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ElBshari S, Afrooz I, Beck RH, Watad R, Al-Qahtani N, Deeb A. Dental caries in children and adolescents with poorly-controlled diabetes: a case-control study. FRONTIERS IN ORAL HEALTH 2024; 5:1401485. [PMID: 39035710 PMCID: PMC11258009 DOI: 10.3389/froh.2024.1401485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/14/2024] [Indexed: 07/23/2024] Open
Abstract
The relationship between diabetes and dental caries remains uncertain. The main objective of this study was to quantify dental caries in children and adolescents with and without poorly-controlled diabetes to examine whether poorly-controlled diabetes influences caries prevalence and severity. This was a case-control study of children and adolescents with poorly-controlled diabetes and age-matched controls attending paediatric clinics at Sheikh Shakhbout Medical City, Abu Dhabi, UAE in August 2022. Dental caries was diagnosed by visual examination and dental probing to derive total number of decayed, missing, and filled tooth or surface (DMFT/DMFS) indices. Differences in caries metrics between subjects with diabetes and controls were assessed using chi-squared or Mann Whitney U-tests. Fifty-seven children and adolescents without diabetes and 42 with poorly-controlled (HbA1c ≥ 7.5) diabetes were recruited. The median (interquartile range, IQR) DMFT index was 4 (5) and the DMFS index was 4 (11). There were no significant differences in DMFT % [14.0 (21.5) vs.13.0 (20.0); p = 0.602], DMFT index [4 (5) vs. 3 (6); p = 0.749], nor DMFS index [5 (12) vs. 4 (11); p = 0.484] between patients and controls. Diabetes either has no effect on caries risk or its effect is so small that it is masked by dominant risk factors such as diet and obesity that require addressing through robust public health measures. While poor glycaemic control does not appear to influence caries risk, diet and obesity remain serious and addressable risk factors affecting oral health.
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Affiliation(s)
- Shahd ElBshari
- Dental School, Ajman University, Ajaman, United Arab Emirates
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Imrana Afrooz
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Rasha Hassan Beck
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
- Medical School, Gulf University, Ajaman, United Arab Emirates
| | - Rama Watad
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Nabras Al-Qahtani
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Asma Deeb
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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Triebl Z, Bencze B, Bányai D, Rózsa N, Hermann P, Végh D. Poor glycemic control impairs oral health in children with type 1 diabetes mellitus - a systematic review and meta-analysis. BMC Oral Health 2024; 24:748. [PMID: 38943074 PMCID: PMC11212250 DOI: 10.1186/s12903-024-04516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024] Open
Abstract
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.
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Affiliation(s)
- Zsuzsanna Triebl
- Diabetes-Dental Workgroup, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
| | - Bulcsú Bencze
- Diabetes-Dental Workgroup, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
- Department of Prosthodontics, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
| | - Dorottya Bányai
- Diabetes-Dental Workgroup, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
| | - Noémi Rózsa
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary
| | - Dániel Végh
- Diabetes-Dental Workgroup, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary.
- Department of Prosthodontics, Semmelweis University, Szentkirályi 47, Budapest, 1088, Hungary.
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Al-Dlaigan YH, Al-Dabaan RA. Dental health status of children with diabetes in Riyadh, Saudi Arabia. Saudi Dent J 2024; 36:926-931. [PMID: 38883900 PMCID: PMC11178960 DOI: 10.1016/j.sdentj.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 06/18/2024] Open
Abstract
Objective The impact of diabetes on oral diseases remains debatable. We aimed to determine the prevalence of dental caries, gingival health status and knowledge, and oral hygiene level and practice in children with type 1 diabetes mellitus in Riyadh, Saudi Arabia. Methods The teeth of Sixty children with diabetes (33 males and 27 females; age 11.3 ± 2.2 [7-14] years) were examined for dental caries following the modified World Health Organization criteria. Data on age, sex, medical history, gingival health status and knowledge, and oral hygiene level and practice were collected from parents. Results In this study, 53 % of the children had dental caries with decayed, missing, and filled primary and permanent teeth scores of 5.6 ± 3.8 and 3.6 ± 3.2, respectively, with similar scores for male and female children. Children with and without caries had similar oral hygiene practices and oral health knowledge but differed in the rates of good or fair oral hygiene status (89.2 vs. 56.6 %; P = 0.024) and normal gingival health status or mild gingivitis (96.5 vs. 81.3 %; P = 0.010). Conclusions We found that the oral hygiene status and rate of gingivitis differed in children with type 1 diabetes mellitus with or without dental caries.
