Downstream effects from diabetes mellitus affected on various tooth tissues: A mini review

Abstract

• Hyperglycemia from diabetes mellitus induce downstream effects of ROS activity and xerostomia in oral cavity • Ion transport of calcium during enamel and dentin mineralization is affected by hyperglycemia. • Diabetes alters immune function and upregulate production of NF-kB to induce pro-inflammatory responses in periodontal pockets • Cytokines TNF and NF-kB induce inflammation in dental pulp and necrosis of cells follows. Diabetes mellitus is a systemic metabolic disease that affects organs and tissues. Inside the oral cavity, dental hard and soft tissues are primarily affected by downstream effects from diabetes mellitus. Damage to the periodontal tissues has been looked into for decades. However, the effects of diabetes mellitus on other dental hard and soft tissues of the tooth structure were not well-discussed. Hence, the present study intended to review downstream effects from diabetes mellitus that cause damage to enamel, dentin, cementum, and pulp tissues. ethods An electronic search was performed on PubMed, MEDLINE, and EMBASE databases via OVID from January 2000 to August 2021 using the keywords mentioned in the PubMed and Medical Subject Headings terms. When comparing dental enamel and dentin damages, both tissue layers are weakened with mineral loss from increased reactive oxygen species activity, leading to developmental defects. Hyperglycemia induced from diabetes mellitus creates inflammation by increasing NF-κB signaling at the gum. The consequences allow easier leakage of fluids and allow microbes to penetrate the cementum to progress into the pulp chamber. More microbes entering pulp can cause dental root damage and severe pain. Downstream effects from diabetes mellitus, such as hyperglycemia, impaired immunity, insulin resistance, and dyslipidemia, have changed the oral environment. Change of conditions in the oral environment increases the susceptibility to oral complications. Therefore, a combined analysis of multiple downstream effects of diabetes on different tooth tissues is needed to prevent tooth damage and increase the treatment success rate.