Sistema Endocrino

Yonsei Med J 49(3):357 - 365, 2008 DOI 10.3349/ymj.2008.49.3.357

Original Article

The Influence of Type-1 Diabetes Mellitus on Dentition and Oral Health in Children and Adolescents
Recep Orbak,1 Sera Simsek,2 Zerrin Orbak,3 Fahri Kavrut,1 and Meltem Colak4
Departments of 1Periodontology, 2Pedodonti, 4Endodontics, Faculty of Dentistry and 3Pediatrics, Faculty of Medicine, AtaturkUniversity, Erzurum, Turkey.

Purpose: The present study is to investigate the effects of type 1 diabetes mellitus on dentition and oral health for children and adolescents. Materials and Methods: The investigation was carried out on 100 subjects. The first group consisted of 50 subjects with type 1 diabetes mellitus (21 females, 29 males), age 9 ± 0.14 years; In the second group, there were 50 healthysubjects who did not suffer from any systemic disease (25 females, 25 males), age 9 ± 0.11 years. The subjects were evaluated and divided into two groups of 5 - 9 years old, and 10 - 14 years old. The dentition of all participants was examined. Besides, the DFS/dfs index, oral hygiene conditions were evaluated, as well as the plaque index (PI), gingival index (GI) and calculus index (CI). The dataobtained from each group were compared statistically. Results: When compared to the non-diabetic group, we observed that dental development was accelerated until the age of 10 in the diabetic group, and there was a delay after the age of 10. The edentulous interval was longer in the group with type 1 diabetes mellitus. This was accompanied by a high ratio of gingival inflammation. Gingivalinflammation was 69.7% in the group of 5 - 9 year-old, and 83.7% in the group of 10 14 year-old with type 1 diabetes mellitus. Though there was a greater loss of teeth in the group with type 1 diabetes mellitus, there were more caries in the control group. The PI, GI and CI values showed an increase with aging in favor of the group with type 1 diabetes mellitus. There was statistically significantdifference in PI, GI and CI between the control and type 1 diabetes mellitus groups for 10 - 14 year-old patients (p < 0.001). Conclusion: The findings we obtained showed that type 1 diabetes mellitus plays an important part in the dentition and oral health of children and adolescents. Key Words: Type 1 diabetes mellitus, dentition, oral health

INTRODUCTION
Diabetes mellitus (DM) is a metabolicdisease leading to abnormal fat, carbohydrate, and protein metabolism.1,2 Two basic types of primary diabetes mellitus have been described: insulin-dependent diabetes mellitus (IDDM; type I) and noninsulin-dependent diabetes mellitus (NIDDM; 3 type II). The prevalence of type 1 diabetes mellitus exhibits a wide range, as great as 20 - 60 times, in 4 separate geographic populations. According to dataof World Health Organization DIAMOND Project Group, while the incidence of type 1 diabetes mellitus was low in Asia and South America, it was high in Europe.5 In addition, the incidence rate is currently increasing in Europe.6 The prevalence of Type 1 Diabetes Mellitus was found to be 0.09 per 1000 in Japan and, 1.91 per 1000 in Finland.5,7 It was reported to be 0.27 per 8 1000 in Turkey. The maincomplications of diabetes mellitus affect the organs and tissues rich in capillary vessels, such as the kidney, retina and nerves. These complications are secondary to the development of microangiopathy.9 Similar changes in small vessels can be found in the oral tissues.10,11 Periodontal disease has also been recognized as the sixth leading complication of 12 diabetes. All of these long-termconsequences have been widely studied in recent years, and this has led to improvements in disease prevention and effective therapy, thus giving patients with diabetes a better quality of life.6 The influence of diabetes on the risk of developing periodontal disease has been the subject of
Yonsei Med J Vol. 49, No. 3, 2008

Received January 3, 2003 Accepted June 3, 2004 Reprint address: requests...