Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
Impact Factor (IF) – 1.514
Index Copernicus (ICV 2018) – 157.72
MNiSW – 40
Average rejection rate – 84.38%
ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download PDF

Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 2, March-April, p. 225–233

Publication type: original article

Language: English

Prevalence of Xerostomia and the Salivary Flow Rate in Diabetic Patients

Barbara Malicka1,A,B,C,D, Urszula Kaczmarek1,A,B,C,D,E,F, Katarzyna Skośkiewicz-Malinowska1,B,C,D

1 Department of Conservative dentistry and Pedodontics, Wroclaw Medical University, Poland


Background. diabetes is a metabolic disease characterized by hyperglycemia, which results from relative or absolute insulin deficiency. One of the first oral symptoms of diabetes is xerostomia.
Objectives. The aim of the study was to determine the prevalence of the xerostomia symptoms and salivary flow rate in diabetic patients according to the type of diabetes, the level of metabolic control and the duration of the disease.
Material and Methods. The study involved 156 adult patients of both sexes including 34 patients with diabetes type 1 (group C1), 59 with diabetes type 2 (group C2), and 63 generally healthy individuals as two control groups, sexand age-matched to the diabetic group. The patients suffering from both types of diabetes were additionally subdivided according to the level of metabolic control and the duration of the disease. Xerostomia was diagnosed with the use of a specially prepared questionnaire and fox’s test. Moreover, the salivary flow rate of resting mixed saliva was measured.
Results. In type 1 diabetics, a significantly lower salivary flow rate in comparison to the age-matched control group (0.38 ± 0.19 mL/min vs. 0.53 ± 0.20 mL/min, p < 0.01) was found. However in type 2 diabetics, a slight lower salivary flow rate was noticed (on average, 20% lower). dry mouth was far more frequently diagnosed in type 1 diabetics than in the control group.
Conclusion. In type 1 diabetics, in comparison to healthy subjects, a significantly lower resting flow rate of saliva and significantly higher prevalence of xerosomia were observed, but in type 2 diabetics, only a trend of such variability was observed.

Key words

diabetes mellitus type 1 and 2, xerostomia, salivary flow rate.

References (29)

