The prevalence of dental caries in 5 - 18-year-old insulin-dependent diabetics of Fars Province, southern Iran

Abstract

Background: The association of dental caries and diabetes mellitus has not received enough attention, in spite of the fact that both diseases are associated with the ingestion of dietary carbohydrates. This study was undertaken in Fars Province, southern Iran, to determine the prevalence rates of dental caries in a group of metabolically well-controlled patients with type I diabetes mellitus and in a control group.

Methods: Fifty patients (22 boys and 28 girls) with type I diabetes mellitus under follow-up of the Endocrinology and Metabolism Research Center of Shiraz University of Medical Sciences, with a mean +/- SD age of 11.72 +/- 3.36 years and mean +/- SD fasting blood sugar of 235.74 +/- 103.61 mg/dL, entered this study. A similar study was conducted to determine the prevalence of dental caries in 12-year-old school children in Shiraz, Iran who served as the control group. After completing a questionnaire, the patients were examined separately by two dentists. Before the clinical examination, bitewing radiographies were performed. Student's t- and Chi-square tests were used for statistical analysis in relation to sex, age of onset of diabetes mellitus, socioeconomic and nutritional status, family history of diabetes mellitus, and orohygiene status.

Results: The mean +/- SD DMFT for diabetic children was 9.64 +/- 4.64 (decayed = 8.12 +/- 3.90, missing = 0.62 +/- 1.34, and filling = 0.90 +/- 2.10). The lower permanent first molars were the most frequency decayed and the incisors were the healthiest teeth. DMFT score and the frequency of decayed teeth were higher in boys than in girls. However, the rate of filling and missing teeth were higher in girls. DMFT and the number of decayed teeth were higher in patients with poor oral hygiene. The number of healthy first permanent molars was much higher in the mixed dentition groups than in those with permanent teeth. A direct correlation was found between the health status of the first permanent molar tooth and having type I diabetes mellitus.

Conclusion: Oral hygiene was somewhat poorer in diabetic patients than in the control group. Regular dental check-ups for preventive measures such as fluoride therapy, fissure sealant, regular medical follow-ups for proper control of metabolic abnormalities to decrease occurrence of xerostomia, omission of cariogenic substances from dietary regimen, fluoridation of drinking water, and individual and group education of diabetic patients regarding proper dental hygiene are recommended.