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.     

An update on dental caries in children with type 1 diabetes mellitus

IntroductionType 1 diabetes mellitus (T1D) is a chronic autoimmune disease that commonly manifests in childhood as insulin deficiency and resultant hyperglycaemia. Improved understanding of the pathogenesis of T1D has occurred in recent decades and is currently considered to be complex interaction between an individual's genetics, environment, microbiome, and immune system. Oral complications of T1D include periodontal disease, xerostomia, and mucosal changes and early evidence suggesting an association with dental caries. Caries in children with T1D can lead to serious complications including poor sleep quality, reduced performance and attendance at school, and decreased oral intake.There is preliminary evidence suggesting that poorer glycaemic control is related to a higher experience of caries.Materials and methodsA crtical review of the literature was undertaken to hypothesise the pathogenesis and explore the presence of a potential relationship between T1D and caries.ConclusionChildren with T1D who have poorer glycaemic control face an increased risk of caries experience. Further research is required to determine if there is an association between glycaemic control and oral microbiota.     

Dental caries: age, income level and dental care

We have studied a population of 527 school children between 6 and 17 years old, having as main characteristic to have free odontological care. The prevalence of caries found was 40.4%. The age appears as a risk factor. However, we have not found any influence in the social status. The odontological care is considered essential in the decrease of prevalence of dental caries.     

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.     

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.     

Dental caries, sugar consumption and restorative dental care in12–13-year-old children in Riyadh, Saudi Arabia

A 3-day dietary history was obtained from 363 Riyadh schoolchildren aged 12-13 yr, after which their dentitions were examined for dental caries. About 16-31% of the children were caries-free and the mean DMFT varied between 1.67 and 2.43. However, in those with at least one tooth decayed, missing or filled, the mean DMFT remained constant at about 3, irrespective of age or gender; and most of the carious teeth were unrestored. There was a statistically significant relationship between DFS and the frequency of sugar consumption on the first 2 days of the dietary diary. It is suggested that the management of dental caries in the children must include the control of dietary sugar.     

Two-year longitudinal observations of salivary status and dental caries in children with insulin-dependent diabetes mellitus.

Salivary status and caries incidence were studied in 28 young, Type 1 diabetics from the onset of the disease and during a two-year period. Flow rate, buffer capacity, glucose content, total protein concentration and levels of mutans streptococci and lactobacilli were determined in stimulated whole saliva every third month. Dental caries was recorded at onset and then once a year. Forty-six per cent of the children developed caries during the observation period. Caries incidence was significantly higher (P less than 0.05) during the first year of diabetes, compared with the second. Caries-active children displayed significantly higher HbA1c levels (P less than 0.001), compared with caries-inactive diabetics. The number of salivary lactobacilli dropped significantly (P less than 0.05) during the first six months of the disease, while mutans streptococci levels remained unchanged during the study period. Salivary glucose concentration showed a considerable individual variation, but tended to be lower during the second year. The results suggest a possible relationship between Type 1 diabetes treatment and caries.     

Periodontal and caries experience in children with insulin-dependent diabetes mellitus

This study compared the periodontal and caries experience of young patients with insulin-dependent diabetes mellitus (IDDM) with a nondiabetic population of the same age. The plaque scores of children with IDDM were statistically higher. The caries experience of a child with closely monitored IDDM and a family history of diabetes was significantly lower than that of a child with IDDM and no such family history, even though the gingival and plaque indexes of both children were the same.     

Ethnic disparities in the prevalence of dental caries and restorative dental treatment in Brazilian children

Aim : This study assesses disparities in the oral health status of Brazilian black and white children. Participants : 11‐and 12‐year‐old schoolchildren living in 131 cities of the State of São Paulo, Brazil. Methods : Spatial data analysis of city‐level indexes of oral health, socio‐economic status and provision of dental services. Main outcome measures : Ethnic ratios of the DMFT and the care index. Results : White children had higher indexes of caries in permanent teeth than their black counterparts, concurrent with a higher utilisation of dental attendance. The gap of caries prevalence between black and white children was reduced in cities with a better profile of socio‐economic status. Cities with higher per‐capita yearly budget, expenditure in health, and provision of public dental services presented reduced indications of ethnic inequality in dental care. Conclusion : The knowledge of conditions associated with a lower ethnic discrepancy in the risk of caries and in the incorporation of dental services can be used to design socially appropriate dental services. An improved community dental service, higher public expenditure in health and per‐capita municipal yearly budget contribute effectively to reducing inequities in oral health by allowing an incorporation of restorative dental treatment more equitably distributed between black and white children.     

