The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1

Arch Endocrinol Metab. 2015 Dec;59(6):535-40. doi: 10.1590/2359-3997000000117.

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).

Subjects and 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.

Conclusion: 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.

MeSH terms

  • Adolescent
  • Blood Glucose / analysis*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Dental Caries
  • Dental Health Surveys
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / prevention & control
  • Female
  • Gingival Hemorrhage
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Male
  • Oral Health*
  • Quality of Life
  • Salivation / physiology*
  • Sex Factors
  • Statistics, Nonparametric

Substances

  • Blood Glucose
  • Glycated Hemoglobin A