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

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.     

Bacterial, behavioral and environmental factors associated with early childhood caries

The goals of this cross-sectional study were to characterize and compare demographic, behavioral, and environmental factors potentially associated with early childhood caries (ECC) and to assess salivary levels of mutans streptococci (MS) and lactobacilli (LB) in underserved, predominantly Hispanic children. One hundred forty-six children aged 3 to 55 months with a range of caries experience were identified and examined. ECC was primarily associated with the presence of MS and lack of access to dental care. Salivary MS levels among young children with ECC were higher than would be expected in a dentally healthy population, but lower than levels reported among older children at high risk for caries. After adjustment for age, children with log10 MS > or = 3.0 or log10 LB > or = 1.5 were about five times as likely (OR=4.9, 95% CI=2.0, 12.0) to have ECC than those with lower bacterial levels. This study demonstrated a significant association between relatively low cariogenic bacterial levels and dental caries in infants and toddlers. Antibiotic use, exposure to lead, and anemia were not significantly associated with the number of decayed and filled surfaces or decayed and filled teeth. ECC correlated significantly with child's age and lack of dental insurance of the children, as well as inversely with both family income and the educational level of the mother of the child.     

Cariogenic microorganisms and oral conditions in asthmatic children

This study evaluated the caries risk of asthmatic patients on the basis of mutans streptococci (MS) and lactobacilli levels in saliva samples as well as the index of oral hygiene and dental caries (DMFT index). The study population was composed of 80 asthmatic children, aged 3-15 years, who use specific medication, and 80 matched, healthy control children. The parents were interviewed about oral health-related factors. The World Health Organization criteria were used for dental examinations. The K?hler and Bratthal methodology was used to detect salivary MS levels and dilutions of saliva were done for lactobacilli counting. No differences between asthma and control groups were observed for caries prevalence in children aged 3-6 and 7-10 years, except in severe cases in the younger group. However, higher caries prevalence for permanent dentition was observed in 11- to 15-year-old asthmatic children. An increased dental biofilm was observed in the asthma group, as well as salivary levels of MS. No differences were observed in levels of lactobacilli. No statistical correlations were found between medication, frequency of treatment, method of consumption and caries experience, dental biofilm and salivary levels of MS or lactobacilli. However, there was a correlation between MS levels and treatment duration. The logistic regression revealed that MS level is an important risk factor for increased caries experience. Asthma should be evaluated as a risk factor for caries experience because it can increase the levels of MS and the dental biofilm.     

Antimicrobial systems of human whole saliva in relation to dental caries, cariogenic bacteria, and gingival inflammation in young adults

The association of salivary antibody (total IgA, IgG, and IgM and antibodies reactive with Streptococcus mutans) and non-antibody (lysozyme, lactoferrin, salivary peroxidase, myeloperoxidase, hypothiocyanite, thiocyanate) defense factors with oral health (past and present dental caries, gingival bleeding, the number of salivary S. mutans and lactobacilli) were studied in 50 naval recruits. Dental caries was significantly associated with large amounts of S. mutans, lactobacilli, and total salivary immunoglobulins and with low salivary flow rate and buffer capacity. Salivary anti-S. mutans antibodies did not correlate with dental caries or S. mutans levels. Moreover, none of the salivary non-antibody factors alone had any strong relationship to dental caries or S. mutans levels. Gingival inflammation was associated with elevated levels of lysozyme in whole saliva. It is concluded that in adults the associations between single-point measurements of most salivary antimicrobial constituents and the factors describing oral health are weak.     

Immunological and microbiologic changes during caries development in young children

