Caries incidence in young type 1 diabetes mellitus patients in relation to metabolic control and caries-associated risk factors.
The aim of this study was to evaluate the caries incidence in a group of young patients with type 1 diabetes mellitus over a 3-year period from the onset of the disease in relation to metabolic control and to caries-associated risk factors. Sixty-four children and adolescents (8-15 years of age) had their diabetes treated and monitored according to a standard medical protocol and received extensive preventive oral health care based on individual needs. Data on blood glucose and glycosylated haemoglobin (Hb A(Ic)) were collected from the medical records. Whole saliva was collected every 3rd month and secretion rate, buffer capacity, glucose concentration, mutans streptococci and lactobacilli counts were determined. Dental examinations, including radiographs, were carried out once a year. Patients with less good metabolic control (>8.0% Hb A(Ic)) exhibited higher glucose levels in resting saliva (p < 0.05) and a significantly higher caries incidence (p < 0.05) compared to those with good metabolic control. The most influential determinants for high caries development during the 3-year follow-up period were metabolic control (odds ratio, OR = 5.7), poor oral hygiene (OR = 6.5), previous caries experience (OR = 5.3) and high levels of salivary lactobacilli (OR = 5.0). The findings suggest that the level of metabolic control and traditional caries risk markers are important factors for caries development in children and adolescents with type 1 diabetes mellitus.
Twetman
S
S
Paediatric Dentistry and Cariology, Department of Odontology, Umeå University, Sweden. svante.twetman@odont.umu.se
Johansson
I
I
Birkhed
D
D
Nederfors
T
T
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002021:Buffers; D002648:Child; D015169:Colony Count, Microbial; D004245:DMF Index; D003731:Dental Caries / Q000000981:diagnostic imaging; D003733:Dental Caries Susceptibility; D003774:Dental Plaque Index; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007778:Lactobacillus / Q000254:growth & development; D008297:Male; D016017:Odds Ratio; D009910:Oral Hygiene; D016300:Radiography, Bitewing; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry / Q000378:metabolism / Q000382:microbiology / Q000502:physiology; D012636:Secretory Rate; D013223:Statistics as Topic; D013295:Streptococcus mutans / Q000254:growth & development
D001786:Blood Glucose; D002021:Buffers; D005947:Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin