Oral health status and impact on the oral health-related quality of life of Egyptian children and early adolescents with type-1 diabetes: a case-control study

Oral health status and oral health-related quality of life among children with type 1 diabetes mellitus in the age group of 11-14 years in Delhi-NCR Region

PURPOSE

The purpose of this study was to assess the impact of oral health status (OHS) and sociodemographic indicators on oral health-related quality of life (OHRQoL) among children with type 1 diabetes mellitus (T1DM) aged 11-14 years and compare it with age-matched nondiabetic children.

MATERIALS AND METHODS

This cross-sectional study included 80 children aged between 11 and 14 years with T1DM and 80 age-matched nondiabetic children. The OHRQoL was measured using a validated structured Hindi version of the child perception questionnaire (CPQ11-14) questionnaire. The clinical OHS was assessed using the decayed, missing, or filled teeth index, plaque index (PI), and gingival index (GI). Associations between OHRQoL and independent predictors were analyzed with the log-linear Poisson model regression method.

RESULTS

CPQ11-14 scores were significantly lower in nondiabetic children than diabetic children, indicating better OHRQoL among nondiabetic children than diabetic children (P ≤ 0.05). The GI score exhibited a significantly lower value in nondiabetic children than in diabetic children (P = 0.014). In contrast, the mean decayed, missing, and filled teeth score showed a significantly higher value in nondiabetic children than in diabetic children (P ≤ 0.001). There was no difference in the mean PI of diabetic and nondiabetic children (P = 0.096).

CONCLUSION

The result of the present study highlighted the detrimental effect of T1DM on OHRQoL in children.

Poor glycemic control impairs oral health in children with type 1 diabetes mellitus - a systematic review and meta-analysis

OBJECTIVE

There are more than one million children and adolescents living with type 1 diabetes mellitus, and their number is steadily increasing. Diabetes affects oral health through numerous channels, including hyposalivation, immune suppression, and the inflammatory effect of glycation end-products. However, patients with type 1 diabetes must follow a strict sugar free diet that is proven to be carioprotective. Therefore, the aim of this systematic review and meta-analysis is to investigate whether children with type 1 diabetes have a difference in Decayed, Missing, Filled Teeth index (DMFT), salivary function, and periodontal status than children without diabetes, with an emphasis on glycemic control.

MATERIALS AND METHODS

PubMed, Embase and Cochrane libraries were screened for articles, using predefined search keys without any language or date restrictions. Two independent authors performed the selection procedure, extracted data from the eligible articles, carried out a manual search of the reference lists, and assessed the risk of bias using the Newcastle-Ottawa scale. Meta-analysis was performed in R using the random-effects model. Effect sizes were mean differences; subgroup analysis was performed on glycemic control.

RESULTS

33 studies satisfied the eligibility criteria. 22 studies did not show a significant difference regarding the DMFT index between the diabetes and non-diabetes groups; six studies found that children living with diabetes had higher DMFT scores, compared to five studies that found significantly lower scores. Meta-analysis found no statistically significant differences in plaque, gingival, and calculus indexes, however it found significant differences in pooled DMFT indexes, and salivary flow rate. Subgroup analysis on glycemic control using DMFT values found significant differences in children with good and poor glycemic control with results of 0.26 (CI95%=-0.50; 1.03) and 1.46 (CI95%=0.57; 2.35), respectively.

CONCLUSIONS

Children with poor glycemic control face higher risk of developing caries compared to good control and non-diabetes children. Regular dental check-ups and strict control of glycemic levels are highly advised for children living with type 1 diabetes, further emphasizing the importance of cooperation between dentists and diabetologists.

