Caries Incidence in Young Type 1 Diabetes mellitus Patients in Relation to Metabolic Control and Caries-Associated Risk Factors
Caries Incidence in Young Type 1 Diabetes mellitus Patients in Relation to Metabolic Control and Caries-Associated Risk Factors
复制标题
年轻 1 型糖尿病患者的龋齿发生率与代谢控制和龋齿相关危险因素的关系
作者：
S. Twetman;I. Johansson;D. Birkhed;T. Nederfors
本研究的目的是评估一组年轻1型糖尿病患者从发病起3年内的龋齿发病率与代谢控制和龋齿相关危险因素的关系。64名儿童和青少年（8-15岁）根据标准医疗方案接受糖尿病治疗和监测，并根据个人需要接受广泛的预防性口腔保健。从病历中收集血糖和糖化血红蛋白（Hb AIc）数据。每3个月收集一次全唾液，测定唾液分泌率、缓冲能力、葡萄糖浓度、变形链球菌和乳酸杆菌计数。每年进行一次牙科检查，包括X光检查。与代谢控制良好的患者相比，代谢控制不佳的患者（>8.0% Hb AIc）在静息唾液中显示出较高的葡萄糖水平（p <0.05）和显著较高的龋齿发病率（p < 0.05）。在3年的随访期内，高龋发展的最有影响力的决定因素是代谢控制（比值比，OR = 5.7），口腔卫生差（OR = 6.5），以前的龋齿经验（OR = 5.3）和高水平的唾液乳酸杆菌（OR = 5.0）。研究结果表明，代谢控制水平和传统的龋病危险标志物是儿童和青少年1型糖尿病患龋发展的重要因素。
The aim of this study was to evaluate the caries incidence in a group of young patients with type 1 diabetes mellitus over a 3-year period from the onset of the disease in relation to metabolic control and to caries-associated risk factors. Sixty-four children and adolescents (8–15 years of age) had their diabetes treated and monitored according to a standard medical protocol and received extensive preventive oral health care based on individual needs. Data on blood glucose and glycosylated haemoglobin (Hb AIc) were collected from the medical records. Whole saliva was collected every 3rd month and secretion rate, buffer capacity, glucose concentration, mutans streptococci and lactobacilli counts were determined. Dental examinations, including radiographs, were carried out once a year. Patients with less good metabolic control (>8.0% Hb AIc) exhibited higher glucose levels in resting saliva (p < 0.05) and a significantly higher caries incidence (p < 0.05) compared to those with good metabolic control. The most influential determinants for high caries development during the 3-year follow-up period were metabolic control (odds ratio, OR = 5.7), poor oral hygiene (OR = 6.5), previous caries experience (OR = 5.3) and high levels of salivary lactobacilli (OR = 5.0). The findings suggest that the level of metabolic control and traditional caries risk markers are important factors for caries development in children and adolescents with type 1 diabetes mellitus.