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Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research

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Open Access   Full Text Article                                                                                                                                                Review Article

Association Between Type 1 Diabetes Mellitus and Dental Caries in Children: A Systematic Review

Hendry Boy *, Risda Alvia

Department of Dental Health, Health Polytechnic of Jambi, Indonesia

 

 

Introduction

Diabetes mellitus is one of the chronic diseases that the prevalence keeps increasing, not only in adults but also in children. Diabetes mellitus type 1 is the most common type that occurs in children. It is characterized by the failure of insulin production by the pancreas, which causes chronic hyperglycemia. Condition hyperglycemia This can cause various complications, one of them is enhancement risk incident caries tooth ¹.

Dental caries are disease infections caused by metabolizing bacteria Streptococcus mutans and Lactobacilli carbohydrates become acid, which then damages tooth enamel ². Children with diabetes mellitus risk more tall experiencing caries tooth for several reasons. First, levels of high glucose in the blood can increase the rate of glucose in saliva, creating more environment conducive to the growth of bacteria. Second, diabetes mellitus can influence the flow and composition of saliva, reducing effect saliva's protective effect on teeth ^3,4.

This matter is caused by the influence of hyperglycemia's chronic effects on oral flora and salivary function, as well possibility of changing patterns of eating and habits of clean mouth in children with diabetes. Additionally, control of poor glycemia in children with diabetes mellitus relates to the high incidence of caries ^5,6.

Diabetes can cause changes in saliva composition and flow. Saliva works important in guarding the healthy tooth by neutralizing acid and providing minerals for the remineralization of tooth enamel. Decline frequent flow of saliva (xerostomia). Experienced by diabetics, which causes condition mouth to become more dry and vulnerable to caries^7,8.

Studies emphasize the importance of monitoring a healthy mouth in a way periodically in children with diabetes mellitus, as well as necessary intervention more prevention intensive to reduce the risk of caries. Therefore that is important for power medical and elderly to understand the connection between diabetes mellitus and caries tooth to increase the quality of life for children suffering from diabetes mellitus.

Methods

This research method is a systematic review that is carried out systematically using the Preferred Reporting Items for Systematic Reviews and Metanalysis method (PRISM). Search review studies through Pub Med, Proquest, Cochran, and Wiley databases, in English. Keywords Diabetes Mellitus and dental caries. The strategy used in the search for articles using the Picos Framework consists of

1. Population: children with diabetes Mellitus type I or diabetes Mellitus type II for at least a year
2. Intervention: deft or DMF-T 
3. Result: Children with Diabetes Mellitus had a higher risk of dental caries 
4. Study design is the research design used in the articles reviewed, namely: cross-sectional and observational study from January 2019 to June 2024

 

 

 

An article search was carried out according to keywords and inclusion criteria, there were 1700 articles found but after evaluation 50 articles met the inclusion criteria. Then 4 articles are rated quality, which can be seen in Chart 1

 

 

 

 

 

 

Table 1: Summary Of Results for A Systematic Review 

 

 

This study included 4 articles in the analysis the features outlined in Table 1, provide a comprehensive summary of the reason for dental health in individuals 6-18 years old with Diabetes Mellitus Type II and Type II and who had dental caries. 

Review results from 4 journals showing Diabetes Mellitus type I and type II have a significant relationship with the number of incident caries. Children with Diabetes have a higher risk higher for those affected by Caries compared with children who don't have a history of illness caries

Discussion

Dental caries is a problem with significant health outcomes in children and their prevalence is high in various countries, including Indonesia. Diabetes in children also shows enhancement prevalence, and conditions This can worsen the risk happen caries tooth. Therefore that is important to increase awareness about the connection between diabetes and a healthy mouth, as well importance guard a clean mouth and good diabetes control to prevent Health.

Consumption of foods and drinks that are high in sugar can increase the risk of caries Because bacteria inside the mouth ferment the sugar to become acid that damages the tooth enamel ⁹. Children with diabetes predisposed own rate more glucose tall in their saliva. High glucose This can become a source of nutrition for bacteria cariogenic like Streptococcus mutants, which contribute to the formation of plaque and acids that damage tooth enamel ¹⁰.

