Periodontal health, dental caries, and metabolic control in insulin-dependent diabetic children and adolescents.

The purpose of this investigation was to examine the relationship between dental health and metabolic control in insulin-dependent diabetic children. Thirty diabetic children and adolescents (ages 4-19 years) were matched by age, sex, and race to 30 healthy children. Metabolic control was determined for each diabetic child by percentage of glycosylated hemoglobin, HbAI; 14 children were judged to be well controlled (HbAI < 10%); 16 were poorly controlled (HbAI > 10%). Plaque index, gingival index, loss of periodontal attachment, and presence of caries were recorded for each subject. Poorly controlled diabetic children displayed an increased plaque index. The gingival index of diabetics in poor control was significantly higher than that of healthy children. Prevalence of caries was the same for all children in the study. Despite the ubiquitous nature of the complications of insulin-dependent diabetes, relatively few studies have examined the complications of diabetes manifested in oral tissues of diabetic children. Dental disease in the diabetic child can increase the difficulty of maintaining metabolic control (Gottsegen 1983). Insulin-dependent diabetics with periodontal disease have been reported to have more hospital admissions and require more insulin than diabetics without periodontal disease (Williams and Mahan 1960). Diabetes appears to act as a modifying and probably accelerating factor in periodontitis (Gottsegen 1983). Diabetic children are reported to have an increased prevalence of periodontal disease.’ However, only one group of investigators has compared the prevalence of periodontal disease in poorly controlled and well controlled diabetic children (Gislen et al. 1980). The degree of diabetic control may influence the biological mechanisms which cause increased periodontal disease in diabetics. There is general agreement that diabetic subjects have the same caries prevalence as healthy controls ~ Bernick et al. 1975; Cianciola et al. 1982; Falconbridge et al. 1981; Ringelberg et al. 1975. (Gottsegen 1983). The diabetic child’s decreased daily intake of refined carbohydrate and the universal availability of fluoride have a protective effect against cariespromoting factors like increased salivary glucose and decreased flow of saliva. The purpose of the present study was to examine the relationship between dental health and metabolic control in diabetic children. Materials and Methods