Oral Health Implications and Dental Management of Diabetic Children
Sotiria Davidopoulou, Anna Bitzeni-Nigdeli, Chrysoula Archaki, Aristidis Arhakis
Keywords :
Children, Dental management, Diabetes mellitus type 1, Oral health
Citation Information :
Davidopoulou S, Bitzeni-Nigdeli A, Archaki C, Arhakis A. Oral Health Implications and Dental Management of Diabetic Children. Int J Clin Pediatr Dent 2022; 15 (5):631-635.
Aim: To review the effect of diabetes mellitus (DM) on the oral health status of children.
Background: Diabetes mellitus (DM) is one of the most severe chronic diseases in children and adolescents. It appears as type 1 DM and type 2 DM. Children are mainly diagnosed with type 1 DM. Genetic, as well as environmental factors, contribute to disease risk, indicating a multifactorial etiology. Early symptoms may vary from polyuria to anxiety or depression disorders.
Review results: A variety of signs and symptoms have been reported regarding the oral health of DM children. Both dental and periodontal health is compromised. Qualitative and quantitative changes in saliva have also been reported. Moreover, there is a direct effect of type 1 DM on oral microflora and increased sensitivity to infections. A variety of protocols have been developed regarding the dental treatment of diabetic children.
Conclusion: Children with diabetes, due to the increased risk of periodontal disease and dental caries, are recommended to follow an intensive prevention program and a diet with strict instructions.
Clinical significance: The dental care provided to children with DM should be personalized, and all patients should follow a strict program of reexaminations. Moreover, the dentist may evaluate oral signs and symptoms of inadequately controlled diabetes and, in coordination with the patient's physician, can play a crucial role in maintaining oral and general health.
Dileepan K, Feldt MM. Type 2 diabetes mellitus in children and adolescents. Pediatr Rev 2013;34(12):541–548. DOI: 10.1542/pir.34-12-541
Dabelea D. The accelerating epidemic of childhood diabetes. Lancet 2009;373(9680):1999–2000. DOI: 10.1016/S0140-6736(09)60874-6
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37(Suppl 1):S81–S90. DOI: 10.2337/dc14-S081
Mayer-Davis EJ, Lawrence JM, Dabelea D, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med 2017;376(15):1419–1429. DOI: 10.1056/NEJMoa1610187
Tuomilehto J, Ogle GD, Lund-Blix NA, et al. Update on worldwide trends in occurrence of childhood type 1 diabetes in 2020. Pediatr Endocrinol Rev 2020;17(Suppl 1):198–209. DOI: 10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetes
Norris JM, Johnson RK, Stene LC. Type 1 diabetes-early life origins and changing epidemiology. Lancet Diabetes Endocrinol 2020;8(3):226–238. DOI: 10.1016/S2213-8587(19)30412-7
Stankov K, Benc D, Draskovic D. Genetic and epigenetic factors in etiology of diabetes mellitus type 1. Pediatrics 2013;132(6):1112–1122. DOI: 10.1542/peds.2013-1652
Ziegler R, Neu A. Diabetes in childhood and adolescence. Dtsch Arztebl Int 2018;115(9):146–156. DOI: 10.3238/arztebl.2018.0146
Elamin A, Hussein O, Tuvemo T. Growth, puberty, and final height in children with type 1 diabetes. J Diabetes Complications 2006;20(4):252–256. DOI: 10.1016/j.jdiacomp.2005.07.001
Novotna M, Podzimek S, Broukal Z, et al. Periodontal diseases and dental caries in children with type 1 diabetes mellitus. Mediators Inflamm 2015;2015(51):379626. DOI: 10.1155/2015/379626
Díaz Rosas CY, Cárdenas Vargas E, Castañeda-Delgado JE, et al. Dental, periodontal and salivary conditions in diabetic children associated with metabolic control variables and nutritional plan adherence. Eur J Paediatr Dent 2018;19(2):119–126. DOI: 10.23804/ejpd.2018.19.02.05
Moreira AR, Passos IA, Sampaio FC, et al. Flow rate, pH and calcium concentration of saliva of children and adolescents with type 1 diabetes mellitus. Braz J Med Biol Res 2009;42(8):707–711. DOI: 10.1590/s0100-879x2009005000006
Siudikiene J, MacHiulskiene V, Nyvad B, et al. Dental caries increments and related factors in children with type 1 diabetes mellitus. Caries Res 2008;42(5):354–362. DOI: 10.1159/000151582
Bimstein E, Zangen D, Abedrahim W, et al. Type 1 diabetes mellitus (juvenile diabetes) - a review for the pediatric oral health provider. J Clin Pediatr Dent 2019;43(6):417–423. DOI: 10.17796/1053-4625-43.6.10
Hoseini A, Mirzapour A, Bijani A, et al. Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus. Electron Physician 2017;9(9):5244–5249. DOI: 10.19082/5244
Javed F, Sundin U, Altamash M, et al. Self-perceived oral health and salivary proteins in children with type 1 diabetes. J Oral Rehabil 2009;36(1):39–44. DOI: 10.1111/j.1365-2842.2008.01895.x
Malicka B, Skoskiewicz-Malinowska K, Kaczmarek U. Salivary lactate dehydrogenase and aminotransferases in diabetic patients. Medicine 2016;95(47):e5211. DOI: 10.1097/md.0000000000005211
Zalewska A, Knaś M, Kuźmiuk A, et al. Salivary innate defense system in type 1 diabetes mellitus in children with mixed and permanent dentition. Acta Odontol Scand 2013;71(6):1493–1500. DOI: 10.3109/00016357.2013.773071
Ferizi L, Dragidella F, Spahiu L, et al. The influence of type 1 diabetes mellitus on dental caries and salivary composition. Int J Dent 2018;2018(4):5780916. DOI: 10.1155/2018/5780916
Al-Khayoun JD, Diab BS. Dental caries, mutans streptococci, lactobacilli and salivary status of type 1 diabetic mellitus patients aged 18-22 years in relation to glycated haemoglobin. J Bagh College Dent 2013;25(1):153–158.