We explored the association between caries development, colonization with caries-associated microflora, and immunity as children begin the transition to mixed dentition. Forty children received dental examinations at 3-4 years of age, repeated a year later. Children were grouped into caries-free (n = 23; CF) and caries-active (n = 17; CA ≥3 new lesions on follow-up). Salivary IgA and IgA antibody to Streptococcus mutans virulence epitopes were measured by Luminex assay. Mutans streptococci (MS), lactobacilli and total microorganisms were enumerated on selective media from plaque samples. There was no significant difference in baseline levels of MS or lactobacilli between CF and CA groups. However, both MS and lactobacilli levels were higher at follow-up in the CA group. Furthermore, children with detectable lactobacilli at baseline had significantly higher caries risk. Salivary IgA concentrations increased significantly in both groups during the study. Both CF and CA groups also displayed significant increases in salivary IgA antibody levels to glucosyltransferase, glucan-binding protein (Gbp) and antigen I/II salivary binding region. CF antibody levels to seven peptides associated with domains of biological importance increased at follow-up, in contrast to increases to only three peptides in CA saliva samples. Multivariate modeling showed that a lower baseline level of salivary IgA anti-GbpB was associated with higher caries risk. These data indicate that MS and lactobacilli are associated with caries in this population, that the secretory immune system is undergoing significant maturation during this period, and that the breadth of mucosal IgA response to epitopes of S. mutans virulence components may influence the degree to which these cariogenic microorganisms can cause disease.     

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

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.     

Salivary characteristics and dental caries: Evidence from general dental practices

BackgroundSaliva is one of the intraoral host factors that influence caries development. The authors conducted a study to investigate whether salivary characteristics are associated with recent dental caries experience.MethodsDentist-investigators and dental staff members collected data pertaining to a two-year cumulative incidence of dental caries (previous 24 months) and salivary characteristics during baseline assessment in an ongoing longitudinal study. The systematic random sample consisted of patients (n = 1,763) visiting general dental practices (n = 63) within the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT). The authors estimated adjusted rate ratios (RRs) by using generalized estimating equations log-linear regression to relate salivary characteristics to coronal carious lesions into dentin.ResultsLow resting pH (≤ 6.0) in the overall sample and low stimulated salivary flow rate (≤ 0.6 milliliter/minute) in older adults (≥ 65 years old) were associated with increased dental caries (RR, 1.6; 95 percent confidence interval [CI], 1.1–2.2; RR, 2.4; 95 percent CI, 1.5–3.8, respectively). Low buffering capacity was associated with decreased dental caries in children and adolescents (RR, 0.3; 95 percent CI, 0.1–1.0; RR, 0.2; 95 percent CI, 0.1–0.7, respectively). A thick, sticky or frothy salivary consistency also was associated with decreased dental caries in adults (RR, 0.6; 95 percent CI, 0.4–1.0). Associations between other salivary characteristics and dental caries for the overall sample and within each age group were not statistically significant.ConclusionsSalivary characteristics were associated weakly with previous dental caries experience, but the authors did not find consistent trends among the three age groups. Different salivary characteristics were associated with an increased caries experience in older adults and a lowered caries experience in children and adolescents and adults.Practical ImplicationsFurther investigations are needed in this population setting to understand the study’s conflicting results. The study findings cannot support the use of salivary tests to determine caries risk in actual clinical settings.     

A randomized clinical trial of anticaries therapies targeted according to risk assessment (caries management by risk assessment)

This randomized parallel group clinical trial assessed whether combined antibacterial and fluoride therapy benefits the balance between caries pathological and protective factors. Eligible, enrolled adults (n = 231), with 1-7 baseline cavitated teeth, attending a dental school clinic were randomly assigned to a control or intervention group. Salivary mutans streptococci (MS), lactobacilli (LB), fluoride (F) level, and resulting caries risk status (low or high) assays were determined at baseline and every 6 months. After baseline, all cavitated teeth were restored. An examiner masked to group conducted caries exams at baseline and 2 years after completing restorations. The intervention group used fluoride dentifrice (1,100 ppm F as NaF), 0.12% chlorhexidine gluconate rinse based upon bacterial challenge (MS and LB), and 0.05% NaF rinse based upon salivary F. For the primary outcome, mean caries increment, no statistically significant difference was observed (24% difference between control and intervention groups, p = 0.101). However, the supplemental adjusted zero-inflated Poisson caries increment (change in DMFS) model showed the intervention group had a statistically significantly 24% lower mean than the control group (p = 0.020). Overall, caries risk reduced significantly in intervention versus control over 2 years (baseline adjusted generalized linear mixed models odds ratio, aOR = 3.45; 95% CI: 1.67, 7.13). Change in MS bacterial challenge differed significantly between groups (aOR = 6.70; 95% CI: 2.96, 15.13) but not for LB or F. Targeted antibacterial and fluoride therapy based on salivary microbial and fluoride levels favorably altered the balance between pathological and protective caries risk factors.     

