Page 9 - MDJ Volume 47 Number 2 ( Jul-Dec 2024)

Review Article

Dental Caries in the Elderly with Diabetes Mellitus and the Use

of Metagenomic Sequencing for Oral Microbiome Analysis

Bibi Aisiah Babu Osman , Noorharliana Mohamed Zohdi , Mustaffa Jaapar , Rohana Ahmad , Eleena Mohd Yusof 1
1
2
1
3
1 Centre for Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia, Centre for Comprehensive
2
Care Studies, Faculty of Dentistry, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia, Oral Health Division, Ministry of Health Malaysia,
3
Putrajaya, Malaysia
Abstract
Dental caries amongst the elderly is on the rise due to increased life expectancy and the trend that older adults are retaining their
teeth for longer. Diabetes mellitus is known to be associated with an increased risk of periodontal disease. However, the relationship
between diabetes and dental caries amongst the elderly has received far less attention. Dental caries is a polymicrobial disease,
where the eubiosis and dysbiosis of the oral microbiota are key in determining the strategies of diagnosis, prevention and treatment.
Dysbiosis of the oral microbiota, for example in the presence of systemic diseases, plays a role in the pathogenesis of dental caries. The
advancement of genomic techniques provides a greater understanding of how the oral microbiome is associated with oral and systemic
health. Next-generation sequencing using targeted 16S ribosomal RNA gene sequencing allows analysis of the oral microbiota with
a relatively lower cost and eliminating the need for culture or polymerase chain reaction amplification to study the broad genomic
group of the oral microbiome in health and disease. The purpose of this narrative review is to provide an understanding on the use of
metagenomic sequencing in the prediction and control of dental caries.

Keywords: Dental caries, diabetes mellitus, elderly, oral microbiome

IntroductIon periodontal disease is well documented, but the link
The global population is ageing, with 962 million between DM and dental caries, particularly in the elderly,
is less explored. Both diseases are associated with dietary
individuals aged 60 years and above in 2017, projected to carbohydrate intake, with higher caries prevalence in those
nearly double to 2.1 billion by 2050. This demographic consuming large amounts of fermentable carbohydrates. [7,8]
[1]
shift, along with increased life expectancy and prolonged Diabetics, especially those with poor glycaemic control,
retention of natural teeth, has led to a rise in dental caries may have a higher risk of root caries. Improved oral
[7]
amongst the elderly. Dental caries, a multifactorial health can facilitate better glycaemic control in diabetic
[2]
non-communicable disease mediated by biofilm and individuals. [9]
dietary habits, results in mineral loss of dental tissues.
[3]
A systematic review revealed the highest prevalence of Recent advances in next-generation sequencing (NGS)
untreated caries in Asia and Africa, with over 50% of have revealed diverse microbial communities involved
older adults affected. In addition, root caries incidence
[4]
increases over time, even amongst healthier elderly
individuals, indicating a growing burden of oral diseases Address for correspondence: Dr. Eleena Mohd Yusof,
[5]
due to population ageing. Centre for Restorative Dentistry Studies, Faculty of Dentistry, Universiti
Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Selangor, Malaysia.
Diabetes mellitus (DM) is another significant healthcare E-mail: [email protected]
burden, characterised by hyperglycaemia and metabolic
abnormalities due to insulin production and action This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
[6]
deficiencies. The relationship between DM and others to remix, tweak, and build upon the work non-commercially, as long as
appropriate credit is given and the new creations are licensed under the identical terms.
Access this article online For reprints contact: [email protected]
Quick Response Code:
Website: How to cite this article: Babu Osman BA, Zohdi NM, Jaapar M,
https://journals.lww.com/mdj Ahmad R, Yusof EM. Dental caries in the elderly with diabetes
mellitus and the use of metagenomic sequencing for oral microbiome
analysis. Malaysian Dent J 2024;47:35-40.
DOI:
10.4103/MDJ.MDJ_3_24 Received: 02-Jul-2024 Revised: 05-Aug-2024
Accepted: 27-Aug-2024 Published: 30-Dec-2024

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