Caries experience and gingival health in children and adolescents with type 1 diabetes mellitus-A cross-sectional study.

Abstract

AimTo investigate the oral health of children and adolescents with type 1 diabetes (T1D) and its associations with diabetes‐related and lifestyle factors.DesignCross‐sectional study at a large tertiary hospital pediatric diabetes clinic. Oral examination determined dental caries experience and gingival health. Secondary outcome measures included salivary characteristics, oral hygiene and dietary practices, and diabetes‐related factors.ResultsEighty children and adolescents with T1D participated; mean (SD) age and HbA1c were 13.4(2.6) years and 7.7(0.9)%, respectively. Forty‐seven (59%) participants had one or more decayed, missing or filled teeth; 75 (94%) participants had gingivitis. Half (50%) reported ≥3 hypoglycemic episodes necessitating rapid‐acting carbohydrate in the previous week. Sixty‐two participants (78%) had normal saliva flow, however, 42 (52%) had reduced salivary buffering capacity. Glycemic control (HbA1c) was not associated with caries experience, gingival health or salivary characteristics. Increased frequency of tooth brushing (OR, 0.11; 95%CI 0.01–0.97, p = 0.05) and interdental flossing (OR, 0.31; 95%CI 0.12–0.81, p = 0.02) were associated with lower caries experience. Interdental flossing (OR, 0.31; 95% CI 0.12–0.80, p = 0.02) and good oral hygiene (OR, 0.06; 95% CI 0.01–0.22, p < 0.001) were associated with less gingivitis.ConclusionPoor oral health is common in children with T1D, regardless of HbA1c. Given potential implications for short‐ and long‐term systemic health, this study demonstrates the need for targeted strategies to improve oral health in children with T1D.