Salivary levels of mutans streptococci, lactobacilli, yeasts, and root caries prevalence in non-institutionalized elderly dental patients

Root caries prevalence was recorded for a consecutive sample of dental patients (n = 146), aged over 55 yr and with at least 12 natural teeth. The mean root DFS score of the males (n = 49) was 6.34 +/- 4.55 and for the females (n = 97) 3.76 +/- 3.31 (P less than 0.001). The salivary levels of mutans streptococci, lactobacilli, and yeasts were determined in addition to salivary flow rate and buffering capacity. Subjects with greater than 1 root DFS had significantly higher salivary levels of mutans streptococci, lactobacilli, and yeasts. They also had fewer teeth and more exposed root surfaces. In step-wise multivariate analyses the factors significantly related to the root DFS score were the number of exposed root surfaces, number of teeth, sex and salivary yeast levels (R2 = 0.41). In the multivariate analyses salivary levels of mutans streptococci were not significantly related to any clinical measurement of root caries experience due to the greater strength of association between the root DFS score and salivary levels of yeasts. Subjects prescribed medicines with a reported xerostomic effect had significantly fewer active root lesions than those not prescribed such medicines and salivary levels of all microorganisms studied were significantly elevated in subjects prescribed medications containing sucrose.     

Diet intake and caries prevalence in four-year-old children living in a low-prevalence country

Preventive measures have dramatically decreased the prevalence of dental caries in children. However, risk factors for the disease in children living in low-prevalence areas remain elusive. In the present study we evaluated associations between dental caries, saliva levels of mutans streptococci and lactobacilli, and diet with special emphasis on the intake of fermentable carbohydrates and dairy products in 4-year-old children living in an area where the overall caries prevalence was low. Dietary intake was recorded in 234 infants as part of the Study of Infant Nutrition in Ume?, Sweden (SINUS). Of these the parents of 124 children gave consent to participate in a follow-up at 4 years of age. Dietary intake, height and weight, dental caries, oral hygiene, including tooth brushing habits, presence of plaque and gingival inflammation, fluoride habits and numbers of mutans streptococci and lactobacilli in saliva were recorded. Using multivariate stepwise logistic regression, caries experience was negatively associated with intake frequency of cheese (OR = 0.67; 95% CI = 0.44-0.98) and positively associated with the salivary level of mutans streptococci (OR = 1.57; 95% CI = 1.21-2.03). Caries experience was not correlated with intake frequency or amounts of carbohydrate-containing foods, with any other particular food, or with daily intake of energy, carbohydrate or any other macro- or micronutrient. We conclude that cheese intake may have a caries-protective effect in childhood populations where the overall caries prevalence and caries experience are low and the children are regularly exposed to fluoride from toothpaste.     

Relationships between socioeconomic backgrounds, caries associated microflora and caries experience in 12-year-olds in Bosnia and Herzegovina in 2004

