Oral hygiene in children with type I diabetes mellitus

Abstract

Oral hygiene is an important etiological factor related to oral health status in children. The aim of the study was to evaluate the oral hygiene status in children with type I diabetes mellitus (DM) and in their non-diabetic controls, and to correlate it with the health condition of the gingival tissues.

Materials and methods: Seventy 10-15 year-old children (mean age 13.6, SD=1.6) with type I DM and 70 their age and sex-matched non-diabetic controls were included in the study. The metabolic control of DM was categorized into well- to- moderately controlled and poorly-controlled diabetes groups based on glycosylated haemoglobin HbA1c. The oral hygiene and gingival status were assessed using the Simplified Oral hygiene index OHI-S (Greene-Vermillion) and gingival index GI (Löe-Silness), respectively. Student's t, Mann-Whitney U or chi-square tests and linear regression were used in the statistical analyses.

Results: There were no statistically significant differences in the mean values of OHI-S between the diabetics and non-diabetics, however the mean calculus index (CI-S) was significantly higher and the mean plaque index (DI-S) was significantly lower in diabetic subjects than non-diabetics (p<0.05). The children with type I DM had significantly higher mean values of GI compared with the non-diabetic subjects (0.15, SD=0.37 and 0.05, SD=0.19 respectively) (p<0.05). Healthy gingiva was recorded in 73% diabetics, and 87% of the non-diabetics (p<0.05). The poorly controlled diabetics had higher mean gingival, plaque, calculus indices than well-moderately controlled subjects, although the differences were not statistically significant. Statistically significantly higher mean OHI-S index was found in children with poor control of diabetes compared with the well-moderately-controlled diabetics (1.39, SD=0.75 and 1.07, SD=0.53, respectively) (p<0.05). The level of gingivitis statistically significantly correlated with the levels of calculus in both study groups (p<0.001). No difference in toothbrushing habits was revealed between the study subjects.

Conclusion: Despite similar oral hygiene habits, the children with type I DM were more prone to calculus accumulation which seemed to be a predisposing factor in development of gingivitis in these individuals.