title: Type 1 diabetes mellitus and oral health: assessment of coronal and root caries.
abstract: OBJECTIVE
  The oral health of a large cohort of adult insulin-dependent diabetic patients (Type 1), diagnosed 24 years previously with juvenile onset, was comprehensively assessed. This paper describes the prevalence of coronal and root caries in this adult Type 1 diabetic population and evaluates demographic, dietary, behavioral, physiologic, salivary and medical variables associated with decayed and filled surfaces in the crown (DFS) or root (RDFS).
  
  
  METHODS
  Type 1 diabetes mellitus subjects participating in this oral health evaluation had been monitored for 6-8 years as participants in the University of Pittsburgh, Department of Epidemiology, longitudinal study of medical complications associated with diabetes. Four hundred and six diabetic subjects received a comprehensive oral health examination during one of their regularly scheduled medical visits. Oral assessments included coronal and root caries, missing teeth, edentulism, periodontal status, soft tissue pathologies, salivary function and health behaviors. Sixteen diabetic subjects and one control subject were edentulous. Coronal and root caries data from the remaining 390 dentate diabetic subjects were compared with 202 dentate nondiabetic control subjects.
  
  
  RESULTS
  The adult Type 1 diabetic subjects were not found to have significantly higher DFS rates as compared with our control subjects or published age-adjusted NHANES III findings. Both control and diabetic subjects had low decayed to filled tooth surface ratios. A linear regression model evaluated possible associations with coronal decayed and filled tooth surfaces (DFS) within the diabetic population. Significant factors included older age, women, fewer missing teeth, more frequent use of dental floss, more frequent visits to the dentist during the last 12 months, and diabetic nephropathy. The prevalence of RDFS was higher in the diabetic subjects as compared to recruited control subjects. Neither dietary behaviors nor glycemic control were found to contribute to coronal or root caries.
  
  
  CONCLUSIONS
  Factors associated with presence of coronal and root caries and fillings are discussed. Possible causes and implications for the association between DFS and diabetic nephropathy are provided.
authors.affiliation: Department of Dental Public Health, University of Pittsburgh, School of Dental Medicine, PA 15261, USA. PAM7@pitt.edu
authors.forename: P A
authors.initials: PA
authors.lastname: Moore
authors.forename: R J
authors.initials: RJ
authors.lastname: Weyant
authors.forename: K R
authors.initials: KR
authors.lastname: Etzel
authors.forename: J
authors.initials: J
authors.lastname: Guggenheimer
authors.forename: M B
authors.initials: MB
authors.lastname: Mongelluzzo
authors.forename: D E
authors.initials: DE
authors.lastname: Myers
authors.forename: K
authors.initials: K
authors.lastname: Rossie
authors.forename: H
authors.initials: H
authors.lastname: Hubar
authors.forename: H M
authors.initials: HM
authors.lastname: Block
authors.forename: T
authors.initials: T
authors.lastname: Orchard
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D015331:Cohort Studies; D004245:DMF Index; D003731:Dental Caries / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009909:Oral Health; D012044:Regression Analysis; D017213:Root Caries / Q000209:etiology; D016388:Tooth Loss / Q000209:etiology; D014987:Xerostomia / Q000209:etiology