AIM: To present the prevalence of dental caries in Bosnia and Herzegovina (BH), to estimate the levels of salivary mutans streptococci and lactobacilli and compare them with caries prevalence in 12-years-old children from different socioeconomic backgrounds. STUDY DESIGN AND METHODS: A survey was carried out in 8 cantons of the Federation of BH (FBH) and in Republic Srpska (RS) in 2004. The final sample included 560 12-year-olds. The clinical examinations focused on dental status, expressed as DMFT index, and they were carried out by one examiner, following WHO standard methodologies. Additionally, the study involved 109 12-years old children from Sarajevo, divided in three groups, based on their socioeconomic background. For measuring lactobacillus and mutans streptococci (MS) count in saliva Dentocult LB and Dentocult SM-Strip Mutans were used. Levels of MS and lactobacilli were expressed as a score between 0 and 3, indicating very low to very high levels of SM and lactobacilli. RESULTS: The average DMFT of the 12-year-olds was 4.16+/-2.92. On average, 91% of the 12-year-olds were affected with dental caries. The SiC Index was 7.41+/-3.31. Investigating the relationship between caries associated microflora and caries experience in children of different socioeconomic status showed the following: significant difference in caries prevalence was found in children with different living conditions, where children with high socioeconomic status had better oral health compared to the other two groups. For mutans streptococci, 25.7% of the children had mutans class 0, 24.8% class 1, 34.9% class 2 and 14.6% class 3. The mean DMFT for mutans class 0 was 3.50, for class 1 was 4.30, for class 2 was 5.62 and for class 3 was 6.0. For lactobacilli, 38.5% of the children had lactobacilli class 0, 25.7% class 1, 23.9% class 2 and 11.9% class 3. The mean DMFT for lactobacilli class 0 was 4.3, for class 1 was 4.9, for class 2 was 4.8 and for class 3 was 6.0. No significant differences in the level of mutans streptococci and lactobacilli were found between the groups. CONCLUSION: There is moderate caries prevalence among BH 12-year-olds (DMFT 4.16+/-2.92). Caries experience varies between children with different living condition but no relation between levels of salivary mutans streptococci and lactobacilli and socioeconomic status of children could be found.     

Role of smoking and HbA1c level in periodontitis among insulin-dependent diabetic patients

OBJECTIVES: The aim was to analyse the role of smoking and HbA1c level in attachment loss (AL) and probing depths (PDs) among insulin-dependent diabetic patients. MATERIAL AND-METHODS: The study subjects were selected from a group of 149 insulin-dependent diabetic patients and included 64 patients (39 men and 25 women) aged 30 years or older. Data were obtained from patient records and by clinical examination. The outcome variables were the number of sites with AL and PDs of 5-9 mm. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated using Poisson regression models. RR was adjusted for the number of teeth, dental calculus and age. RESULTS: RR for AL among the smokers was 4.15 (95% CI: 2.30-7.63) and that for PD among the smokers was 7.96 (95% CI: 4.91-13.19). HbA1c was not related to AL or PD. Among smokers with HbA1c > 8.5, RR for AL was 12.34 (95% CI: 4.14-39.35), but RR was not elevated for PD. CONCLUSIONS: It can be concluded that the poor metabolic control together with smoking is extremely detrimental for AL.     

Dietary and salivary factors associated with root caries

In this pilot study, dietary habits, microbial factors, and salivary factors in 20 older adults who had active decay on root surfaces were compared with those of 20 adults who had inactive or no root caries. In this case-control study, the groups were matched by sex and were of similar age. Subjects using medications known to induce dry mouth were excluded. Subjects completed a nutrition interview and a four-day food diary. Stimulated whole saliva flow rate, buffering capacity, levels of salivary lactobacilli with use of the Dentocult method, and S. mutans cultured on MSB agar were determined. The root caries group had a greater mean number of eating occasions per day (6.1 vs. 4.6), more frequent exposures to fermentable carbohydrates (5.8 vs. 4.2), and higher average daily sugars intake (133 g/day vs. 105 g/day) than the control group. Root caries subjects had significantly higher lactobacilli counts and less salivary buffering capacity. Within the root caries group, significant correlations were found with Root Caries Index and lactobacilli (r = 0.56) and S. mutans counts (r_S= 0.50). These results show that frequent intake of simple sugars, high lactobacilli counts, and low saliva buffering capacity may be risk factors associated with root caries in older adults.     

Dental caries increments and related factors in children with type 1 diabetes mellitus

