Restor Dent Endod.  2024 Feb;49(1):e4. 10.5395/rde.2024.49.e4.

Prevalence of salivary microbial load and lactic acid presence in diabetic and non-diabetic individuals with different dental caries stages

• Mohanty M
• Govind S
• Rath S

• KMID: 2554132
• DOI: http://doi.org/10.5395/rde.2024.49.e4

Abstract

Objectives
This study aims to correlate caries-causing microorganism load, lactic acid estimation, and blood groups to high caries risk in diabetic and non-diabetic individuals and low caries risk in healthy individuals.
Materials and Methods
This study includes 30 participants divided into 3 groups: Group A, High-risk caries diabetic individuals; Group B, High-risk caries non-diabetic individuals; and Group C, Low-risk caries individuals. The medical condition, oral hygiene, and caries risk assessment (American Dental Association classification and International Caries Detection and Assessment System scoring) were documented. Each individual’s 3 mL of saliva was analyzed for microbial load and lactic acid as follows: Part I: 2 mL for microbial quantity estimation using nutrient agar and blood agar medium, biochemical investigation, and carbohydrate fermentation tests; Part II: 0.5 mL for lactic acid estimation using spectrophotometric analysis. Among the selected individuals, blood group correlation was assessed. The χ² test, KruskalWallis test, and post hoc analysis were done using Dunn’s test (p < 0.05).
Results
Group A had the highest microbial load and lactic acid concentration, followed by Groups B and C. The predominant bacteria were Lactobacilli (63.00 ± 15.49) and Streptococcus mutans (76.00 ± 13.90) in saliva. Blood Group B is prevalent in diabetic and non-diabetic highrisk caries patients but statistically insignificant.
Conclusions
Diabetic individuals are more susceptible to dental caries due to high microbial loads and increased lactic acid production. These factors also lower the executing tendency of neutrophils, which accelerates microbial accumulation and increases the risk of caries in diabetic individuals.

Keyword

Diabetes; Dental caries; Microbial load; Lactobacillus; Streptococcus mutans; Lactic acid

Figure

• 

  Figure 1 Pathogenic bacteria generally enter the oral cavity to form biofilm over the tooth surface. In the absence of oxygen, bacteria respire anaerobically, producing lactic acid. This over-secretion of lactic acid slowly corrodes the tooth's outer hard surface, leading to dental caries or tooth loss.

Reference

1. Scanlan CA, Rahmani H, Bowles R, Bennamoun M. Three-dimensional scanning for measurement of bulk density in gravelly soils. Soil Use Manage. 2018; 34:380–387.

2. van Houte J. Role of micro-organisms in caries etiology. J Dent Res. 1994; 73:672–681. PMID: 8163737.

3. Byun R, Nadkarni MA, Chhour KL, Martin FE, Jacques NA, Hunter N. Quantitative analysis of diverse Lactobacillus species present in advanced dental caries. J Clin Microbiol. 2004; 42:3128–3136. PMID: 15243071.

4. Chhour KL, Nadkarni MA, Byun R, Martin FE, Jacques NA, Hunter N. Molecular analysis of microbial diversity in advanced caries. J Clin Microbiol. 2005; 43:843–849. PMID: 15695690.

5. The Lancet. Diabetes: a defining disease of the 21st century. Lancet. 2023; 401:2087. PMID: 37355279.

6. Mohanty S, Mohanty N, Rath S. Analysis of oral health complications in diabetic patients—a diagnostic perspective. J Oral Res. 2018; 7:278–281.

7. K M P, Johnson P, Ganesh M, Subhashini AS. Evaluation of salivary profile among adult type 2 diabetes mellitus patients in South India. J Clin Diagn Res. 2013; 7:1592–1595. PMID: 24086848.

8. Sibyl S, Bennadi D, Kshetrimayum N, Manjunath M. Correlations between gingival crevicular blood glucose and capillary blood glucose: a preliminary report. J Lab Physicians. 2017; 9:260–263. PMID: 28966487.

9. Mazumdar P, Das UK, Goswami S. Correlation between blood group and dental caries in 20-60 years age group: a study. Int J Adv Res. 2014; 2:413–424.

10. Orbak R, Simsek S, Orbak Z, Kavrut F, Colak M. The influence of type-1 diabetes mellitus on dentition and oral health in children and adolescents. Yonsei Med J. 2008; 49:357–365. PMID: 18581583.

11. Singla S, Verma A, Goyal S, Singla I, Shetty A. Correlation of dental caries and blood group in Western Punjab population in India. Indian J Multidiscip Dent. 2015; 5:59.