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Affiliation(s)
- Yousef H Al-Dlaigan
- Division of Pediatric Dentistry, Department of Pediatric Dentistry and Orthodontics Sciences, College of Dentistry, King Saud University, P.O. BOX 60169, Riyadh 11545, Saudi Arabia
| | - Rasha A Al-Dabaan
- Department of Pediatric Dentistry and Orthodontics Sciences, College of Dentistry, King Saud University, P.O. BOX 60169, Riyadh 11545, Saudi Arabia
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Nassar M, Nassar O, Abosheaishaa H, Elhakim N. Association between type 1 diabetes mellitus and dental caries: A systematic review and meta-analysis. DENTISTRY REVIEW 2024; 4:100088. [DOI: 10.1016/j.dentre.2024.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
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Ribeiro TR, Silva SM, Martins RARC, Santos CF, Silva PGDB, Forti ACE, Costa FWG, Fonteles MC, Fonteles CSR. Salivary immunoglobulin levels and periodontal indices in Brazilian children with and without type 1 diabetes. Braz Oral Res 2024; 38:e043. [PMID: 38747830 PMCID: PMC11376677 DOI: 10.1590/1807-3107bor-2024.vol38.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/11/2023] [Indexed: 09/20/2024] Open
Abstract
This cross-sectional study evaluated the association between salivary immunoglobulins, plaque index, and gingival index in Brazilian children with and without type 1 diabetes mellitus (DM1). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the reporting of observational studies was followed. The DM1 group had 38 children, and an equal number of volunteers matched by sex and age were recruited as controls. Clinical examination was performed for plaque index and gingival index determination. Non-stimulated whole saliva was collected. Concentrations of IgA, IgG, and IgM were determined by ELISA test. Data were tested by the Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests and a multiple linear regression model (p<0.05) was performed. Gingival index was higher in the Control (DM1: 0.16±0.17; Control: 0.24±0.23, p=0.040). In DM1, there was a correlation between IgA and age (rho=0.371, p=0.024), IgM and IgG (rho=0.459, p=0.007), and IgM and gingival index (rho=0.394, p=0.014). In DM1, multiple linear regression showed that age (p=0.041; β=0.363), gingival index (p=0.041; β=0.398), and plaque index (p=0.008; β=-0.506) were good predictors of IgA levels in saliva. Thus, IgA was the only researched immunoglobulin that was directly associated with plaque and gingival indices in Brazilian children with DM1, but not in control subjects.
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Affiliation(s)
- Thyciana Rodrigues Ribeiro
- Universidade Federal do Ceará - UFC, School of Dentistry, Department of Clinical Dentistry, Fortaleza, CE, Brazil
| | - Sara Maria Silva
- Universidade Federal do Ceará - UFC, School of Dentistry, Department of Clinical Dentistry, Fortaleza, CE, Brazil
| | | | - Cláudia Ferreira Santos
- Universidade Estadual do Ceará - UFC, Higher Institute of Biomedical Sciences, Fortaleza, CE, Brazil
| | | | - Adriana Costa E Forti
- Universidade Federal do Ceará - UFC, Department of Clinical Medicine, Fortaleza, CE, Brazil
| | - Fábio Wildson Gurgel Costa
- Universidade Federal do Ceará - UFC, School of Dentistry, Department of Clinical Dentistry, Fortaleza, CE, Brazil
| | | | - Cristiane Sá Roriz Fonteles
- Universidade Federal do Ceará - UFC, School of Dentistry, Department of Clinical Dentistry, Fortaleza, CE, Brazil
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Association between Type 1 Diabetes Mellitus and Periodontal Diseases. J Clin Med 2023; 12:jcm12031147. [PMID: 36769794 PMCID: PMC9917782 DOI: 10.3390/jcm12031147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Gingivitis and periodontitis are chronic inflammatory diseases that affect the supporting tissues of the teeth. Although induced by the presence of bacterial biofilms, other factor, such as tobacco smoking, drugs, and various systemic diseases, are known to influence their pathogenesis. Diabetes mellitus and periodontal diseases correspond to inflammatory diseases that have pathogenic mechanisms in common, with the involvement of pro-inflammatory mediators. A bidirectional relationship between type 2 diabetes and periodontitis has been documented in several studies. Significantly less studies have focused on the association between periodontal disease and type 1 diabetes. The aim of the study is to analyze the association between periodontal status and type 1 diabetes mellitus. The "Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines" was used and registered at PROSPERO. The search strategy included electronic databases from 2012 to 2021 and was performed by two independent reviewers. According to our results, we found one article about the risk of periodontal diseases in type 1 diabetes mellitus subjects; four about glycemic control; two about oral hygiene; and eight about pro-inflammatory cytokines. Most of the studies confirm the association between type 1 diabetes mellitus and periodontal diseases. The prevalence and severity of PD was higher in DM1 patients when compared to healthy subjects.
