Document Type : original article


1 Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2 pediatric dentistry resident, School of Dentistry, Shahid Sadoughi University, Yazd, Iran

3 School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

4 school of medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.


Background: Diabetes mellitus Type I is the most common childhood metabolic disorder. There is evidence indicating that diabetics have different salivary flow and salivary compositions, as compared to non-diabetic individuals. This study investigated salivary flow and unstimulated salivary pH of Type I diabetics aged 6-16 years in comparison to the controls.
Methods: This analytical cross-sectional study was conducted on 120 children. Thirty children with Type I diabetes and ninety children as controls were matched with the diabetic group in terms of age and gender. Unstimulated salivary flow was collected by spitting method for 10 minutes and saliva pH was measured using a digital pH-meter. Salivary flow and pH were compared between two groups using chi-square and t-test.
Results: The mean salivary flow of diabetic and non-diabetic children was 0.268±0.168 and 0.454±0.307 mL/min, respectively. The mean pH of saliva of diabetic and non-diabetic children was 7.19±0.611 and 7.37±0.466, respectively. The mean unstimulated salivary flow was lower in diabetic children as compared to non-diabetic pediatric cases, and this difference was statistically significant (P=0.002). Although diabetic children had lower salivary pH compared to their healthy counterparts, the difference between the two was not statistically significant (P=0.10).
Conclusion: Diabetic children had lower mean unstimulated salivary flow, compared to non-diabetic children. Although diabetic children had a lower mean salivary pH than healthy children, this difference was not statistically significant.


  1. Ferizi L, Dragidella F, Spahiu L, Begzati A, Kotori V. The Influence of Type 1 Diabetes Mellitus on Dental Caries and Salivary Composition. Int J Dent 2018; 2018:5780916.
  2. Novotna M, Podzimek S, Broukal Z, Lencova E, Duskova J. Periodontal Diseases and Dental Caries in Children with Type 1 Diabetes Mellitus. Mediators Inflamm 2015; 2015:379626.
  3. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect 2020; 10(2):98-115.
  4. Pachoński M, Jarosz P, Hubsch-Marzec H, Mocny-Pachonska K, Łanowy P, Koczor-Rozmus A. Evaluation of Select Saliva Parameters In Children With Type 1 Diabetes Mel- Litus. Acta Medica Mediterranea 2019; 35:3481-3487.
  5. Gupta VK, Malhotra S, Sharma V, Hiremath SS. The Influence of Insulin Dependent Diabetes Mellitus on Dental Caries and Salivary Flow. Int J Chronic Dis 2014; 2014:790898.
  6. Moreira AR, Passos IA, Sampaio FC, Soares MS, Oliveira RJ. Flow rate, pH and calcium concentration of saliva of children and adolescents with type 1 diabetes mellitus. Braz J Med Biol Res 2009; 42(8):707-11.
  7. Lynge Pedersen AM, Belstrøm D. The role of natural salivary defenses in maintaining a healthy oral microbiota. J Dent 2019; 80 Suppl 1:S3-s12.
  8. Basir L, Aminzade M, Javid A, Khanehmasjedi M, Rezaeifar K. Oral Health and Characteristics of Saliva in Diabetic and Healthy Children. Global Journal of Health Science 2016; 9(10):884-889.
  9. Glick M. Burket's Oral Medicine, 12th Edition. 12th ed. Shelton: People's Medical Publishing House USA; 2015.
  10. Liu T, Wei Y, Zhu Y, Yang W. Caries Status and Salivary Alterations of Type-1 Diabetes Mellitus in Children and Adolescents: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2021; 21(1):101496.
  11. Bernardi MJ, Reis A, Loguercio AD, Kehrig R, Leite MF, Nicolau J. Study of the buffering capacity, pH and salivary flow rate in type 2 well-controlled and poorly controlled diabetic patients. Oral Health Prev Dent 2007; 5(1):73-8.
  12. Vasconcelos AC, Soares MS, Almeida PC, Soares TC. Comparative study of the concentration of salivary and blood glucose in type 2 diabetic patients. J Oral Sci 2010; 52(2):293-8.
  13. Veleganova V, Kondeva V, Uzunova Y, Simitchiev K. Salivary status of diabetic children. Educational Alternatives 2014; 12:263-276.
  14. López ME, Colloca ME, Páez RG, Schallmach JN, Koss MA, Chervonagura A. Salivary characteristics of diabetic children. Braz Dent J 2003; 14(1):26-31.
  15. Mata AD, Marques D, Rocha S, Francisco H, Santos C, Mesquita MF, Singh J. Effects of diabetes mellitus on salivary secretion and its composition in humans. Mol Cell Biochem 2004; 261(1-2):137-42.
  16. Stetiu AA, Dancila A, Mitariu M, Serb B, Mitariu MC, Ormenisan A, Barbu HM, Comaneanu RM, Stetiu M. The influence of the chemical composition of the saliva, buffer capacity and the salivary pH on children with diabetes compared to non-diabetics. Revista de Chimie 2016; 67:1966-1969.
  17. Hoseini A, Mirzapour A, Bijani A, Shirzad A. Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus. Electron Physician 2017; 9(9):5244-5249.
  18. Malicka B, Kaczmarek U, Skośkiewicz-Malinowska K. Prevalence of xerostomia and the salivary flow rate in diabetic patients. Adv Clin Exp Med 2014; 23(2):225-33.
  19. Pappa E, Vastardis H, Rahiotis C. Chair-side saliva diagnostic tests: An evaluation tool for xerostomia and caries risk assessment in children with type 1 diabetes. J Dent 2020; 93:103224.
  20. Costa AL, Silva BMA, Soares R, Mota D, Alves V, Mirante A, Ramos JC, Abreu JMd, Santos-Rosa M, Caramelo F, Gonçalves T. Type 1 diabetes in children is not a predisposing factor for oral yeast colonization. Med Mycol 2017; 55(4):358-367.
  21. Edblad E, Lundin SA, Sjödin B, Aman J. Caries and salivary status in young adults with type 1 diabetes. Swed Dent J 2001; 25(2):53-60.
  22. Thorstensson H, Falk H, Hugoson A, Olsson J. Some salivary factors in insulin-dependent diabetics. Acta Odontol Scand 1989; 47(3):175-83.
  23. Kjellman O. Secretion rate and buffering action of whole mixed saliva in subjects with insulin-treated diabetes mellitus. Odontol Revy 1970; 21(2):159-68.
  24. Javed F, Sundin U, Altamash M, Klinge B, Engström PE. Self-perceived oral health and salivary proteins in children with type 1 diabetes. J Oral Rehabil 2009; 36(1):39-44.
  25. Siudikiene J, Machiulskiene V, Nyvad B, Tenovuo J, Nedzinskiene I. Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease. Eur J Oral Sci 2006; 114(1):8-14.
  26. Karjalainen KM, Knuuttila ML, Käär ML. Relationship between caries and level of metabolic balance in children and adolescents with insulin-dependent diabetes mellitus. Caries Res 1997; 31(1):13-18.
  27. Carneiro VL, Fraiz FC, Ferreira Fde M, Pintarelli TP, Oliveira AC, Boguszewski MC. The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1. Arch Endocrinol Metab 2015; 59(6):535-40.
  28. Reuterving CO, Reuterving G, Hägg E, Ericson T. Salivary flow rate and salivary glucose concentration in patients with diabetes mellitus influence the severity of diabetes. Diabete Metab 1987; 13(4):457-62.