title: The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1.
abstract: OBJECTIVE
  To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM).
  
  
  METHODS
  A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR).
  
  
  RESULTS
  The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys.
  
  
  CONCLUSIONS
  Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow.
authors.affiliation: Departamento de Estomatologia, Universidade Federal do Paraná, Curitiba, PR, Brasil.
authors.forename: Vera Lúcia
authors.initials: VL
authors.lastname: Carneiro
authors.affiliation: Departamento de Estomatologia, Universidade Federal do Paraná, Curitiba, PR, Brasil.
authors.forename: Fabian Calixto
authors.initials: FC
authors.lastname: Fraiz
authors.affiliation: Departamento de Estomatologia, Universidade Federal do Paraná, Curitiba, PR, Brasil.
authors.forename: Fernanda de Morais
authors.initials: Fde M
authors.lastname: Ferreira
authors.affiliation: Departamento de Estomatologia, Universidade Federal do Paraná, Curitiba, PR, Brasil.
authors.forename: Tatiana Pegoretti
authors.initials: TP
authors.lastname: Pintarelli
authors.affiliation: Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Ana Cristina Borges
authors.initials: AC
authors.lastname: Oliveira
authors.affiliation: Departamento de Pediatria, UFPR, Curitiba, PR, Brasil.
authors.forename: Margaret Cristina da Silva
authors.initials: MC
authors.lastname: Boguszewski
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003731:Dental Caries; D003753:Dental Health Surveys; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000517:prevention & control; D005260:Female; D005884:Gingival Hemorrhage; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D009909:Oral Health; D011788:Quality of Life; D012472:Salivation / Q000502:physiology*; D012737:Sex Factors; D018709:Statistics, Nonparametric
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin