Título:	Low-level laser and transcutaneous electrical nerve stimulation on salivary glands impact type 2 diabetes mellitus oral microbiome: an interim analysis of a randomized trial
Autor(es):	Melo, Jéssica Luiza Mendonça Albuquerque de Nunes, Fernanda de Paula e Silva Coelho, Camila Pinho e Souza Heller, Debora Guimarães, Maria do Carmo Machado Thuy Do Borges, Luiz Gustavo dos Anjos Grisi, Daniela Corrêa Teixeira, Naile Dame
Afiliação do autor:	Universidade de Brasília Universidade de Brasília Universidade de Brasília UT Health San Antonio, San Antonio, USA Universidade de Brasília University of Leeds, Leeds, United Kingdom Pontifical Catholic University of Rio Grande do Sul Universidade de Brasília Universidade de Brasília
Assunto:	Diabetes Estimulação elétrica Estimulação nervosa transncutânea Glândulas salivares Microbioma oral
Data de publicação:	20-Set-2024
Editora:	Springer Nature
Referência:	MELO, Jéssica Luiza Mendonça Albuquerque de et al. Low-level laser and transcutaneous electrical nerve stimulation on salivary glands impact type 2 diabetes mellitus oral microbiome: an interim analysis of a randomized trial. Lasers in Medical Science, [S. l.], v. 40, art. n. 372, 2025. DOI: https://doi.org/10.1007/s10103-025-04609-2.
Abstract:	Purpose Diabetes Mellitus (DM) can lead to significant reduction of saliva production, which increases the risk of oral diseases. Managing reduced salivary flow becomes indispensable for restoring microbial balance in this condition. This study aimed to investigate the effects of physical stimulation methods on salivary secretion rate and microbiome composition in individuals with type 2 DM (T2DM) having reduced salivary flow using an exploratory interim analysis of a randomized clinical trial. Methods Eight individuals provided a total of 15 stimulated or rest saliva samples and were randomly assigned to the following groups: low-level laser therapy (LLLT) (G1), transcutaneous electrical nerve stimulation (TENS)(G2), and a combination of both methods(G3), administered twice a week over a span of 10 sessions. Salivary flow was evaluated at three time points: recruitment, before the 1st session (baseline) and after the 10th session. Subjective dry mouth was evaluated using the TESS scale at baseline and after the final session. DNA was extracted from whole saliva immediately before treatment (baseline) and after the final stimulation session, 16 S rRNA gene amplified and sequenced (Illumina MiSeq). Results N = 7 individuals showed improvement in stimulated salivary flow (SSF), achieving or maintaining normal range (SSF > 0.7 ml/min). Bacterial diversity was significantly higher in saliva after stimuli with laser(G1) when compared to TENS(G2). The relative abundance of Firmicutes and Fusobacteriota increased after all treatments, while Actinobacteriota and Proteobacteria decreased. The abundance of minority taxa was reduced after stimulation. Conclusion This exploratory study provides initial indications that physical stimulation may help manage T2DM-related reduced salivary flow and could be associated with subtle changes in low-abundance taxa suggesting a potential “clearance” effect. These preliminary observations require confirmation through larger, long-term studies.
Unidade Acadêmica:	Faculdade de Ciências da Saúde (FS) Departamento de Odontologia (FS ODT)
Programa de pós-graduação:	Programa de Pós-Graduação em Odontologia
DOI:	https://doi.org/10.1007/s10103-025-04609-2
Versão da editora:	https://link.springer.com/article/10.1007/s10103-025-04609-2
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