Oral dysbacteriosis in type 2 diabetes and its role in the progression to cardiovascular disease.

Ziad Nabee1,2, Rajesh Jeewon2, Prity Pugo-Gunsam1
1. Department of Biosciences, Faculty of Science, University of Mauritius, Reduit, Mauritius
2. Department of Health Sciences, Faculty of Science, University of Mauritius, Reduit, Mauritius

Abstract
Background: Salivary changes and proliferation of specifc bacterial communities are known to result in oral disease which may
adversely impact on systemic conditions like diabetes and cardiovascular diseases.

Objectives: This study reports on the changes in oral ecology of healthy and diseased adults and the possible role in disease
causation.

Methods: The study comprised 150 participants divided into control (healthy), diabetic and cardiac groups. After dental examination for (Decayed Missing Filled Teeth (DMFT) and Oral Rating Index (ORI), stimulated saliva was sampled to determine flow rate and buffering capacity. Salivary microbial load of Streptococcus mutans and Lactobacilli were subsequently quantifed.

Results: DMFT, ORI, buffering capacity and flow rate were inferior for both diabetic and cardiac patients, who had higher bacterial counts (p<0.05). Long standing diabetics harboured a higher load of Streptococcus mutans. The microbial load of Streptococcus mutans in cardiac patients was double that of diabetics.

Conclusion: Disruption in the salivary environment and changes in microbial ecology with increased load of cariogenic bacteria
were found in diabetic and cardiac patients. This study brings forward new evidence of a markedly higher load of Streptococcus
mutans in cardiac patients which may underlie the progression of diabetes to cardiovascular disease in this population.

Keywords: Oral ecology, saliva, bacteria, dental caries, diabetes.