The aim of this study was to analyse possible associations between caries increments and selected caries determinants in children with type 1 diabetes mellitus and their age- and sex-matched non-diabetic controls, over 2 years. A total of 63 (10-15 years old) diabetic and non-diabetic pairs were examined for dental caries, oral hygiene and salivary factors. Salivary flow rates, buffer effect, concentrations of mutans streptococci, lactobacilli, yeasts, total IgA and IgG, protein, albumin, amylase and glucose were analysed. Means of 2-year decayed/missing/filled surface (DMFS) increments were similar in diabetics and their controls. Over the study period, both unstimulated and stimulated salivary flow rates remained significantly lower in diabetic children compared to controls. No differences were observed in the counts of lactobacilli, mutans streptococci or yeast growth during follow-up, whereas salivary IgA, protein and glucose concentrations were higher in diabetics than in controls throughout the 2-year period. Multivariable linear regression analysis showed that children with higher 2-year DMFS increments were older at baseline and had higher salivary glucose concentrations than children with lower 2-year DMFS increments. Likewise, higher 2-year DMFS increments in diabetics versus controls were associated with greater increments in salivary glucose concentrations in diabetics. Higher increments in active caries lesions in diabetics versus controls were associated with greater increments of dental plaque and greater increments of salivary albumin. Our results suggest that, in addition to dental plaque as a common caries risk factor, diabetes-induced changes in salivary glucose and albumin concentrations are indicative of caries development among diabetics.     

Factors associated with caries incidence in an elderly population

The purpose of this paper was to identify baseline factors associated with future caries development in older adults (age 60) during a 3-year study period. Poisson regression analysis was used to determine the association between potential risk factors and disease incidence. The significant factors associated with high coronal caries incidence rates were high baseline root DMFS ( P < 0.001), high counts of mutans streptococci and lactobacilli ( P =0.036), male geder ( P =0.007), and Asian ethnicity ( P < 0.002). These factors had small to moderate effects on incidence rates, with relative risk values of approximately 1.2 to 2 The significant factors associated with higher disease incidence on root surfaces were baseline coronal DMFS (marginally significant, P =0.078), high bacterial counts ( P =0.002), and Asian ethnicity ( P =0.009). The predictive value of the models was low for both coronal and root caries. This result may be because this population had a higher than usual caries incidence rate, making discrimination among these caries-active individuals difficult. The current study affirmed the value of baseline DMFS and salivary variables to modeling caries incidence and introduced ethnicity as a variable useful for the study of dental caries in older adults.     

Caries in patients with non-insulin-dependent diabetes mellitus

Objective. The purpose of this study was to investigate the prevalence and risk factors of dental caries in patients with non-insulin-dependent diabetes mellitus and to determine whether these factors are associated with metabolic control and vascular complications of the disease.Study design. Both the occurrence of caries, acidogenic oral bacteria, and yeasts and salivary flow were studied in 25 patients with non-insulin-dependent diabetes mellitus whose diagnosis had been set 13 to 14 years earlier and in whom the metabolic evolution of the disease was well established. The patients' glycemic control was determined by means of analysis of the blood hemoglobin A_1C concentration at the time of dental examination. The control group consisted of 40 nondiabetic subjects in the same age group. Decayed, missing, and filled teeth indices and numbers of surfaces with caries, filled surfaces, and root caries were determined by means of clinical dental caries examination. Stimulated salivary flow was measured, and levels of Streptococcus mutans, lactobacilli, and yeasts were analyzed.Results. The median hemoglobin A_1C concentration of the patients was 8.6%, which indicates poor metabolic control of diabetes. No association was found between the metabolic control of disease and dental caries. The occurrence of dental caries was not increased in the patients with non-insulin-dependent diabetes mellitus in comparison with the control subjects. The counts of acidogenic microbes and yeasts did not differ statistically significantly between the groups. There was no association of caries with the prevalence of coronary artery disease or hypertension in either the patients or the control subjects. In a stepwise logistic regression model, a salivary flow of at least 0.8 ml/min was related to the occurrence of dental caries in patients with non-insulin-dependent diabetes mellitus, whereas negligence with respect to dental care was the most important risk predictor in the control group.Conclusion. Our results showed no effect of diabetes on the prevalence of caries. However, the caries-protective effect of saliva was partly lost in patients with non-insulin-dependent diabetes mellitus.     