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He I, Smart G, Poirier BF, Sethi S, Jensen ED. An update on dental caries in children with type 1 diabetes mellitus. PEDIATRIC DENTAL JOURNAL 2022. [DOI: 10.1016/j.pdj.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Assiri SA, El Meligy OAES, Alzain IO, Bamashmous NO. Assessment of dental caries and salivary characteristics among type 1 diabetic Saudi children. J Dent Sci 2022; 17:1634-1639. [DOI: 10.1016/j.jds.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 03/22/2022] [Indexed: 11/17/2022] Open
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Tabatabaei F, Mahjoub S, Alijanpour M, Moslemnejad A, Gharekhani S, Yavarzade F, Khafri S. Evaluation of the Relationship between Salivary Lipids, Proteins and Total Antioxidant Capacity with Gingival Health Status in Type-1 Diabetic Children. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:82-89. [PMID: 34150943 PMCID: PMC8206594 DOI: 10.30476/dentjods.2020.84180.1075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 04/26/2020] [Accepted: 08/02/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF THE PROBLEM Alteration in salivary composition and its effect on the oral cavity in diabetic child patients remains equivocal. PURPOSE This study was performed to assess the relationship between salivary factors and gingival status in children with type-1 diabetes mellitus (DM). MATERIAL AND METHOD In this cross-sectional study, 120 subjects aged 6-16 years (60 well-controlled and poorly-controlled diabetics and 60 healthy individuals) were examined to determine the gingival index (GI) and plaque index (PI). The unstimulated saliva samples were collected to measure the salivary triglyceride, cholesterol, albumin, α-amylase, total protein levels by the laboratory kits. Total antioxidant capacity and the free radicals scavenger index were measured by the Ferric Reducing Ability Of Plasma (FRAP) and 1,1-Diphenyl-2-picryl-hydrazyl (DPPH) assays, respectively. Data were analyzed by parametric and non-parametric, Pearson correlation, and t tests at a 5% error level. RESULTS GI of diabetics was significantly higher than that of healthy individuals (1.51± 0.71 and 0.9±0.81, respectively, p< 0.001). No significant difference was found between the PI of diabetics compared to healthy volunteers (1.59±0.69, 1.63±0.74, respectively). The levels of salivary triglyceride and cholesterol, albumin and total proteins in healthy subjects were significantly higher than that in people with DM (p< 0.001). A significantly more salivary α-amylase activity was found in diabetics compared to non-diabetics (p< 0.001). No significant differences were found between diabetic and non-diabetic subjects in terms of DPPH (95.5, 95.9%, respectively) and FRAP (9.77±0.13, 9.78±0.12 (µmol/mL), respectively). CONCLUSION More gingival inflammation and salivary α-amylase activity and lower level of salivary lipids, albumin, and total proteins were found in diabetic patients, but there was no association between the level of lipids, proteins, and the total antioxidant capacity of saliva with periodontal health indicators in patients with DM and healthy individuals.
