Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease

Abstract

The aim of this study was to investigate the relationship among type 1 diabetes mellitus, dental caries, and salivary status in children. The study comprised 68, 10-15-yr-old diabetics, and 68, age- and gender-matched non-diabetic controls. Diabetics were categorized into well-to-moderately controlled (HbA1c < 9.0%) and poorly controlled (HbA1c >or= 9.0%) groups. Caries was recorded by assessing lesion activity at non-cavitated and cavity levels. Teeth were examined visually for the presence of dental plaque. Saliva was analyzed for unstimulated and stimulated flow rates, buffer effect, mutans streptococci, lactobacilli, and yeasts. Diabetics had fewer caries and plaque, lower salivary flow rates and buffer effect, and more frequent growth of yeasts than their non-diabetic controls. Well-to-moderately controlled diabetics had fewer decayed surfaces and lower counts of mutans streptococci and yeasts than poorly controlled diabetics, but the level of metabolic control of diabetes had no influence on salivary flow rates and buffer effect. High caries levels in diabetics were significantly associated with age, plaque score, and decreased unstimulated salivary flow rate, but were not associated with the level of metabolic control of diabetes. High caries experience in this study population could be related to plaque accumulation and/or to changes in saliva induced by diabetes mellitus.

Relations entre le flux salivaire et le taux élevé des Streptocoques mutans et des Lactobacilles salivaires chez l’enfant diabétique de type 1

“…III). Cette observation a déjà été faite par Twetman et al [10] et Siudikiene et al [9]. Pour ces auteurs, les enfants ayant un diabète insulinodépendant de type I ont tendance à présenter une diminution du débit salivaire et leur salive à contenir un nombre élevé de colonies de Streptocoques mutans et de Lactobacilles.…”

Dental caries and adolescents with type 1 diabetes

“…The age of the patient at the onset of DM was correlated to the caries condition DM patients are known to exhibit hyposalivation with a decrease in the saliva secretion rate, 6,26,27 this changing as a function of the metabolic care. Lower saliva secretion and pH also tends to promote the growth of acidogenic microorganisms such as lactobacilli, mutans streptococci and Candida, as a consequence of diminished mechanical cleaning, increased dental plaque, 28 a long-lasting acidic milieu, and the faulty self-cleansing of the teeth, which all favour caries development.…”

“…[1][2][3][4][5][6] There have been comparatively few studies of the DM adolescent population, in spite of the fact that caries may be more prevalent in this population group. On the other hand, there seems to be no uniform opinion as to whether control of DM or sucrose-free diet of DM patients tends to promote or inhibit the development of dental caries.…”

Diabète de type I chez l’enfant : gestion clinique des pathologies bucco-dentaires

“…La diminution ou les perturbations de la sécrétion salivaire constituent une des complications fréquentes du diabète de type I. Lopez et al [16] et Tsong-Long et al [26] ont déjà montré que chez les enfants diabétiques le débit salivaire au repos ou après stimulation était réduit. Siudikiene et al [23] ont également trouvé un débit salivaire diminué après stimulation chez des patients diabétiques se plaignant de sécheresse buccale. Karjalainen et al [15] et Mata et al [17] considèrent que la valeur réduite du débit salivaire au repos peut être utile pour identifier les patients diabétiques.…”

“…La forte prévalence de la carie chez les diabétiques peut aussi s'expliquer par un taux de glucose plus élevé dans leur salive [2]. Nos résultats corroborent ceux de Siudikiene et al [21,23,24]. Les enfants Tableau VI.…”