Severity of Dental Caries and Saliva Properties in Diabetes Mellitus
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Updated: Jan 7, 2026

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Published on: March 1, 2024
Ashwaq Alkahtani1, Aylin Baysan2
1Department of Dental Health, The College of Applied Medical Sciences (CAMS), King Saud University, Riyadh 11433, Saudi Arabia.
Background/Objective:
Diabetes mellitus type 2 (T2DM) is a significant global public health concern. This analytical cross-sectional study aimed to evaluate the impact of T2DM on the severity of dental caries and salivary properties.
Methods:
A total of 182 participants (n = 91 per group) were recruited into the T2DM and non-diabetes (ND) groups. Unstimulated whole saliva (UWS) and blood samples for HbA1c were collected. Clinical assessments included plaque index, SoproLIFE, ICDAS, and severity index for root caries.
Results:
A total of 92 male and 89 female participants were recruited in this study. The results showed that the mean of UWS pH was slightly lower in the T2DM (6.65 ± 1.12) than the ND group (6.88 ± 0.49), however the difference was statistically insignificant (p = 0.065). The mean saliva buffer capacity was almost identical between the two groups, with values of 7.38 ± 3.2 in T2DM and 7.37 ± 2.83 in the ND groups (p = 0.973), indicating an insignificant difference. The mean saliva spinnbarkeit was slightly high and insignificant in the T2DM (4.57 ± 4.34) compared to the ND group (3.69 ± 3.6) (p = 0.141). The T2DM group had a significantly high proportion of participants with very low saliva flow rate (<0.1 mL/min) in comparison to ND (20.9% vs. 5.5%) (p = 0.004). ICDAS scores were significantly higher in T2DM (0.67 ± 0.32) when compared to the ND group (0.57 ± 0.24) (p = 0.014). ICDAS scores 3 and 6 were significantly higher in T2DM (2.76 ± 2.66; 0.86 ± 2.61) in comparison to ND (2.10 ± 2.00, 0.26 ± 0.96).
Conclusions:
Within the limitations of this analytical cross-sectional study, participants with T2DM demonstrated a higher risk of developing severe carious lesions and exhibited low salivary pH and flow rate when compared with non-diabetic individuals, supporting a possible association between glycemic status, salivary alterations, and caries severity.
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