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Affiliation(s)
- Fatemeh Tabatabaei
- Dental Student, Student's Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Soleiman Mahjoub
- Cellular and Molecular Biology Research Center, Health Research Institute, Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Morteza Alijanpour
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Amene Moslemnejad
- Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Samaneh Gharekhani
- Oral Health Research Center, Dept. of Pediatric Dentistry, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Forough Yavarzade
- Dental Student, Student's Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Soraya Khafri
- Biostatistics & Epidemiology, Medicine Faculty, Babol University of Medical Sciences, Babol, Iran
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Zainal Abidin Z, Zainuren ZA, Noor E, Mohd Nor NS, Mohd Saffian S, Abdul Halim R. Periodontal health status of children and adolescents with diabetes mellitus: a systematic review and meta-analysis. Aust Dent J 2021; 66 Suppl 1:S15-S26. [PMID: 33864280 DOI: 10.1111/adj.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 01/02/2023]
Abstract
Diabetes mellitus (DM) is a complex metabolic disease characterized by hyperglycaemia resulted from defects in insulin secretion or action, or both. Various studies have reported on the bidirectional relationship between DM and periodontal disease. A systematic search of the literature was performed in several databases, EBSCO Medline Complete, PubMed, Science Direct and a manual search for articles from 2000 until 2019. Literature that fulfilled the inclusion criteria were identified, and data measuring plaque index (PI), gingival index (GI), clinical attachment loss (CAL) and periodontal probing depth (PPD) were extracted and subjected to Random-effects meta-analysis. From 947 titles and abstracts screened, 11 articles were included for meta-analysis. It was found that PI, GI, CAL and PPD were significantly higher in DM children than in non-DM children according to the Standardized Mean different (SMD) and 95% confidence intervals (CI) (SMD 0.54, 95% CI 0.20-0.87, P = 0.002; SMD 0.63, 95% CI 0.39-0.87, P < 0.001; SMD 0.79, 95% CI 0.52-1.05, P < 0.001, SMD 0.67, 95% CI 0.23-1.11, P = 0.003, respectively). The meta-analysis showed significant differences in PI, GI, PD and CAL between the two groups, favouring non-DM children. Therefore, early detection of DM children with periodontal disease is crucial to prevent periodontal disease.
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Affiliation(s)
- Z Zainal Abidin
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, UniversitiTeknologi Mara (UiTM), Sungai Buloh, Malaysia
| | - Z A Zainuren
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, UniversitiTeknologi Mara (UiTM), Sungai Buloh, Malaysia
| | - E Noor
- Centre of Periodontology Studies, Faculty of Dentistry, Universiti Teknologi Mara (UiTM), Sungai Buloh, Malaysia
| | - N S Mohd Nor
- Paediatric Department, Faculty of Medicine and Institute for Pathology, Laboratory and Forensic Medicine (IPPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - S Mohd Saffian
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R Abdul Halim
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, UniversitiTeknologi Mara (UiTM), Sungai Buloh, Malaysia
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Jensen E, Allen G, Bednarz J, Couper J, Peña A. Periodontal risk markers in children and adolescents with type 1 diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev 2021; 37:e3368. [PMID: 32558110 DOI: 10.1002/dmrr.3368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Periodontal disease is a frequent complication of diabetes in adults, and both conditions are associated with systemic inflammatory states. This systematic review and meta-analysis was conducted to establish the relative severity of periodontal disease risk markers in children and adolescents with type 1 diabetes (T1D). METHODS A systematic search strategy using PubMed and EMBASE databases was performed to identify relevant studies assessing periodontal risk markers in children and adolescents and T1D through to February 2019. Eligible studies were assessed for quality and heterogeneity, and a random effects model was used to estimate differences in selected periodontal risk markers in children with T1D relative to healthy controls. RESULTS The search identified 551 studies from which 23 were found to meet the inclusion criteria. Random effects meta-analyses demonstrated that relative to healthy controls, children and adolescents with T1D had higher mean values for plaque index, gingival index, bleeding on probing, pocket depth and clinical attachment loss (all P < .001). CONCLUSIONS Risk markers for periodontal disease were found to be more pronounced among children and adolescents with T1D compared to healthy controls. Early referral of these at risk individuals for dental examination is recommended to allow for early intervention.
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Affiliation(s)
- Emilija Jensen
- Discipline of Paediatric Dentistry, University of Adelaide, Adelaide, South Australia, Australia
- Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Gabrielle Allen
- Discipline of Paediatric Dentistry, University of Adelaide, Adelaide, South Australia, Australia
- Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Jana Bednarz
- Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Jennifer Couper
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Department of Diabetes and Endocrinology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Alexia Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Department of Diabetes and Endocrinology, Women's and Children's Hospital, Adelaide, South Australia, Australia
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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. Clin Oral Investig 2020; 24:4033-4042. [PMID: 32468484 DOI: 10.1007/s00784-020-03273-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 04/04/2020] [Indexed: 12/11/2022]
Abstract
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.
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Al-Badr AH, AlJameel AH, Halawany HS, Al-Jazairy YH, Alhadlaq MK, Al-Maflehi NS, Al-Sharif JA, Jacob V, Abraham N. Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh, Kingdom of Saudi Arabia compared to non-diabetic children. Saudi Dent J 2020; 33:276-282. [PMID: 34194191 PMCID: PMC8236546 DOI: 10.1016/j.sdentj.2020.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. Methods The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. Results The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). Conclusion The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.
