral candidiasis. (38,35,43)
High glucose levels in saliva might be a risk factor for developing candidiasis. (44) However, the development of oral candidiasis is most likely multifactoral. Smoking and the continuous wearing of a denture will also promote a fungal infection in the diabetic patient. (38) Another oral symptom common among diabetics is burning mouth syndrome. Burning mouth syndrome may be best characterized as a burning pain, typically involving the tongue. A relationship between burning mouth syndrome and oral candidiasis has been suggested but is inconclusive. (44,45) Burning mouth syndrome and altered taste perception may occur in response to xerostomia or oral neuropathy. (35) Oral neuropathies are considered rare and symptoms can include tingling, numbness, and burning sensation and taste alteration. These conditions could be the presenting symptoms at a dental appointment in a diagnosed and/or undiagnosed diabetic. (38)
Parotid gland enlargement is a possible presenting symptom in an undiagnosed diabetic. The etiology for parotid gland enlargement is unknown and believed to affect 10-25% of patients with poor glycemic control. (36,38)
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Pathogenesis of Factors