12. Demir T, Tezel A, Orbak R, Eltas A, Kara C, Kavrut F. The effect of ABO blood types on periodontal status. Eur J Dent. 2007; 1:139–143. PMID: 19212557.

13. Goyal D, Kaur H, Jawanda MK, Verma S, Parhar S. Salivary pH and dental caries in diabetes mellitus. Int J Oral Maxillofac Pathol. 2012; 3:13–17.

14. Mondal DP, Panda CS, Rath S, Mohanty N. Comparative study on the efficacy of advanced and conventional methods for detection of Streptococcus mutans in the saliva of dental caries patients. Indian J Public Health Res Dev. 2018; 9:6–10.

15. Alghamdi S. Isolation and identification of the oral bacteria and their characterization for bacteriocin production in the oral cavity. Saudi J Biol Sci. 2022; 29:318–323. PMID: 35002424.

16. Shklair IL, Keene HJ. A biochemical scheme for the separation of the five varieties of Streptococcus mutans . Arch Oral Biol. 1974; 19:1079–1081. PMID: 4531861.

17. Ahirwar SS, Gupta MK, Gupta G, Singh V. Screening, isolation and identification of Lactobacillus species from dental caries of children. Int J Curr Microbiol Appl Sci. 2017; 6:497–503.

18. Jones RB, McCallum RM, Kay EJ, Kirkin V, McDonald P. Oral health and oral health behaviour in a population of diabetic outpatient clinic attenders. Community Dent Oral Epidemiol. 1992; 20:204–207. PMID: 1526105.

19. Seethalakshmi C, Reddy RC, Asifa N, Prabhu S. Correlation of salivary pH, incidence of dental caries and periodontal status in diabetes mellitus patients: a cross-sectional study. J Clin Diagn Res. 2016; 10:ZC12–ZC14.

20. Moore PA, Guggenheimer J, Etzel KR, Weyant RJ, Orchard T. Type 1 diabetes mellitus, xerostomia, and salivary flow rates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92:281–291. PMID: 11552145.

21. Taylor GW, Manz MC, Borgnakke WS. Diabetes, periodontal diseases, dental caries, and tooth loss: a review of the literature. Compend Contin Educ Dent. 2004; 25:179–184. 186–188. 190PMID: 15641324.

22. Shiferaw A, Alem G, Tsehay M, Kibret GD. Dental caries and associated factors among diabetic and nondiabetic adult patients attending Bichena Primary Hospital’s Outpatient Department. Front Oral Health. 2022; 3:938405. PMID: 36407659.

23. Twetman S, Petersson GH, Bratthall D. Caries risk assessment as a predictor of metabolic control in young type 1 diabetics. Diabet Med. 2005; 22:312–315. PMID: 15717880.

24. Moin M, Malik A. Frequency of dental caries and level of risk among type II diabetics. Dentistry (Loma Linda). 2015; 5:1000334.

25. Malicka B, Kaczmarek U, Ziętek M. Dental caries in adult patients with type 1 and 2 diabetes mellitus. J Stomatol (Brux). 2011; 64:9–24.

26. Swanljung O, Meurman JH, Torkko H, Sandholm L, Kaprio E, Mäenpää J. Caries and saliva in 12-18-year-old diabetics and controls. Scand J Dent Res. 1992; 100:310–313. PMID: 1465562.

27. Rath S, Bal SCB, Dubey D. Oral biofilm: development mechanism, multidrug resistance, and their effective management with novel techniques. Rambam Maimonides Med J. 2021; 12:e0004. PMID: 33478627.

28. Ahirwar SS, Gupta MK, Snehi SK. Dental caries and Lactobacillus: role and ecology in the oral cavity. Int J Pharm Sci Res. 2019; 10:4818–4829.

29. Caufield PW, Schön CN, Saraithong P, Li Y, Argimón S. Oral lactobacilli and dental caries: a model for niche adaptation in humans. J Dent Res. 2015; 94(Supplement):110S–118S. PMID: 25758458.

30. Sabharwal A, Stellrecht E, Scannapieco FA. Associations between dental caries and systemic diseases: a scoping review. BMC Oral Health. 2021; 21:472. PMID: 34563194.

31. Ligtenberg AJ, Veerman EC, de Graaff J, Nieuw Amerongen AV. Influence of the blood group reactive substances in saliva on the aggregation of Streptococcus rattus . Antonie van Leeuwenhoek. 1990; 57:97–107. PMID: 2321934.