Periodontal health and glycemic control and type 1 diabetic children of Dubai

Date
2011
DOI
Authors
Ba'alawi, Farha Faisal
Version
OA Version
Citation
Abstract
Diabetes mellitus is considered one of the most common endocrine diseases of our time. In the UAE, diabetes is a major health problem with the United Arab Emirates ranking second per capita with the highest prevalence of the disease worldwide. Type 1 diabetes constitutes 5-10% of the diagnosed cases of diabetes with children being affected more than adults. Individuals with diabetes are considered at a greater risk of developing gingivitis and periodontitis. The association of gingivitis and diabetes in children and adolescents has led to the addition of another entity into the classification of periodontal diseases known as 'diabetes mellitus-­associated gingivitis'. The present study was undertaken to determine if improved oral health and resolution of inflammation after periodontal therapy improved glycemic control. 12 children with type 1 diabetes from the Juvenile Diabetic Education Center (JDEC) located in Dubai Healthcare city were selected for our study. The children were randomly allocated into either treatment or control groups after receiving the necessary caries control and recording baseline clinical parameters. The clinical parameters include the periodontal measures such as bleeding on probing, gingival index, plaque index, clinical attachment loss, pocket depths and percentage of sites with gingivitis in addition to the metabolic control (HbA le). The treatment group received conventional periodontal therapy which included prophylaxis or scaling and polishing. The patients were then followed up at 3 months and 6 months after therapy during which the clinical parameters were recorded to observe for any change post therapy. Our results show a short term improvement in the treatment group with mean decrease in bleeding on probing scores 3 months after therapy from 0.23 ± 0.21 to 0.20 ± 0.08 (P = 0.9) compared to control. Within the treatment group, 62.5% of the subjects demonstrated better response to treatment with steady improvement in bleeding on probing from baseline to 6 months (P = 0.7). Similarly, the mean gingival index score demonstrated a significant decline from 0.54 ± 0.21 at baseline to 0.57 ± 0.19 at 6 months (P[less than]0.05) within the same subjects. Interestingly, gingival index was significantly higher in those subjects that had calculus compared to those who did not (P = 0.04). On the other hand, glycemic control (HbA le) showed a transient improvement in the treatment group with mean decrease from 8.78% ± 1.87% to 7.96% ± 1.32% at three months (P = 0.4) after therapy. No correlation could be observed between HbA1c and the periodontal variables. These results confirm that resolution of periodontal inflammation did not necessarily result in improved glycemic control in our small cohort of diabetic children. Inter-individual differences exist among the diabetic subjects with regards to response to periodontal therapy. A better response to periodontal therapy was observed in the well - controlled subjects compared to the poorly-controlled diabetic subjects. However, oral disease prevention and treatment programs should be considered as a standard of care for young patients with diabetes in addition to maintaining glycemic control. Future studies with greater numbers of subjects are needed to confirm the effect of periodontal therapy on the periodontal health and glycemic control of the diabetic child.
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Thesis (MSD) --Boston University Institute for Dental Research and Education, Dubai, 2011 (Pediatric Dentistry).
Includes bibliographic references: leaves 47-51.
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This work is protected by copyright. Downloading is restricted to the BU community. If you are the author of this work and would like to make it publicly available, please contact open-help@bu.edu.