Evaluation of caries risk factors and effects of a fluoride-releasing adhesive material in children with insulin-dependent diabetes mellitus (IDDM): initial first-year results

Abstract

The aims of this study were to evaluate the prevalence and risk factors of dental caries, and to determine whether there is any relationship between a fluoride-releasing adhesive material and the development of dental caries in the first year in children with insulin-dependent diabetics (IDDM). The average age of the subjects was 4-15 years, and they had been suffering from IDDM for at least 2 years. The DMF/df(t) indices of 70 patients were calculated and total HbA1 (%) (glucose levels of blood) values were recorded from the medical records after clinical examination. The mean DMF/df(t) values of poorly controlled subjects (HbA1 values over 13%) were significantly higher than those of moderately (HbA1, 10.0-12.9%) and well-controlled (HbA1 values, <10%) subjects. The levels of salivary mutans streptococci (MS) and lactobacilli (LB) and the pH of paraffin-stimulated whole saliva were measured in diabetic patients. Salivary MS and LB scores of the poorly controlled subjects were significantly higher (2.5+/-0.7 and 2.1+/-1.0) than those of the moderately (1.6+/-0.9 and 1.1+/-0.8) and well-controlled (1.2+/-1.0 and 0.8+/-0.8) subjects. The mean pH values among all subjects were not statistically significant. All dental caries were restored with a fluoride-releasing adhesive material. At the end of the first year, no new caries or lost restorations were observed in these patients. Moreover, the rate of MS in the poorly and moderately controlled subjects was considerably reduced. However, no significant statistical reduction of MS was determined in the well-controlled subjects. The level of lactobacilli in the poorly controlled, moderately controlled, and well-controlled subjects was reduced.

Investigation of the oral status and microorganisms in children with phenylketonuria and type 1 diabetes

“…Some studies have been able to highlight a positive correlation between metabolic control of diabetes and dental caries, whereby poorly controlled patients show higher levels of caries [29][30][31][32][33][34]. The majority of the patients (>88 %) included in the present study had a good to moderate control of diabetes, with all patients having a HbA1c value of over 9 % being considered as poorly controlled.…”

“…Some studies have shown no difference in the counts for Sm and Lac between the diabetic and nondiabetic children [28,43]. Others have shown an increase in the counts in patients with poor diabetic control [27,33]. The high levels of Lca found in the diabetic children might suggest a relationship between a shift in the oral microflora and the relatively unrestricted dietary habits of the diabetic patients nowadays.…”

“…These results are in part comparable to results of other studies as no other study has investigated the specific bacteria relevant to caries and periodontal disease together, using PCR, in a group of type 1 diabetic children and adolescents, as in this study. Most studies have investigated solely Sm and Lactobacillus species [25,27,28,31,33,42] (Table 5) using either traditional laboratory culture methods or a commercial kit to determine the levels of bacteria. Moreover, all the studies used saliva as a sample to determine the bacterial count.…”

Importance of dental care to maintain oral health of children and youth with type 1 diabetes

“…tococus mutans i Lactobacillus acidophilus w ślinie w porównaniu z grupą dzieci z cukrzycą niewyrówna-ną [10]. Syrjala i wsp.…”

Protein expression in salivary glands of rats with streptozotocin diabetes

“…In humans, DM1 has significant deleterious effects in virtually all tissues. Oral complications of DM1 include an increased burden of mutans streptococci and lactobacilli and increased caries risk (Twetman et al 2002;Syrjala et al 2003;Bolgul et al 2004), increased oral yeast counts (Karjalainen et al 1997), increased mucosal abnormalities and infections (Guggenheimer et al 2000) and increased frequency of periodontal disease (Lö e & Genco 1995). Changes in salivary gland function include gland enlargement (Davidson et al 1969;Donath & Seifert 1975), reduced salivary flow rates and altered composition (Ben-Aryeh et al 1988;Rossie 1993;Moore et al 2001;Mata et al 2004).…”