Systems mapping of multilevel factors contributing to dental caries in adolescents

Dental caries is a prevalent chronic disease among adolescents. Caries activity increases significantly during adolescence due to an increase in susceptible tooth surfaces, immature permanent tooth enamel, independence in pursuing self-care, and a tendency toward poor diet and oral hygiene. Dental caries in permanent teeth is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades. Several conceptual and data-driven models have proposed unidirectional mechanisms that contribute to the extant disparities in adolescent dental caries experience. Our objective, using a literature review, is to provide an overview of risk factors contributing to adolescent dental caries. Specifically, we map the interactive relationships of multilevel factors that influence dental caries among adolescents. Such interactive multilevel relationships more closely reflect the complex nature of dental caries experience among the adolescent population. The methods that we use are two-fold: (1) a literature review using PubMed and Cochrane databases to find contributing factors; and (2) the system dynamics approach for mapping feedback mechanisms underlying adolescent dental caries through causal loop diagramming. The results of this study, based on the review of 138 articles, identified individual, family and community-level factors and their interactions contributing to dental caries experience in adolescents. Our results also provide hypotheses about the mechanisms underlying persistence of dental caries among adolescents.

Conclusions

Our findings may contribute to a deeper understanding of the multilevel and interconnected factors that shape the persistence of dental caries experience among adolescents.

Clinical Evaluation of CAD/CAM Ceramic Endocrown Versus Prefabricated Zirconia Crown in the Restoration of Pulpotomized Primary Molars: A Two-Year Spilt-Mouth Randomized Controlled Trial

Objectives  The current trial aimed to compare lithium disilicate (LS2) endocrowns' clinical performance, gingival health, and parental satisfaction to those of prefabricated zirconia crowns (ZCs) over a 24-month of follow-up.

Materials and Methods  This study designed as a spilt-mouth randomized controlled trial. A total of 88 pulpotomized mandibular second primary molars of 44 children were assigned into two equal groups. Forty-four molars were restored with prefabricated primary ZCs (control group) and the same number were restored with LS2 endocrown (intervention group). Clinical performance and gingival status were evaluated using a modified United States Public Health Service criterion, and plaque and gingival indices. Parental satisfaction was assessed using a 5-point Likert-scale questionnaire.

Statistical Analysis  Paired data were analyzed using McNemar's test, a statistical test used on paired nominal data, and paired t -tests. The significance level was set to 5% at 95% confidence interval.

Results  Both restorations showed comparable gingival health status over the follow-ups. Marginal adaptation of the endocrowns and ZCs at the end of follow-up was 95.5 and 90.9%, respectively ( p  = 0.68). For marginal integrity and discoloration, both restorations showed similar results at the follow-ups. The overall parental satisfaction of both groups was statistically insignificant ( p  = 0.07). However, parents were more satisfied with the endocrown color over that of the ZC ( p  < 0.05).

Conclusion  Endocrowns' clinical performance and gingival health were comparable to those of ZCs. For both restorations, parental satisfaction was nearly similar except for the color that showed an advantage in favor of the endocrowns.

Determinants of caries experience and the impact on the OHRQOL of 6-year-old Libyan children: a cross-sectional survey

Objective

The current study aimed to assess the caries experience and associated factors and its impact on the oral health-related quality of life (OHRQoL) among 6-year-old Libyan children.

Methods

A cross-sectional survey including 706 six-year-old children was conducted in 2017 in Benghazi, Libya. Data were collected through a self-administered questionnaire assessing socioeconomic status and oral health behaviours, and the Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) to assess the OHRQoL. Clinical examination assessed caries experience at tooth level (dmft) and the number of decayed, missing due to caries and filled teeth (dt, mt and ft). Poisson regression analysis was performed to determine the association between dmft scores and the independent predictors. Linear regression analysis was conducted for ECOHIS scores with the children’s gender, SES and OHB. The statistical significance was set to ≤  0.05.

Results

Data were available for 706 children. Caries prevalence (dt) and dmft of ≥ 1 were 69.1% and 71% respectively. The mean ± SD dmft score was 3.23 ± 3.32. There was a significant and direct association between dmft scores and daily consumption of sugary snacks (B = 1.27, P = 0.011) and a significant inverse association with teethbrushing twice daily (B = 0.80, P = 0.041). There was a significant and direct association between A-ECOHIS and dmft (B = 1.14, P ≤ 0.001) and a significant and inverse association between A- ECOHIS and high and intermediate family income compared to low income (B = −3.82, P = 0.0001 and B = −2.06, P = 0.028).

Conclusions

6-year-old Libyan children had a relatively high caries experience an untreated decay with impact on OHRQoL. Social disparities, sugar consumption patterns and oral hygiene practices were associated with high caries experience.