The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1

Abstract

Objective: To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). Subjects and methods: A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). Results: The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. Conclusion: Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow. Arch Endocrinol Metab. 2015;59(6):535-40

Differences in dental caries experience between diabetic adolescents and healthy controls

“…The results of Miko et al (25) also showed that the mean number of decayed teeth in well-controlled T1DM adolescents is lower, but the number of filled teeth is higher than in patients with poorer glycemic control. Carneiro et al (27) demonstrated that the DMFT score was higher in individuals with higher HbA1c values and that more caries-free individuals were found in the group with lower HbA1c. In the study of Sudikiene et al (28), well to moderately controlled diabetics had fewer decayed surfaces.…”

Microbiological, lipid and immunological profiles in children with gingivitis and type 1 diabetes mellitus

“…Al-Khabbaz, et al 1 (2013) observed that, in children with type 1 diabetes, periodontitis was significantly associated with longer duration of diabetes and older age at diagnosis of diabetes. Studies have demonstrated that poor metabolic control, including high levels of fasting glucose and glycosylated hemoglobin are important factors that could increase the susceptibility to periodontal disease, as well as other systemic complications of diabetes mellitus 3,22 .…”

Oral Health of Down Syndrome Adults in Bosnia and Herzegovina

“…CPI (Community Periodontal Index) evaluates three periodontal indicators: bleeding gums, periodontal calculus and periodontal pockets. The CPI was coded by as: 0 = healthy; 1 = bleeding; 2 = calculus; 3 = pocket 4-5 mm; 4 = pocket >6mm; X = sextant excluded; 9 – not registered (8, 9). Participants were also divided into four groups according to their age, as follows: a) Age 6 years (n=10); b) Age 7–12 years (n=17); c) Age 13-18 years (n=30) and d) Age 19-45 years (n=33).…”