Objectives: The purpose of the present study is to (1) evaluate the oral health-related quality of life (OHRQoL) among a group of Egyptian children and early adolescents with type-1 diabetes mellitus (T1DM) aged from 8 to 14 years and the impact of individual, environmental, oral health care and biological independent predictors (2) assess oral health status (OHS) in terms of oral hygiene, caries experience, untreated carious cavities and gingival condition.
Materials and methods: A case-control investigation conducted on eligible 444 participants who have been assigned into four groups (two case groups included 125 children and 97 early adolescents with T1DM and two matched control groups). The OHRQoL was measured using a validated structured CPQ8-10 for children and CPQ11-14 short-form questionnaires for early adolescents. The questionnaire comprised of four parts that represented the study independent variables. Descriptive data were analysed using Mann-Whitney U test for the non-parametric data. Pearson's correlations have been calculated to inspect the interrelation between metabolic disease control and study of different OHS representatives. Log-linear Poisson model regression analyses performed to determine associations between the OHRQoL and independent predictors.
Results: The prevalence of dental caries (DT ≥ 1) in children with diabetes was 49.6% (75.3%). The worse GI mean and median scores were recorded among early adolescents with T1DM [mean (SD) = 2.24 ± 0.61; median (IQR) = 2.3(1)]. The social well-being of CPQ domains was a prominent concern that negatively affected children and early adolescents' life aspects. A strong correlation between OHRQoL and the level of HbA1c in the two diabetic groups (r = 0.69 for children's group and 0.74 for the early adolescent group) was observed. The final model of log-linear Poisson regression analysis demonstrated that the odds ratio (OR) of poor OHRQoL among children and early adolescents with poor metabolic control was 1.30 [95% CI 1.18-1.47] and 1.22 [95% CI 1.11-1.38] times more than those with good metabolic control do.
Conclusions: The overall self-reported OHRQL appears to be adversely affected by T1DM especially among children and early adolescents with poor metabolic control. Socioeconomic status and oral health care demonstrate a significant impact on the OHRQoL; however, the effect was obvious in the diabetic and non-diabetic groups.
Clinical relevance: 1. In Egypt, the number of new cases rises progressively in a retrospective survey to figure out the prevalence of T1DM among children and adolescents. The available data is limited regarding the incidence and prevalence of dental caries and gingival condition among Egyptian children and early adolescents. 2. The present study is a premier study that assesses the OHRQoL and studies the impact of the individual, environmental, biological and oral health care variables. 3. This study highlights the urgent need for improving the oral health status of diabetic children and adolescents and the necessity for qualified oral health education programs for children and parents. There is an intense need to reinforce the role of preventive oral hygiene measures.
Keywords: Dental caries; Diabetes mellitus; Oral health; Quality of life.