Periodontal disease is defined as inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss. It results from an extension of inflammation from the gingiva into deeper periodontal tissue. Periodontal disease is well studied among the adult population. Diabetes mellitus is considered as one of its risk factors among adults. We conducted this cross-sectional pilot study to investigate the association of periodontal disease and metabolic control among children with type one diabetes mellitus T1DM. We looked into the association between periodontitis and other variables including age, sex, BMI, duration of T1DM, number of DKA admissions, consumption of fizzy drinks, fruits and vegetables; as well as brushing of teeth and vitamin D status among children with T1DM. The study was conducted on children 6 14 years of age attending the diabetic clinic at KAH Alahsa, Saudi Arabia with specific inclusion and exclusion criteria were.
Patients were assessed by Pediatric endocrinologist at outpatients' clinic; and Pedodontists at the dental clinic who assessed them in 1-3 sessions using Gingival Index scoring tool as well as Plaque Index score Pocket depths 'WHO' periodontal examination probe.
Results: showed that out of 81 children enrolled in the study: 29 dropped off. There were 25 boys and 27 girls. 37% of the 52 children had moderate and severe gingival inflammations. 48% had sub-gingival plaque and calculus deposits. 29% had pocket depths greater than 3 mm. The gingival and plaque index scores were both moderately correlated with the HbA1c. The correlation of average HbA1c and GI Score after controlling for other variables was not statistically significant p = 0.07.
We concluded that: The findings of this pilot study indicate that children with T1DM have an actual gingival disease that predisposes them to future periodontitis. Dental examination, although it is not part of the standard care, it is important to take history and examine the mouth of children with T1DM by pediatricians and early referral to a dentist if concerned. Strict oral hygiene practices, and patient and family education are essential, which all could reverse the gingivitis and eliminate the risk of progressing to chronic periodontal disease. There is a gap of knowledge in this interesting research area. A large size-randomized controlled study is required to further elucidate the association between periodontal disease and metabolic control among children and adolescents with T1DM.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology