Clinical and immunological parameters of dental status in children with type 1 diabetes mellitus

BACKGROUND: Destructive processes in the pancreas in type 1 diabetes mellitus alter oral homeostasis. The first signs of a change in dental health in type 1 diabetes mellitus are pastosity of the oral mucosa and hyposalivation, which causes dental plaque formation. Many researchers note the high prevalence of periodontal disease in patients with type 1 diabetes mellitus.

AIM: To examine the dental status, cytokine profile, and specific factors of oral immunological protection in children with type 1 diabetes mellitus.

MATERIALS AND METHODS: Two groups of children aged 6–17 years were examined. The main group (n=53) included patients with type 1 diabetes mellitus, whereas the comparison group (n=30) included children without somatic pathologies. The study analyzed the results of a clinical examination of patients, including an assessment of the intensity of caries, oral hygiene, and periodontal status, and results of an immunological examination of the oral fluid, including the level of cytokines (interleukin (IL)-1β, tumor necrosis factor-α, IL-4, and IL-10) and immunoglobulins (IgA, IgG, and IgM).

RESULTS: Both groups had satisfactory levels of oral hygiene, and the extent of plaque formation on the proximal surfaces of the teeth was unacceptable. The prevalence of chronic catarrhal gingivitis was higher in the main group. An immunological study showed that both groups had pro-inflammatory cytokine imbalance in the oral fluid, and the levels of these cytokines are higher in the main group. The levels of immunoglobulins in the oral fluid were also different: the levels of IgA and IgM in the saliva of the main group were 1.1 and 1.2 times higher, and the IgG level was 1.25 times lower.

CONCLUSION: The high prevalence of periodontal disease in children with type 1 diabetes mellitus was associated with poor oral hygiene and carbohydrate metabolism. Patients with type 1 diabetes mellitus showed a pronounced imbalance of oral immunological protection factors. With worsening compensation of carbohydrate metabolism, immunological changes in the oral cavity became more pronounced.