Oral Microbiome and Local Immune Response In The Development Of Alveolitis In Children With Type 1 Diabetes Mellitus: Current Evidence And Future Perspectives

Abstract

Alveolitis remains one of the most common inflammatory complications following tooth extraction in pediatric dental practice. Children with type 1 diabetes mellitus (T1DM) represent a particularly vulnerable population because chronic hyperglycemia affects local immunity, wound healing, and microbial homeostasis within the oral cavity. During the last decade, increasing evidence has demonstrated that disturbances of the oral microbiome together with impaired innate and adaptive immune responses significantly contribute to delayed socket healing and the development of postoperative inflammatory complications.

This review summarizes current knowledge regarding alterations of the oral microbiome, biofilm formation, dysbiosis, antimicrobial defense mechanisms, inflammatory mediators, and host–microbe interactions in children with T1DM. Particular attention is given to modern molecular diagnostic technologies, microbiome sequencing, salivary biomarkers, and future perspectives of precision dentistry. The available evidence suggests that comprehensive assessment of microbial composition together with local immune biomarkers may substantially improve risk stratification, early diagnosis, and personalized prevention of alveolitis in pediatric patients with type 1 diabetes mellitus.

Keywords:

Type 1 diabetes mellitus, oral microbiome, alveolitis, dysbiosis

References

American Diabetes Association. Standards of Care in Diabetes—2025. Diabetes Care. 2025.

Kilian M, et al. The oral microbiome – an update. Oral Diseases. 2023.

Lamont RJ, Koo H, Hajishengallis G. The oral microbiota: dynamic communities and host interactions. Nature Reviews Microbiology. 2018.

Hajishengallis G, Lamont RJ. Polymicrobial communities in periodontal disease. Trends in Microbiology. 2021.

Deo PN, Deshmukh R. Oral microbiome: unveiling the fundamentals. Journal of Oral and Maxillofacial Pathology. 2019.

Marsh PD. Dental plaque as a biofilm. Journal of Clinical Periodontology. 2005.

Graves DT, Ding Z, Yang Y. The impact of diabetes on periodontal diseases. Periodontology 2000. 2020.

Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nature Reviews Disease Primers. 2017.

Hupp JR, Ellis E, Tucker MR. Contemporary Oral and Maxillofacial Surgery. 7th ed. Elsevier; 2019.

McDonald RE, Avery DR. Dentistry for the Child and Adolescent. Elsevier; 2022.

Verma D, Garg PK, Dubey AK. Insights into the human oral microbiome. Archives of Microbiology. 2018.

Belibasakis GN, et al. The oral microbiome in health and disease. Cellular and Molecular Life Sciences. 2023.

Baker JL, Bor B, Agnello M, et al. Ecology of the oral microbiome. Annual Review of Microbiology. 2024.

World Health Organization. Global Oral Health Status Report. Geneva; 2022.

Nature Reviews Microbiology Editorial. Microbiome medicine: present and future. Nature Reviews Microbiology. 2024.