López del Valle LM, Ocasio-López C. Comparing the oral health status of diabetic and nondiabetic children from Puerto Rico: a case-control pilot study. P R Health Sci J 2011;30(3):123–127.
Siudikiene J, Machiulskiene V, Nyvad B, et al. Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease. Eur J Oral Sci 2006;114(1):8–14. DOI: 10.1111/j.1600-0722.2006.00277.x
El-Tekeya M, El Tantawi M, Fetouh H, et al. Caries risk indicators in children with type 1 diabetes mellitus in relation to metabolic control. Pediatr Dent 2012;34(7):510–516.
Groele L, Szajewska H, Szypowska A. Effects of Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 on beta-cell function in children with newly diagnosed type 1 diabetes: protocol of a randomized controlled trial. BMJ Open 2017;7(10):e017178. DOI: 10.1136/bmjopen-2017-017178
Siudikiene J, Maciulskiene V, Nedzelskiene I. Dietary and oral hygiene habits in children with type I diabetes mellitus related to dental caries. Stomatologija 2005;7(2):58–62.
Naing C, Mak JW. Salivary glucose in monitoring glycaemia in patients with type 1 diabetes mellitus: a systematic review. J Diabetes Metab Disord 2017;16(1):2. DOI: 10.1186/s40200-017-0287-5
Orbak R, Simsek S, Orbak Z, et al. The influence of type-1 diabetes mellitus on dentition and oral health in children and adolescents. Yonsei Med J 2008;49(3):357–365. DOI: 10.3349/ymj.2008.49.3.357
Rafatjou R, Razavi Z, Tayebi S, et al. Dental health status and hygiene in children and adolescents with type 1 diabetes mellitus. J Res Health Sci 2016;16(3):122–126.
Aral CA, Nalbantoğlu Ö, Nur BG, et al. Metabolic control and periodontal treatment decreases elevated oxidative stress in the early phases of type 1 diabetes onset. Arch Oral Biol 2017;82(Suppl 14):115–120. DOI: 10.1016/j.archoralbio.2017.06.009
Takahashi K, Nishimura F, Kurihara M, et al. Subgingival microflora and antibody responses against periodontal bacteria of young Japanese patients with type 1 diabetes mellitus. J Int Acad Periodontol 2001;3(4):104–111.
Preshaw PM, Alba AL, Herrera D, et al. Periodontitis and diabetes: a two-way relationship. Diabetologia 2012;55(1):21–31. DOI: 10.1007/s00125-011-2342-y
Lalla E, Cheng B, Lal S, et al. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol 2007;34(4):294–298. DOI: 10.1111/j.1600-051X.2007.01054.x
Popławska-Kita A, Siewko K, Szpak P, et al. Association between type 1 diabetes and periodontal health. Adv Med Sci 2014;59(1):126–131. DOI: 10.1016/j.advms.2014.01.002
Xavier AC, Silva IN, Costa Fde O, et al. Periodontal status in children and adolescents with type 1 diabetes mellitus. Arq Bras Endocrinol Metabol 2009;53(3):348–354. DOI: 10.1590/s0004-27302009000300009
Llambés F, Silvestre FJ, Hernández-Mijares A, et al. The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus. Clin Oral Investig 2008;12(4):337–343. DOI: 10.1007/s00784-008-0201-0
Mahalakshmi K, Arangannal P, Santoshkumari, et al. Frequency of putative periodontal pathogens among type 1 diabetes mellitus: a case-control study. BMC Res Notes 2019;12(1):328. DOI: 10.1186/s13104-019-4364-3
Rapone B, Corsalini M, Converti I, et al. Does periodontal inflammation affect type 1 diabetes in childhood and adolescence? A meta-analysis. Front Endocrinol 2020;11:278. DOI: 10.3389/fendo.2020.00278
Sharma M, Tiwari SC, Singh K, et al. Occurence of bacterial flora in oral infections of diabetic and nondiabetic patients. Life Sci Med Res 2011;1:1–6.
Ionescu O, Sonnet E, Roudaut N, et al. Oral manifestations of endocrine dysfunction. Ann Endocrinol 2004;65(5):459–465. DOI: 10.1016/s0003-4266(04)95952-5
Lal S, Cheng B, Kaplan S, et al. Accelerated tooth eruption in children with diabetes mellitus. Pediatrics 2008;121(5):e1139–e1143. DOI: 10.1542/peds.2007-1486
Pasquel FJ, Lansang MC, Dhatariya K, et al. Management of diabetes and hyperglycaemia in the hospital. Lancet Diabetes Endocrinol 2021;9(3):174–188. DOI: 10.13039/100000002
Nirmala SV, Saikrishna D. Dental care and treatment of children with diabetes mellitus - an overview. J Pediatr Neonatal Care 2016;4(2):00134. DOI: 10.15406/jpnc.2016.04.00134
Sadeghi R, Taleghani F, Mohammadi S, et al. The effect of diabetes mellitus type I on periodontal and dental status. J Clin Diagn Res 2017;11(7):ZC14–ZC17. DOI: 10.7860/JCDR/2017/25742.10153
AAPD Guidelines. Guideline on antibiotic prophylaxis for dental patients at risk for infection. Pediatr Dent 2016;38(6):328–333.