Clinical and immunological parameters of dental status in children with type 1 diabetes mellitus

Abstract

Background. Destructive processes in the pancreas in type 1 diabetes mellitus cause a violation of oral homeostasis. The first signs of a change in dental health in type 1 diabetes are pastosity of the oral mucosa, hyposalivation, which causes the formation of dental plaque. Many researchers note the high prevalence of periodontal disease in patients with type 1 diabetes.
 Aim: to study the features of the dental status, cytokine profile and the state of specific factors of oral immunological protection in children with type 1 diabetes mellitus.
 Materials and methods: 2 groups of children aged 6-17 were examined. The main group (n=53) included patients with type 1 diabetes mellitus, the comparison group (n=30) included children without somatic pathology. The material for the study was the results of a clinical examination of patients - an assessment of the intensity of caries, oral hygiene, periodontal status, as well as the results of an immunological examination of the oral fluid - the level of cytokines (IL- 1, TNF-, IL-4, IL-10) and immunoglobulins (A, G, M).
 Results: in both groups, a satisfactory level of oral hygiene prevailed, and the level of plaque on the proximal surfaces of the teeth was unacceptable. The prevalence of chronic catarrhal gingivitis was higher in patients with type 1 diabetes. An immunological study showed that in patients of both groups there was an imbalance of cytokines in the oral fluid, caused by a group of pro-inflammatory cytokines, the level of which was higher in patients with type 1 diabetes mellitus. The levels of immunoglobulins in the oral fluid also had their differences: the levels of IgA and IgM in the saliva of patients with type 1 diabetes mellitus were 1.1 and 1.2 times higher, and the IgG level was 1.25 times lower.
 Conclusions: The high prevalence of periodontal disease in children with type 1 diabetes mellitus was associated with poor oral hygiene and carbohydrate metabolism. Patients with type 1 diabetes mellitus showed a pronounced imbalance of oral immunological protection factors. As the compensation of carbohydrate metabolism worsened, the nature of immunological changes in the oral cavity became more pronounced.