  1. Abrairaa C, Duckworthb W, McCarrenc M, Emanueled N, Arcaa D, Redac D, Henderson W: design of the cooperative study on glycemic control and complications in diabetes mellitus type 2. J diabet Complic 2003, 17, 6, 314–322.
  2. Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y, Iwamoto Y, Kobayashi M, Nanjo K, Sasaki A, Seino Y, Ito Ch, Shima K, Nonaka K, Kadowaki T: Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. The Committee of the Japan diabetes Society on the diagnostic criteria of diabetes mellitus. diabetes Res Clin Pract 2002, 55, 1, 65–85.
  3. Chavez EM, Taylor GW, Borrel LN, Ship JA, Arbor A: Salivary function and glycemic control in older persons with diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000, 89, 3, 305–311.
  4. Chavez EM, Borrell LN, Taylor GW, Ship J: a longitudinal analysis of salivary flow in control subjects and older adults with type 2 diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001, 91, 2, 166–173.
  5. Lin CC, Sun SS, Kao A, Lee CC: Impaired salivary function in patients with noninsulin-dependent diabetes mellitus with xerostomia. J diabet Complic 2002, 16, 2, 176–179.
  6. Kaczmarek U: Suchość jamy ustnej – etiologia, częstość występowania na podstawie piśmiennictwa. Czas Stomatol 2007, 60, 1, 20–31.
  7. Fox PC, van der Ven PF, Sonie BC, Weiffenbach JM, Baum BJ: Xerostomia: evaluation of a symptoms with increasing significance. J am dent assoc 1985, 110, 4, 519–525.
  8. Karjalainen KM, Knuuttila ML, Käär ML: Relationship between caries and level of metabolic balance in children and adolescents with insulin-dependent diabetes mellitus. Caries Res 1997, 31, 1, 13–18.
  9. Moreira AR, Passos IA, Sampaio FC, Soares MSM, Oliveira RJ: flow rate, pH and calcium concentration of saliva of children and adolescents with type 1 diabetes mellitus. Braz J Med Biol Res 2009, 42, 8, 707–711.
  10. Panchbhai AS, Degwekar SS, Bhowte RR: Estimation of salivary glucose, salivary amylase, salivary total protein and salivary flow rate in diabetics in India. J Oral Sci 2010, 52, 3, 359–368.
  11. Aydin S: a comparison of ghrelin, glucose, alpha-amylase and protein levels in saliva from diabetics. J Biochem Mol Biol 2007, 40, 1, 29–35.
  12. Dodds MW, Dodds AP: Effects of glycemic control on saliva flow rates and protein composition in non-insulindependent diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997, 83, 4, 465–470.
  13. Narhi TO, Meurman JH, Odont D, Ainamo A, Tilvis R: Oral health in the elderly with non insulin dependent diabetes mellitus. Spec Care dentist 1996, 16, 3, 116–122.
  14. Dodds MW, Yeh CK, Johnson DA: Salivary alterations in type 2 (non-insulindependent) diabetes mellitus and hypertension. Community dent Oral Epidemiol 2000, 28, 5, 373–381.
  15. Bernardi MJ, Reis A, Loguercio AD, Kehrig R, Leite MF, Nicolau J: Study of the buffering capacity, pH and salivary flow rate in type 2 well-controlled and poorly controlled diabetic patients. Oral Health Prev dent 2007, 5, 1, 73–78.
  16. Vaziri BP, Vahedi M, Mortazavi H, Abdollahzadeh SH, Hajilooi M: Evaluation of salivary glucose, Iga and flow rate in diabetic patients: a case-control study. J dent (Tehran) 2010, 7, 1, 13–18.
  17. Ben-Aryeh H, Serouya R, Kanter Y, Szargel R, Laufer D: Oral health and salivary composition in diabetic patients. J diabet Complic 1993, 7, 1, 57–62.
  18. Kao CH, Tsai SC, Sun SS: Scintigraphic evidence of poor salivary function in type 2 diabetes. diabetes Care 2001, 24, 5, 952–953.
  19. Moore PA, Guggenheimer J, Etzel KJ, Robert J, Weyant RJ, Orchard T: Type 1 diabetes mellitus, xerostomia, and salivary flow rates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001, 92, 3, 281–291.
  20. Dodds MW, Johnson DA, Yeh CK: Health benefits of saliva: a review. J dent 2005, 33, 3, 223–233.
  21. Lamey PJ, Fisher BM, Frier BM: The effects of diabetes and autonomic neuropathy on salivary flow in man. diabet Med 1986, 3, 6, 537–540.
  22. Sabino-Silva R, Freitas HS, Lamers LM, Okamoto MM, Santos MF, Machado UH: Na+-Glucose Cotransporter SGLT1 Protein in Salivary Glands: Potential Involvement in the diabetes-Induced decrease in Salivary flow. J Membr Biol 2009, 228, 2, 63–69.
  23. Busato IM, Ignaęcio SA, Brancher JA, Moyseęs ST, Azevedo-Alanis LR: Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus. Community dent Oral Epidemiol 2012, 40, 1, 62–69.
  24. Vasconcelos AC, Soares MS, Almeida PC, Soares TC: Comparative study of the concentration of salivary and blood glucose in type 2 diabetic patients. J Oral Sci 2010, 52, 2, 293–298.
  25. Carda C, Mosquera-Lloreda N, Salom L, Gomez de Feraris ME, Peydró A: Structural and functional salivary disorders in type 2 diabetic patients. Oral Medicine and Pathology diabetic salivary disorders. Med Oral Patol Oral Cir Bucal 2006, 11, 4, 309–314.
  26. Bajaj S, Prasad S, Gupta A, Singh VB: Oral manifestations in type-2 diabetes and related complications. Indian J Endocrinol Metab 2012, 16, 5, 777–779.
  27. Yeh CK, Harris SE, Mohan S, Horn D, Fajardo R, Chun P, Jorgensen J, MacDougall M, Abboud-Werner S: Hyperglycemia and xerostomia are key determinants of tooth decay in type 1 diabetic mice. Lab Invest 2012, 92, 6, 868–882.
  28. Fox PC, Busch KA, Baum BJ: Subjective reports of xerostomia and objective measures of salivary gland performance. J am dent assoc 1987, 115, 4, 581–584.
  29. Saes Busato IM, Aparecido IS, Brancher JA, Trindade Grégio AM, Naval Machado MA, Azevedo-Alanis LR: Impact of xerostomia on the quality of life of adolescents with type 1 diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009, 108, 3, 376–382.