MODERN CLINICAL AND LABORATORY METHODS FOR THE PREVENTION AND MANAGEMENT OF DENTAL CARIES IN PATIENTS WITH DIABETES MELLITUS

Background: Patients with diabetes mellitus (DM) face an elevated and disease-specific risk of dental caries, driven by hyposalivation, salivary acidification, and altered oral microbiota, yet clinical prevention protocols rarely account for these mechanisms. Aim: To review modern clinical and laboratory-informed approaches for the prevention and management of dental caries in patients with DM. Methods: A narrative review of randomized controlled trials, systematic reviews, and clinical guidance addressing oral hygiene interventions, salivary substitutes, fluoride- and remineralization-based therapies, and glycemic-control-linked preventive strategies in diabetic patients. Results: Intensive oral hygiene programs combining professional debridement with interdental cleaning aids, and immunologically active saliva substitutes (containing lactoperoxidase, lysozyme, glucose oxidase, and lactoferrin) used alongside oral hygiene instruction and moisturizing gel, have both been shown to reverse or arrest dental caries in patients with type 2 diabetes. Minimally invasive remineralizing approaches and glycemic-control optimization further support caries arrest. Conclusion: Effective caries prevention in diabetic patients requires a combined protocol addressing oral hygiene, salivary dysfunction, and glycemic status, rather than the generic prevention advice applied to non-diabetic patients.