Moore P A, Guggenheimer J, Etzel K R, Weyant R J, Orchard T
School of Dental Medicine, Department of Dental Public Health, University of Pittsburgh, Pa 15261, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Sep;92(3):281-91. doi: 10.1067/moe.2001.117815.
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.
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.
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.
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.
匹兹堡大学口腔健康科学研究所完成了一项横断面流行病学研究，该研究对406名1型糖尿病患者和268名无糖尿病的对照受试者进行了评估，以探讨口腔健康与糖尿病之间的关联。本报告描述了口干症状（口腔干燥症）的患病率、该人群中唾液分泌减少的患病率，以及唾液功能障碍与糖尿病并发症之间可能存在的相互关系。
糖尿病患者是匹兹堡糖尿病并发症流行病学研究的参与者，他们被纳入了一项口腔健康子研究。对照受试者是参与者的配偶或最好的朋友，或者是通过当地报纸上的广告从社区招募的人员。唾液功能评估包括自我报告的口腔干燥症测量以及静息和刺激后全唾液流速的量化。
糖尿病患者比对照受试者更频繁地报告口干症状。糖尿病患者的唾液流速也受损。针对3项自我报告的口腔干燥症测量指标和4项唾液流速变量创建了潜在预测变量的回归模型。在所研究的糖尿病并发症（即视网膜病变、周围神经病变和自主神经病变、肾病和周围血管疾病）中，仅发现神经病变与口腔干燥症和唾液流速降低有关。口干症状的报告与当前吸烟、味觉障碍（味觉不良的报告）以及更频繁的吃零食行为有关。致口干药物和空腹血糖浓度升高与唾液流速降低显著相关。静息唾液流速低于0.01 mL/分钟与龋齿患病率略高有关。报告饮酒量较高的受试者刺激唾液流速较低的可能性较小。
已发生神经病变的1型糖尿病患者更常报告口干症状以及唾液流速降低的症状。由于唾液在维持口腔健康方面的重要性，糖尿病患者口腔疾病的管理应包括对唾液功能的全面评估。