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Affiliation(s)
- Abid Hamoud Al-Badr
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Albandary Hassan AlJameel
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hassan Suliman Halawany
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Yousra Hussein Al-Jazairy
- Department of Restorative Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad Khalid Alhadlaq
- Department of Paediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nassr Saleh Al-Maflehi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Vimal Jacob
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nimmi Abraham
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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14
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Rapone B, Corsalini M, Converti I, Loverro MT, Gnoni A, Trerotoli P, Ferrara E. Does Periodontal Inflammation Affect Type 1 Diabetes in Childhood and Adolescence? A Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:278. [PMID: 32431669 PMCID: PMC7214631 DOI: 10.3389/fendo.2020.00278] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/14/2020] [Indexed: 01/26/2023] Open
Abstract
The emergence of link between periodontal disease and diabetes has created conditions for analyzing new interdisciplinary approach making toward tackling oral health and systemic issues. As periodontal disease is a readily modifiable risk factor this association has potential clinical implications. The aim of this paper was systematically review the extant literature related to analytics data in order to identify the association between type 1 diabetes (T1DM) in childhood and adolescence with periodontal inflammation. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a database search between 2004 and 2019. A manual search of the literature was conducted as an additional phase of the search process, with the aim of identifying studies that were missed in the primary search. One hundred and thirty-nine records were screened and 10 fulfilled the inclusion criteria. Most studies were of moderate methodological quality. Outcomes included assessments of diabetes and periodontal status. In diabetic populations, compared to healthy subjects, interindividual differences in periodontal status are reflected in higher severity of periodontal inflammation. The most reported barriers to evidence uptake were the intrinsic limits of cross-sectional report data and relevant research, and lack of timely research output. Based on the evidence presented within the literature, the aforementioned biomarkers correlate with poor periodontal status in type 1 diabetic patients. Whilst the corpus of the evidence suggests that there may be an association between periodontal status and type 1 diabetes, study designs and methodological limitations hinder interpretation of the current research.
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Affiliation(s)
- Biagio Rapone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, “Aldo Moro” University of Bari, Bari, Italy
- *Correspondence: Biagio Rapone
| | - Massimo Corsalini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Ilaria Converti
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, Bari, Italy
| | - Maria Teresa Loverro
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Antonio Gnoni
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, “Aldo Moro” University of Bari, Bari, Italy
| | - Paolo Trerotoli
- Medical Statistic, Department of Biomedical Science and Human Oncology, University of “Aldo Moro” Bari, Bari, Italy
| | - Elisabetta Ferrara
- Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, Chieti, Italy
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15
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The Influence of Type 1 Diabetes Mellitus on Dental Caries and Salivary Composition. Int J Dent 2018; 2018:5780916. [PMID: 30369949 PMCID: PMC6189668 DOI: 10.1155/2018/5780916] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/26/2018] [Indexed: 11/29/2022] Open
Abstract
Diabetes mellitus is the most common chronic disease that affects the oral health. The aim of the study is to evaluate the dental caries, salivary flow rate, buffer capacity, and Lactobacilli in saliva in children with type 1 diabetes mellitus compared to the control group. Methods. The sample consisted of 160 children of 10 to 15 years divided into two groups: 80 children with type 1 diabetes mellitus and 80 children as a control group. Dental caries was assessed using the DMFT index for permanent dentition. Stimulated saliva was collected among all children. Salivary flow rate and buffer capacity were measured, and the colonies of Lactobacillus in saliva were determined. The observed children have answered a number of questions related to their dental visits and parents' education. The data obtained from each group were compared statistically using the chi-square test and Mann–Whitney U-test. The significant level was set at p < 0.05. Results. DMFT in children with type 1 diabetes was significantly higher than that in the control group (p < 0.001). Diabetic children have a low level of stimulated salivary flow rate compared to control children (0.86 ± 0.16 and 1.10 ± 0.14). The buffer capacity showed statistically significant differences between children with type 1 diabetes and control group (p < 0.001). Also, children with type 1 diabetes had a higher count and a higher risk of Lactobacillus compared to the control group (p < 0.05 and p < 0.001). Conclusion. The findings we obtained showed that type 1 diabetes mellitus has an important part in children's oral health. It appears that children with type 1 diabetes are exposed to a higher risk for caries and oral health than nondiabetic children.
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