Impacts of Diabetes Mellitus Oral Manifestation on Quality of Life: A Systematic Review

Abstract

Aims: This study aimed to investigate and synthesize existing literature on the oral manifestations in individuals with diabetes mellitus and their impact on quality of life (QOL), to mitigate these complications and their consequences. Materials and Methods: The review protocol was registered with PROSPERO under the registration number CRD42023469966. A comprehensive literature search was performed in PubMed and Scopus databases without date restrictions to identify relevant studies based on predefined inclusion and exclusion criteria. This study included observational studies, such as crosssectional, case-control, and cohort studies, as well as clinical trials that examined the relationship between DM exposure and QOL outcomes. Two independent reviewers screened the articles, extracted data, and assessed their quality. Due to significant heterogeneity among studies - including variations in research design, participant selection, study duration, questionnaires, and diagnostic approaches - a meta-analysis was not feasible. The search encompassed English language publications available until October 2023. Results: Of the 1517 records screened, 33 studies met the eligibility criteria, comprising 28 observational studies (22 cross-sectional, 5 case-control, and 1 combined cross-sectional and case-control), and 5 intervention studies. The oral manifestations connected to DM were PD (periodontitis, gingivitis), xerostomia (reduced salivary flow, hypo salivation or drying of the mouth), tooth caries (root decay), halitosis (bad breath), tooth loss, pain, and oral health statues. There was a significant variation in the definition of oral manifestations across the studies. The variations primarily involved the criteria used to determine the extent and severity of these manifestations and to define a 'case' of an oral manifestation. Conclusion: This review confirms a clear association between diabetes and impaired oral health, highlighting its adverse effects on QOL, particularly in individuals with periodontitis and xerostomia. The findings underscore the need for future research employing standardized methodologies to better understand these relationships and to develop targeted interventions aimed at improving oral health outcomes and overall QOL for individuals with diabetes. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/export_details_pdf.php? ID=CRD42023469966.