Avaliação da saúde bucal de crianças e adolescentes com Diabetes mellitus tipo 1: um estudo-piloto

Abstract

Type 1 Diabetes Mellitus (T1DM) is a chronic, metabolic, and multifactorial disorder, most common in childhood and adolescence, characterized by chronic hyperglycemia, which can cause complications in various organs, including the oral cavity. The aim of this cross-sectional pilot study was to compare the oral health conditions, salivary flow, and pH of children and adolescents with T1DM (test group) with systemically healthy individuals (control group). Additionally, it evaluated the influence of glycemic control on intraoral clinical parameters. Socioeconomic and demographic data collection, intraoral clinical examination, unstimulated salivary flow, salivary pH, and glycated hemoglobin A1c (HbA1c) testing were performed for the test group. The sample consisted of 15 participants with T1DM and 14 systemically healthy individuals. In the test group, 40% of participants reported experiencing dry mouth, while only 14.3% of the control group reported this sensation. No statistical differences were observed in salivary flow and pH between the groups; however, when the test group was subdivided by the median HbA1c levels, individuals with higher hyperglycemia levels (HbA1c ≥ 7.6%) tended to have a lower mean salivary flow (0.27 ± 0.15 ml/min) compared to the subgroup with better glycemic control (0.44 ± 0.31 ml/min). Statistically significant differences were found between the groups when analyzing the Simplified Oral Hygiene Index (SOHI) (p = 0.021); 73.3% of participants in the test group had SOHI classified as good, while only 35.7% of the control group had this classification. Statistically significant differences were also found regarding caries experience (p < 0.001), with all participants in the control group having had caries experience, while only 26.7% of the test group had. The most common complaint among the test group participants was bad breath, particularly among those with poorer glycemic control. Regarding the periodontal condition in the test group, 8 participants (53.3%) had gingivitis associated with dental plaque, and 1 participant (3.5%) had stage I periodontitis. In conclusion, in the studied sample, the diagnosis of hyperglycemia influenced the sensation of dry mouth, oral hygiene patterns, and caries experience. Additionally, among diabetic patients, the degree of hyperglycemia affected the salivary flow pattern.