Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

Stefano Lai,Gianfranco Meloni,Maria Grazia Cagetti,Dina Cossellu,Guglielmo Campus,Fabio Cocco,Peter Lingström,Susan R Rittling

doi:10.1371/journal.pone.0188451

Stefano Lai, Gianfranco Meloni + Show 6 more

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https://doi.org/10.1371/journal.pone.0188451

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Abstract

AimTo evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status.MethodsSixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4–14 years) were enrolled. The diabetic children were divided: a) 20 children in good metabolic control (Hb1ac≤7.5) and b) 48 children in bad metabolic control (Hb1ac>7.5). Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse.ResultsSugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively) and in subjects in bad metabolic control (p = 0.03 and p<0.01, respectively). Oral hygiene habits were similar, except for the use of fluoridated adjuvants, higher in non-diabetic children (p = 0.04). No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (p<0.01). Significant difference for the main cariogenic bacteria was found between diabetic and non-diabetic subjects (p<0.05). The pH values showed statistically significant differences between diabetic and non-diabetic subjects and between diabetic subjects in good and bad metabolic control (p<0.01).ConclusionsDiabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

Highlights

Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively) and in subjects in bad metabolic control (p = 0.03 and p
No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (p
Diabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk

Summary

Introduction

Diabetes mellitus is a chronic disease resulting from a relative or absolute deficiency of insulin, which affects the metabolism of carbohydrate, protein, and fat [1]. Tailored dietary advices are given to children and their families about the amount, type and distribution of carbohydrate to include in main meals and snacks (if appropriate) during the day to promote optimal growth and blood glucose control [7]. Dental caries remains one of the most common chronic disease with a dietary-bacterial aetiology [14]. Caries is characterized by an ecological shift within the dental biofilm environment, driven by frequent access to fermentable dietary carbohydrates, leads to a move from a balanced population of microorganisms of low cariogenicity to a microbiological population of high cariogenicity (more aciduric and acidogenic) and to an increased production of organic acids [15]. The acid production near the tooth structures produces the demineralization of enamel and dentin and subsequently may evolve in the development of a cavitation [16]

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