Serum fructosamine correlates with gingival index in children with insulin-dependent diabetes mellitus (IDDM)

Abstract Fructosamine assay, which is used in diagnosing and monitoring diabetic patients, is compared with the hemoglobin and plasma glucose assays in children and adolescent insulin-dependent diabetes mellitus patients. We demonstrated that the gingival index scores were correlated with fructosamine values in insulin-dependent diabetes mellitus patients but not in non-diabetic controls. We also found that there was no correlation between gingivitis scores and fasting plasma glucose and HbAlc values. Periodontitis was found to be rare in diabetic children and adolescents.     

Dental caries prevalence and dental health behaviour in HIV infected children

Objectives . To determine dental caries prevalence in a group of HIV positive children and their reported dental health behaviour.
Design . Standardized epidemiological dental examination and structured interview.
Setting . Paediatric HIV outpatient department in a South London hospital.
Study population . HIV-positive children attending the above outpatient clinic over a 6-month period (30 subjects) and parents (20 informants).
Methods . Epidemiological examination of children was undertaken by one trained and calibrated examiner to determine caries prevalence using dmft/DMFT. Parents were interviewed to obtain information on their children's dental health behaviour: tooth-brushing, diet, fluoride; oral medication and dental attendance were explored.
Results . Sixty-three per cent ( n  = 19) of children had dental caries experience, much of it untreated. Mean dmft/DMFT was 4·4. Sixty per cent ( n  = 18) of all children presented with active or untreated caries and the care index for those at/under age 5 years was low (10%). Unfavourable dental health behaviour included: consumption of nonmilk extrinsic sugars at night, use of sugar-based medications, low fluoride intake, late commencement of toothbrushing and poor dental attendance. Dental health was not considered a priority for many of these children. Parents did not necessarily disclose their child's HIV status on dental attendance.
Conclusion . Caries prevalence was high, much of the disease untreated, and unfavourable dental health behaviour, including the use of sugar-based medicines was common. HIV infected children should be considered a high caries risk and receive appropriate dental care, in terms of both treatment and preventive services, following confirmation of seropositivity.     

Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh,Kingdom of Saudi Arabia compared to non-diabetic children

ObjectiveThe aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters.MethodsThe study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant.ResultsThe mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04).ConclusionThe difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.     

Root surface and coronal caries in adults with type 2 diabetes mellitus

OBJECTIVES: To determine the effect of type 2 diabetes mellitus (DM) on coronal and root surface caries and to investigate some factors suspected of being related to or interacting with DM, that may be associated with coronal and root surface caries. METHODS: A stratified cross-sectional study was conducted in 105 type 2 diabetic patients and 103 non-diabetic subjects of the same age and gender. Coronal and root surface caries, exposed root surfaces, periodontal status, stimulated salivary functions, oral hygiene status, oral health behaviors, and counts of mutans streptococci and lactobacilli were measured. RESULTS: Type 2 diabetic patients compared with non-diabetic subjects had a higher prevalence of root surface caries (40.0% versus 18.5%; P = 0.001), a higher number of decayed/filled root surfaces (1.2 +/- 0.2 versus 0.5 +/- 0.1; P < 0.01) and a higher percentage of generalized periodontitis (98.1% versus 87.4%; P < 0.01); but the prevalence and decayed/filled surface of coronal caries was not significantly different (83.8% versus 72.8% and 8.0 +/- 9.4 versus 6.3 +/- 7.5 respectively). The factors associated with root surface caries included type 2 DM, a low saliva buffer capacity, more missing teeth, and existing coronal caries; whereas wearing removable dentures, more missing teeth, a high number of lactobacilli, and a low saliva buffer capacity were associated with coronal caries. CONCLUSION: Type 2 DM is a significant risk factor for root surface, but not for coronal caries. Periodontal disease should be treated early in type 2 diabetic subjects to reduce the risk of subsequent root surface caries.     

The treatment of periodontal and dental involvement in patients with diabetes mellitus type 1

The 3 years of out-patient dentist's follow-up of 86 patients aged 15 to 35 with type I diabetes mellitus are overviewed. In 98.8% of diabetic patients the periodontal diseases were detected. Characteristic features of periodontal diseases and dental caries are described along with the results of treatment and follow-up.