Diabetes mellitus and poor glycemic control increase the occurrence of coronal and root caries: a systematic review and meta-analysis.

OBJECTIVES: To assess the occurrence of coronal and root caries in adults with diabetes mellitus (DM). MATERIALS AND METHODS: This study was performed accordingly to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A search strategy was adapted for six databases, as well as gray literature. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools for observational studies. Revman 5.3 was used to conduct five meta-analyses. The quality of evidence of meta-analysis was evaluated by GRADE. RESULTS: From 4047 titles retrieved, 29 studies were included in qualitative synthesis and 20 in quantitative synthesis. Findings showed a higher mean of DMFT in DM individuals compared with healthy controls (mean difference = 1.71; 95% CI 1.08-2.33; p < 0.01; I2 = 55%). Individuals with type 2 DM were three times more likely to have root caries in comparison with non-DM individuals (OR = 3.17; 95% CI 1.19-8.49; p = 0.02; I2 = 70%). Individuals with uncontrolled glycemic levels within the population with DM had higher prevalence of caries than individuals with controlled DM (OR = 3.82; 95% CI 1.12-13.07; p < 0.01; I2 = 89%; DMFT index mean difference = 2.61; 95% CI 1.14-4.08; p < 0.01; I2 = 75%). CONCLUSIONS: Diabetes mellitus may increase the occurrence of coronal and root caries in adults. Poor glycemic control turned diabetic individuals more likely to have caries. CLINICAL RELEVANCE: Dental caries can be an oral sign to indicate poor glycemic control in individuals with DM. Strategies to prevent root caries should be adopted in individuals with type 2 DM. Besides, dental and medical treatments should synergistically explore whether dietary habits are healthy for controlling both, DM and caries.