Oral disorders associated with diabetes mellitus in children

Abstract

Introduction: The oral cavity plays an important role in the overall health of the body. Systemic diseases, such as diabetes mellitus, may first become apparent because of mouth lesions or other oral problems. Both in Moldova and worldwide, the progressive increase in the incidence of diabetes continues. Over the years this disease has become increasingly common among children and young people. In Republic of Moldova 395 children with type 1 diabetes and 72 adolescents with type 2 diabetes are registered. Purpose and Objectives: The aim of the study was to highlight the main dental pathologies in children with diabetes. Materials and methods: Were examined 258 children with diabetes hospitalized in the Endocrinology Department of RCH "Emil Cotaga" during September 2013 - March 2014. Results: Following the clinical examination of children with endocrine pathology, 258 children were suffering from diabetes (69.5%); among them 20 children were newly diagnosed and 10 children showed a prediabetes condition. Oral disorders were not detected in children with altered basal glucose and in children with newonset diabetes, except xerostomia (80%) and cheilitis (45%). Patients with type 1 diabetes with history disease of 2 years and more had various manifestations of mouth disorders, some of them of severe forms. Catarrhal gingivitis was detected most frequently (55%), mostly in children aged 5-10. Hypertrophic gingivitis was found in children with decompensated diabetes (32%), especially in children aged 14-16. Reduction of salivary flow in children with diabetes is a risk factor for the occurrence and development of dental caries, so there were multiple dental caries (90%), located particularly in the root or dental neck regions. Temporary tooth decay was frequently located in areas of enamel hypoplasia. Oral candidosis was present in children with decompensated diabetes (5%). It was detected oral mucosal lesions (70%) such as stomatitis, geographic tongue, benign migratory glossitis, fissured tongue, traumatic ulcers, and lichen planus were detected. Eruption acceleration was observed in dentition until the age of 10 and delay after the age of 10 (especially for the eruption of canines and the premolars). Conclusions: Diabetes is a chronic metabolic disease which affects the entire organism, disturbing especially the oral health. Oral manifestations related to diabetes mellitus may have a strong inclination to periodontal disease, as well as an increased incidence of dental caries, mucosal lesions, dry mouth, oral infections; they present more severe forms in decompensated diabetes. Health habits are substantial for preventing dental and periodontal diseases and maintaining oral health in children with diabetes.