Diabetes Mellitus (DM) is one of the diseases that affects the metabolism of human body at many levels. This disease is characterized by increasing the concentrations of glucose in blood, abnormalities in protein, and lipid metabolism, which is the result of defect in insulin secretion or dysfunctions or both. DM is a chronic disease that leads to disorder in many functions in the body.
The purpose of this study is to investigate the influence of DM type 1 on oral mucosa in general and the assessment of periodontal disease in particular. Also it investigates the effect of variables of DM like duration of disease, age at diagnosis, glycemic control HBA1c, and the amount of daily injected insulin on the oral tissue.
Material and methods: 80 diabetic patients of 6-18 years old having DM type 1 were chosen from patients at the Polyclinic of Damascus Health Department in addition to another 80 control samples of similar age and sex.
The investigations have been done on general health, medical history, measuring the height, measuring weight, and figuring out the body mass index (BMI). Patients were also asked about Xerostomia, their frequency of dental visits and using the toothbrush. Further, the soft tissue including buccal, labial, sublingual, lingual and hard, soft palate mucosa was examined. Finally, dental plaque, gingival inflammation and bleeding on probing concerning primary and erupting/erupted permanent teeth were evaluated. The probing depth of four sides just for erupted permanent teeth was measured.
The results: concerning buccal mucosa, it was observed that the percentage of ulcers in diabetic adolescents was less than in the control group, and the percentage of white lesions in diabetic adolescents was more than in the control. This result happened only in the 12-18-year-old subgroup. It was also observed that there was no influence of DM on the labial, sublingual and lingual mucosa. On hard and soft palate mucosa, it was observed that the percentage of red lesions was more than in the control group as a whole.
The study showed that Xerostomia in diabetic patients was more than in the control group.
Results also showed that the plaque index (PI) in diabetic patients was more than in the control group; the gingival index (GI) was more than in the diabetic patients in the 12-18-year-old subgroup; the gingival bleeding index (GBI) in diabetic patients was more than in the control group in all groups; and in the subgroup of 12- 18 years old and in the complete sample, the probing depths were in diabetic patients more than in the control group.
It has been found that there was no relationship between BMI and PI, GI and GBI; but it was found that there was a reverse relationship between BMI and the probing depth in the 12-18-year-old subgroup in the diabetic patients.
It has been found that there was no relationship between age at diagnosis and PI and probing depth; but there was an increasing relationship between age diagnosis and GI and GBI in the complete sample.
It has been found that there was no relationship between the duration of DM and the entire studied dental index in all groups.
It has been found that there was no relationship between the amount of the daily injected insulin and PI; but there was a weak relationship with GI and GBI in diabetic patients; and there was a reverse relationship with probing depth in the subgroup of 12-18.
It has also been found that there was no relationship between the glycemic control HBA1c and PI and probing depth; but there was a weak relationship with GI and GBI in the complete sample.
Conclusion: Our study showed an increase in the periodontal index in children and adolescents with DM type 1, which stresses the role of DM as a general disease that leads to a periodontal disease. It also stresses the importance of glycemic control in preventing patients from manifestations of the periodontal disease.
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