BackgroundThere have been inconsistent conclusions regarding salivary abnormalities and their effect on oral health of Juvenile Idiopathic Arthritis (JIA) patients. The purpose of the study was to evaluate the flow rate and selected biochemical parameters of unstimulated whole saliva in correlation to oral health in JIA children.MethodsThirty-four JIA patients and 34 age- and sex-matched controls not affected by JIA (C) were divided into two groups: with mixed and permanent dentition. DMFT/dmft, gingival and simplified oral hygiene indices were evaluated. Salivary flow rate, pH, lysozyme, lactoferrin, salivary protein concentrations and peroxidase activity were assessed.ResultsThe salivary flow rate was significantly lower in the total JIA group (0.41 ml/min) as compared with the C (0.51 ml/min) and in the permanent dentition of JIA children (0.43 ml/min) as compared with the C (0.61 ml/min). A significantly lower pH was observed in total (6.74), mixed (6.7) and permanent (6.76) dentition of JIA groups in comparison to the C (7.25, 7.21, 7.28 respectively). The specific activity of peroxidase was significantly higher in JIA patients (total 112.72 IU/l, mixed dentition 112.98 IU/l, permanent dentition 112.5 IU/l) than in the C group (total 70.03 IU/l, mixed dentition 71.83 IU/l, permanent dentition 68.61 IU/l). The lysozyme concentration in JIA patients (total and permanent dentition groups) was significantly higher than in the C group. There were no significant differences in lactoferrin and salivary protein concentrations. There were no statistically significant differences in oral status between JIA patients and C, respectively: DMFT = 5.71, dmft = 3.73, OHI-S = 0.95, GI = 0.25 and DMFT 5.71, dmft = 3.73, OHI-S = 0.85, GI = 0.24. The specific activity of peroxidase in the unstimulated whole saliva was inversely correlated with the GI index, whereas the salivary lysozyme concentration was inversely correlated with the dmft index in JIA patients.ConclusionIn the course of JIA occur a reduction of the resting salivary flow rate and a decrease of saliva pH. In spite of this, no differences in the clinical oral status between the JIA children population and the control group were found. The mobilisation of salivary peroxidase and lysozyme contributes to the maintenance of healthy oral tissues.

In conclusion, it may be stated that type 1 diabetes mellitus causes functional changes in the salivary glands, resulting in a decrease of the salivary flow and weakening of the salivary innate defense system, thus creating a threat to the oral and general health of type 1 diabetes mellitus children. The results showed that the salivary glands of younger children, when compared to adolescents with type 1 diabetes mellitus, are more susceptible to the injurious effects of the disease.

StreszczenieWstęp: Opieka lekarza stomatologa nad dziećmi i młodzieżą z cukrzycą typu 1 powinna polegać na rzetelnym badaniu jamy ustnej, wczesnej terapii zmian próchnicowych zębów i utrzymaniu wyników leczenia. Można osiągnąć to dzięki regularnemu, zgodnemu ze standardami, wizytami kontrolnymi, oraz stosowaniu się do zaleceń dotyczących profilaktyki choroby próchnico-wej i chorób przyzębia. Celem pracy było zbadanie, czy opieka lekarza stomatologa pozwala na zachowanie zdrowia jamy ustnej dzieci i młodzieży z cukrzycą typu 1. Materiał i metody: Badaniem stomatologicznym objęto 60 chorych z cukrzycą typu 1 w wieku 7-17 lat oraz 30 zdrowych dzieci i młodzieży w tym samym przedziale wiekowym. Oceniono intensywność próchnicy, efektywność leczenia zachowawczego, stan przyzębia i higienę jamy ustnej. Wyniki: Stwierdzono istotnie niższą intensywność próch-nicy oraz lepszy stan przyzębia u badanych dzieci i młodzieży z cukrzycą typu 1. Efektywność leczenia zachowawczego była istotnie wyższa u dzieci chorych z uzębieniem mieszanym. Nie wykazano znamiennych różnic w higienie jamy ustnej między porównywanymi grupami. Wnioski: Cukrzyca jest czynnikiem ryzyka schorzeń jamy ustnej, dlatego dzieci i młodzież z cukrzycą typu 1 należy objąć szczególnymi działaniami prewencyjnymi i leczniczymi. Głównym celem programu opieki nad dziećmi z cukrzycą insulinozależną jest wczesne zakwalifikowanie ich do grupy wysokiego ryzyka w celu poprawy stanu ogólnego zdrowia jamy ustnej, a tym samym zwiększenia komfortu życia. Właściwa opieka stomatologiczna nad dziećmi i młodzieżą z cukrzycą typu 1 jest warunkiem utrzymania zdrowia jamy ustnej. Med. Pr. 2018;69(1):37-44 Słowa kluczowe: choroba przyzębia, higiena jamy ustnej, próchnica, cukrzyca typu 1, opieka stomatologiczna, wskaźnik leczenia Abstract Background: Dental care for children and youth with type 1 diabetes should rely on reliable examination of the oral cavity, early treatment of dental caries and maintenance of the treatment results. This can be achieved through regular control visits consistent with the standards, and also through following the recommendations for prevention of dental caries and periodontal disease. The aim of the study was to investigate whether dental care allows to preserve good oral health of children and youth with type 1 diabetes. Material and Methods: The study included 60 patients with type 1 diabetes, aged 7-17 years, and 30 healthy children and youth within the same age range. There were evaluated intensity of caries, the effectiveness of conservative treatment, periodontal health and oral hygiene. Results: The results of examinations showed significantly lower caries prevalence and better periodontal health in the children and youth with type 1 diabetes. The effectiveness of conservative treatment was significantly higher among patients with mixed dentition. There was no significant difference in oral hygiene between the compared groups. Conclusions: Diabetes is a risk factor for oral diseases, so children and youth with type 1 diabetes should be provi...

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Introdution. Molar-incisor hypomineralisation is a disorder of dental enamel of a systemic origin. It may affect one or all four first permanent molars, and often involves permanent incisors. Aim. The aim of this study was to present views on aetiology, clinical picture and treatment of molar-incisor hypomineralisation. Material and methods. PubMed database was reviewed for years 2003-2017, the search criteria were: “molar incisor”, “hypomineralisation”, “permanent teeth”. Results. The aetiology of MIH is multifactorial and not fully explained. Authors agree that the general health during the first 3-4 years of life has a major impact on this disorder. The clinical picture includes demarcated white, yellow or brown tissue spots, and increased porosity of the enamel. Enamel damage and defects can also occur. Therapeutic management depends on the severity of the disease and includes intensive prevention, hard tissue reconstruction, and extractions. Conclusions. Due to the increasing prevalence of this disorder, special attention should be paid to children whose health status is or was bad in the first 3-4 years of life. They are at a higher risk for this condition.