Dental health status in children with type 1 diabetes mellitus in Montenegro

Abstract

Background/Aim. The number of children with diabetes is constantly increasing. The aim of this study was to evaluate oral health in children with type 1 diabetes mellitus compared to healthy children. Methods. The study included 177 patients aged 10-15 years, divided into two groups. Group T1DM, made up of children with type I diabetes mellitus. Control group was healthy children. The dental health was assessed using the DMFT index. The Plaque Index (PI) according to Silness-Löe and the Calculus Index (CI) by Green were used to determine oral hygiene. Salivary status involved determining the amount of secreted stimulated saliva and buffer capacity of the same patient. Results. In terms of average values of DMFT index of permanent teeth, there were no statistically significant differences in study groups. A significant difference in PI value in group T1DM (1.29 ± 0.56) and control group (1.01 ± 0.50 ) was observed (p =0.001). Also, a significant difference in CI value in group T1DM (0.09 ± 0.23) and in control group (0.03 ± 0.14) was observed (p=0.047). The average amount of secreted stimulated saliva for diabetic children was significantly lower (0.99 ± 0.14 ml/min), compared to healthy children (1.06 ± 0.20 ml/min; p=0.020). Conclusion:Children with type 1 diabetes mellitus have no more diseased teeth; however, they have more dental plaque, dental calculus and lower saliva than children in the control group. Also, our results point to the absence of preventive measures and programs in Montenegro. ApstraktUvod/Cilj. Broj djece sa dijabetesom u stalnom je porastu. Cilj ovog istraživanja je bio utvrĊivanje stanja oralnog zdravlja kod djece oboljele od dijabetesa mellitusa tip I u odnosu na zdravu djecu. Metode. U studiju je bilo ukljuĉeno 177 pacijenata uzrasta 10-15 godina, podeljenih u dve grupe. Grupu T1DM, ĉinila su deca obolela od dijabetes mellitus-a tip I. Zdrava deca, predstavljala su kontrolnu grupu .Stanje zdravlja zuba ocenjeno je pomoću KEP indeksa. Za utvrĊivanje oralne higijene primenjivan je Plak Indeks (PI) po Silness-4 Löe i Indeks zubnog kamenca po Green-u (CI). Salivarni status je podrazumevao odreĊivanje koliĉine izluĉene stimulisane pljuvaĉke i puferski kapacitet iste pacijenata.Rezultati. U pogledu proseĉnih vrednosti indeksa KEP stalnih zuba nije bilo statistiĉki znaĉajnih razlika izmeĊu obolele i zdrave dece. Uoĉena je znaĉajna razlika u vrednostima PI grupe T1DM (1,29±0,56) i kontrolne grupe (1,01±0,50; p=0,001). TakoĊe je uoĉena znaĉajna razlika u vrednostima CI grupe T1DM (0,09±0,23) i kontrolne grupe (0,03±0,14; p=0,047). Proseĉna koliĉina izluĉene stimulisane pljuvaĉke za obolelu decu bila je znaĉajno niža i iznosila je 0,99±0,14ml/ min, u odnosu na zdravu decu (1,06±0,20 ml/min; p=0,02). Zaključak. Deca obolela od dijabetes mellitus-a tip 1 u CG nemaju više obolelih zuba, ali imaju više dentalnog plaka, zubnog kamenca i manji protok pljuvaĉke u odnosu na decu iz kontrolne grupe. TakoĊe, naši rezultati upućuju na nepostojanje preventivnih mera i programa u Crnoj Gori.

Poor glycemic control impairs oral health in children with type 1 diabetes mellitus - a systematic review and meta-analysis

“…All in all, the included articles were from 14 countries. There were five studies from India [ 35 – 39 ], four from Iran [ 27 , 40 – 42 ],two from Saudi Arabia [ 43 , 44 ], two from Egypt [ 45 , 46 ], two from Greece [ 47 , 48 ], one from Kuwait [ 14 ], one from The United States [ 49 ] one from Poland [ 50 ], one from Portugal [ 51 ], one from Montenegro [ 52 ], one from Kosovo [ 53 ], one from Turkey [ 54 ], one from Brazil [ 55 ], one from Iraq [ 56 ], one from Libya [ 57 ], one from Sweden [ 58 ], one from Belgium [ 29 ], one from Romania [ 59 ], one from Italy [ 60 ], one from Hong Kong [ 61 ], one from Finland [ 62 ], one from Lithuania [ 63 ] and one from Hungary [ 64 ].…”

“…Twenty-two studies did not find statistically significant differences between the study group and the control group [ 27 , 29 , 38 , 41 – 44 , 46 – 52 , 54 , 55 , 57 , 59 – 62 , 64 ]. There were six studies revealing higher DMFT values in the DM groups [ 14 , 35 , 40 , 45 , 53 , 56 ]; and five studies found that children living with type 1 DM had lower DMFT values, which means a better caries prevalence [ 36 , 37 , 39 , 58 , 63 ].…”

“…All the other studies revealed that there was no statistically significant difference between the study and control groups regarding the DMFT or DMFS indexes. From these 22 articles, twelve showed a higher DMFT value in DM groups, but these differences were not significant [ 27 , 38 , 44 , 46 , 29 , 42 , 49 , 51 , 55 , 57 , 62 , 64 ], and there were five studies in which children with DM had better DMFT values than healthy controls [ 41 , 43 , 52 , 54 , 61 ]. The remaining five articles did not report on the comparison of healthy and DM individuals, only comparing the groups divided by metabolic control [ 47 , 48 , 50 , 59 , 60 ].…”

“…There were 17 studies included in the meta-analysis [ 14 , 27 , 29 , 35 , 36 , 38 , 40 – 42 , 44 , 46 , 49 , 52 , 55 , 56 , 61 , 62 ]. Statistically significant differences were found between the groups, with a result of 0.41 (CI95%=0.03; 0.78).…”

“…Seven articles investigated the buffer capacity of children with DM [ 14 , 44 , 47 , 48 , 52 , 53 , 62 ]. Two articles showed statistically significantly worse buffer capacity [ 44 , 53 ], three articles did not find significant differences between the study and control group [ 14 , 48 , 62 ], and two studies reported better results in the DM group, while the buffer capacity of these children was not significantly higher compared to children without DM [ 47 , 52 ].…”