[Occurrence of oral subclinical infections in insulin treated diabetics]

The purpose of this study was to examine oral cavity condition, identify microorganisms and evaluate interrelation between protozoans, bacteria and fungi occurring in mouths of insuline treated diabetics. 30 men and women, 25-60 years old, were clinically assessed for their oral cavity condition including pH range. Fifteen of them were the insuline treated diabetics. Swabs taken of different sites of periodontium, dental plaques and dental pockets collected from each patients were used for detection and identification of protozoans, bacteria and fungi. Mucosal inflammation, dental caries, loose teeth, periodontitis were observed in the diabetic patients, whereas the oral cavities were generally in better condition in the control patients. Prevalence of the protozoan parasites Entamoeba gingivalis and Trichomonas tenax was higher in the control patients than in the diabetics (26.6% and 13.3%, respectively). Fecal bacteria Enterococcus fecalis, E. faecium, Klebsiella pneumoniae occurred with significantly higher frequency in the insuline treated patients (60%) than in the control (6.6%). Various Candida albicans strains were more often found in the diabetic (53.2%) than in the control patients (13.3%). The results of our studies show a clear interrelation between alteration of oral health and the occurrence of microorganisms in the insuline treated diabetics. Metabolic disease that causes serious multi-organ disturbances as well as insulinotherapy are the very important factors changing oral cavity ecology of the persons with diabetes mellitus; decresed pH (the average 5.5) may inhibit development of infection with protozoans in the oral cavity of these patients and favour subclinical infections with other microorganisms. Thus, in the insuline treated diabetics, examination of mouths with regard to the occurrence of opportunistic fecal bacteria and fungi, particularly before a therapy with antibiotics is strongly recommended.