Background: Obese children with and without Type 2 diabetes have periodontal disease that relates to systemic inflammation. There is limited data on periodontal disease in children with Type 1 diabetes (T1D).
Aim: We aimed to assess periodontal disease markers and its determinants in children and adolescents with T1D.
Materials and Methods: Cross-sectional study including 73 children with T1D (34 males, mean age 13.7 ± 2.6) years) were recruited consecutively from paediatric diabetes clinics at the Women's and Children's Hospital (Adelaide, South Australia) for a comprehensive oral health assessment and collection of two gingival swabs for salivary microbiome analysis. Periodontal health parameters using plaque index, gingival index, bleeding on probe index and periodontal pocket depth were measured. Orthopantomogram and bitewing radiographs were taken. Clinical data included diabetes duration, insulin regimen, HbA1c and body size measurements.
Results: Children with T1D had mean ± SD diabetes duration 5.7 ± 4.0 years, total daily insulin dose 0.73 ± 0.30 units/kg/day, body mass index 22.2 ± 3.9 kg/m2, median [Range] HbA1c 8.2 [5.8-13.3]% and 29/73 were using continuous subcutaneous insulin infusion. None of the children had clinical background diabetic retinopathy or microalbuminuria; or were taking angiotensin converting enzyme inhibitors or statins. Four had celiac disease and 2 had hypothyroidism.
The average plaque index was 0.93 ± 0.52, gingival index was 0.68 ± 4.3, percentage of bleeding on probing sites 22.2 ± 19.4%. The presence of periodontal disease by presence of a periodontal pocket depth greater than 3mm occurred in 37/73 (51%) of the children examined. Children with HbA1c ≥ 8.2 % [n=38] compared to those with HbA1c < 8.2% [n=35] had significantly higher markers of periodontal disease: plaque index (1.11± 0.5 vs 0.7 ± 0.5, P=0.02), gingival index (0.81±0.42 vs 0.55±0.42, P=0.01) and percentage of bleeding on probing sites (29.0 ± 20.3% vs 15.0 ± 15.6%, P= 0.001).
Conclusions: About one half of the children and adolescents with T1D had early periodontal disease, which was more marked with poorer metabolic control. Dental management should include routine periodontal assessment and education in children and adolescents with T1D.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology