Clinical and microbial oral health status in children and adolescents with type 1 diabetes mellitus

Int Dent J. 2020 Apr;70(2):136-144. doi: 10.1111/idj.12530. Epub 2019 Dec 23.


Objectives: To study the oral health of young individuals with controlled and uncontrolled type 1 diabetes mellitus (T1DM) and compare the results with those for healthy counterparts.

Materials and methods: One-hundred and forty-four youngsters (6-15 years of age) were assigned, according to glycaemic control, to three study groups: (i) diabetic patients with poor glycaemic control [glycated haemoglobin (HbA1c ≥7.5%)] (n = 35); (ii) diabetic patients with good glycaemic control (HbA1c <7.5%) (n = 39); and (iii) healthy individuals (n = 70). Plaque, gingival inflammation, calculus and decayed, missing and filled surfaces (DMFS) indices were recorded. Salivary parameters were determined, and stimulated saliva was collected to allow detection and determination of the levels of oral Candida albicans and Streptococcus mutans by real-time polymerase chain reaction (PCR).

Results: Significantly different amounts of plaque were found among the study groups (P = 0.024): youngsters with poor glycaemic control had significantly more plaque than youngsters in the other two groups. The gingival, calculus and DMFS indices were not significantly different among groups (P > 0.05). Candida albicans levels were not statistically significant different among groups, but the group with poor glycemic control showed an elevated frequency of detection. Streptococcus mutans was isolated from the oral cavity of 96 of the 144 individuals. A statistically significant difference in the level of S. mutans was found between the group with poor glycaemic control and the healthy control group (P = 0.032).

Conclusions: The results imply that youngsters with T1DM have a lower level of oral hygiene and are potentially at a higher risk of future oral disease, particularly when their metabolic disorder is uncontrolled. However, factors outside the oral cavity may also have a considerable impact on the initiation and progression of oral diseases.

Keywords: Candida albicans; Streptococcus mutans; Children; oral health status; type 1 diabetes mellitus.

MeSH terms

  • Adolescent
  • Child
  • Diabetes Mellitus, Type 1*
  • Glycated Hemoglobin A
  • Humans
  • Oral Health
  • Oral Hygiene
  • Saliva
  • Streptococcus mutans


  • Glycated Hemoglobin A