Oral mucosal lesions, xerostomia, and burning sensation among diabetic and non-diabetic patients in Benghazi, Libya: A comparative cross-sectional study

Abstract

Background: Diabetes mellitus is associated with oral complications that may adversely affect quality of life and may provide clinically relevant clues to metabolic dysregulation. Objective: To compare the prevalence of oral mucosal lesions (OMLs), subjective xerostomia, and oral burning sensation among diabetic and non-diabetic patients in Benghazi, Libya. Methods: This comparative cross-sectional study included 303 participants aged 15-75 years: 153 diabetic patients and 150 non-diabetic controls. Data were collected from September 2024 to February 2025 using a structured questionnaire, clinical oral examination, and glycated hemoglobin (HbA1c) assessment. Subjective xerostomia was evaluated using a study questionnaire adapted from Torres et al. Statistical analysis was performed using descriptive statistics, the chi-square test, and Fisher's exact test, with statistical significance set at p<0.05. Results: OMLs were recorded in 189 participants (62.4%) and were significantly more prevalent among diabetic patients than controls (92.8% vs 31.3%, p<0.001). Fissured tongue and coated tongue were the most frequently recorded lesions. Oral burning sensation was more common among diabetic patients than non-diabetic controls (13.7% vs 2.0%, p<0.001). Moderate and severe subjective xerostomia were observed only among diabetic patients (30.1% and 37.3%, respectively; p<0.001). Poor glycemic control was associated with a greater burden of OMLs, burning sensation, and more severe xerostomia. Conclusion: Diabetic patients in Benghazi had a substantially higher burden of oral manifestations than non-diabetic controls. Routine oral examination and closer collaboration between dental and medical professionals may support earlier recognition and improved management of diabetes-related oral complications.