Relationship of microbial and salivary parameters with dental caries in Brazilian pre-school children

Caries examination and collection of paraffin wax-stimulated saliva samples were performed in 37 children, 3-6 years old, in a child-care facility at the Vidigal slum, Rio de Janeiro, Brazil. The levels of mutans streptococci and lactobacilli in saliva were estimated by the Cariescreen and by the Dentocult tests and the saliva secretion rate was determined. Statistical analysis was performed on surface-based and patient-based caries prevalence rates (SBCPR and PBCPR), and related to bacterial and salivary parameters. The results show that 31 of the 37 children were caries active. The SBCPR for the primary dentition was 6.7% +/- 1.0%. Occlusal surfaces were the most affected by decay. Regression analysis revealed that mutans streptococci salivary levels were significantly associated with the SBCPR (P = 0.0001). Similarly, lactobacilli salivary levels were significantly associated with the SBCPR (P = 0.0001). No significant association could be found between the saliva secretion rate and the SBCPR. When regression analysis was used to model dependence of the SBCPR on both organisms, the mutans streptococci and lactobacilli salivary levels were significantly associated with the SBCPRs (P = 0.0021 and 0.0118, respectively), and salivary levels of these organisms accounted for 57% of the SBCPR variability. These findings indicate that the levels of mutans streptococci and lactobacilli in saliva are significantly related to the SBCPRs on the primary dentition of these children.     

Dietary and oral hygiene habits in children with type I diabetes mellitus related to dental caries

The aims of the study were to evaluate differences in dietary, oral hygiene habits and social class in children with Type I diabetes mellitus (DM), compared to non-diabetics, and to investigate relationship between selected caries-risk factors and caries experience in diabetics. MATERIAL AND METHODS: 70 children with Type I DM and 70 age- and sex-matched non-diabetic controls were included in the study. Metabolic control of diabetes was categorized into well- to- moderately-controlled and poorly-controlled groups based on glycosylated haemoglobin HbA1c. The study was based on the data obtained from the questionnaire including information about dietary and oral hygiene habits, pattern of dental visits and social class. Results showed that the diabetic children had more frequent main meals and less snacking than their controls: the mean number of main meals/day was 4.33 (SD = 0.93) in the diabetics, and 2.53 (SD = 0.85) in the controls. Significantly less diabetics (43%) used sweet drinks than their controls (79%). There were no differences according to the frequency of toothbrushing as well as frequency of dental visits between the diabetics and controls, however, significantly more diabetics reported that they never used dental floss than non-diabetics. There were no significant differences in the diet, toothbrushing frequency between the diabetics with different metabolic control. Multiple logistic regression analysis showed that among caries risk associated variables only age of children (OR = 1.98; CI = 1.23-3.19) and level of metabolic control of diabetes (OR = 4.65; CI = 1.28-16.89) were statistically significantly associated with high caries experience in the diabetics. CONCLUSIONS: Frequent consumption of sweet drinks and snacks can influence caries development in children. Amongst the diabetics, the differences in caries prevalence can be explained by combination of biological and behavioral factors rather than single dietary or oral hygiene elements.     

Nitric oxide modulates levels of salivary Lactobacilli

Abstract

Objective. Nitric Oxide (NO) is one of the most powerful antibacterial compounds. The aim of this study was to determine the association between salivary NO, dental caries and cariogenic bacteria. Materials and methods. The salivary NO concentration of 257 Korean children was analyzed by the Griess colorimetric reaction method. Salivary mutans streptococci (MS) and Lactobacilli (LB) were counted using the Dentocult MS and Dentocult LB kit, respectively. Dental caries status was examined using the WHO criteria. Confounders were age, gender, salivary flow rate and salivary buffer capacity. Analysis of covariance (ANCOVA) was used to evaluate the association among NO, salivary MS level, salivary LB level and dental caries status after adjusting for the effects of confounders. Results. A significant decrease was found in salivary NO levels as the salivary LB count increased after controlling for confounders (p = 0.049). However, the MS level, caries experience and active caries status showed no significant association. Conclusion. This result indicates that NO production might be a host defense mechanism against the growth of cariogenic bacteria.     

Dental findings in diabetic adults

The dental status of dentate diabetic adults (n = 299) and its associations with diabetes-related factors was explored in Tehran, Iran. Presence of diabetes-related complications made no difference in mean values of DMFT, but was associated with a higher number of decayed and missing teeth, and fewer filled teeth. Higher level of HbA1c was associated with higher DMFT for men, but not for women. In conclusion, the results suggest a possible association between the level of metabolic control of diabetes mellitus and cumulative caries experience.