Children with diabetes and the elderly must be given education about the importance guard cleanliness good mouth and live inspecting teeth in a way routine. Education This covers technique brushing correct gear, usage of thread teeth, and a healthy diet that is low in sugar. Children with diabetes and the elderly must be given education about the importance guard cleanliness good mouth and  inspecting teeth in a way routine. Education This covers technique brushing correct gear, usage of thread teeth, and a healthy diet that is low in sugar ¹¹

The result of a systematic review of 4 articles on children who have diabetes mellitus against the number of incident caries. Journal with sample study as many as 400 children aged 6-18 years who have diabetes disease outcome show me that the prevalence of teeth with dental caries among non-diabetic subjects was found to be 87% (350) whereas among diabetic subjects, it was found to be 93% (371). The prevalence of teeth without dental caries was found to be 13% (50) among non-diabetic subjects whereas among diabetic subjects, it was found to be 7% (29).

The results of research conducted by Pachonski in Polan show that The DMFT index was used to determine the level of dental caries among the participants of the study. The highest DMFT value (14) was observed in the children with diabetes mellitus group. In the WC and group control, the highest DMFT values were 11 and 9, respectively. The lowest value in all studied children was 0. Statistical analysis - sis revealed a significant difference between the DMFT values in the PC and WC groups (post-hoc test p = 0.04). The Average value in the group child with diabetes is 5.80 while in the control group, it is 3.88 ⁵.

Research Gunasekaran in Melbourne, Australia 2022 shows result that Over half, 47/80 (58.7%) of the participants experienced dental caries. When early lesions were excluded, 20/80 (25.0%) of participants had advanced carious lesions for nine participants, of whom five had carious lesions extending radiographically into dentine. Caries prevalence across the different age groups were: 8–10 years (9/11, 81.8%), 11–14 years (25/41, 61.0%), and the 15–18 years (13/28, 46.4%) age groups. Half (40/80) of the participants reported hypoglycemic episodes at least three or more times-a- week, requiring home management with rapid-acting carbohy- drates. More than half of the children 43/76 (56.6%) consumed sweets and candies several times a week or more, and 41/78 (52.6%) consumed sweet cakes and biscuits several times a week or more. A total of 24/80 (30.0%) parents reported regularly giving additional snacks either before bed or overnight to prevent a hypoglycemic episode from occurring.

The research by Awad showed that a significant increase in the prevalence of permanent dental caries (DMFT-index) was observed during the adolescence period (P=0.001), in children with longer T1DM duration (>5 years) compared to those with diabetes duration 0.5-2 years (P=0.019) and in children with poor compared to those with good glycemic control (P=0.028). A significant increase in the prevalence of primary dental caries (dft-index) was observed in children with earlier onset of T1DM (before six years of age) compared to those with age at onset of T1DM between 6-12 years (P=0.004) and in children with good compared to those with poor glycemic control (P=0.010).

Correlation analyses revealed that the patient´s age was positively correlated with SSFR, DMFT, and GI. There was a significant positive correlation between GI and age at T1DM onset and between DMFT and both T1DM duration and HbA1c level. The dft- index was negatively correlated with the patient´s age, age at onset and duration of T1DM, and HbA1c level. Among oral health-related variables, there was a significant positive correlation between OHI-S and GI and a significant negative correlation between the dft-index and both SSFR and DMFT¹²

Conclusions 

The result of the review article shows that Diabetes mellitus is a risk factor for oral health. Diabetes Mellitus had a significant correlation with dental caries in children.

Conflict of Interest: The authors declare no potential conflict of interest with respect to the contents, authorship, and/or publication of this article.

Author Contributions: All authors have equal contribution in the preparation of manuscript and compilation.

Source of Support: Nil

Funding: The authors declared that this study has received no financial support.

Data Availability Statement: The data supporting in this paper are available in the cited references. 

Informed Consent to participate: Not applicable.

Ethics approval: Not applicable.

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