ABSTRACT
PURPOSE: The oral health status of children with type 1 diabetes and its relationship to salivary cytokines have been researched in only one known study. The purpose of the present study was to evaluate the association between levels of salivary cytokines and gingival disease in diabetic and nondiabetic Puerto Rican children. METHODS: A matched case-control study with a convenience sample of 25 children with type 1 diabetes (cases) and 25 nondiabetic children (controls) were evaluated by a calibrated dentist for oral health indices. A five-ml stimulated saliva sample was taken from each subject and analyzed to determine cytokine levels (IL-6, IL-17, IP-10, TNF-alpha, MMP-2, MMP-9, CRP). Descriptive statistics, chi-square tests, and t tests were used. RESULTS: Diabetic children are observed to have more plaque than control children (P=.007), more calculus (P=.06), and more bleeding on probing (P=.001). Only the level of the mediator IL-17 (P=.002) was higher in diabetic children than in nondiabetic children, but no significant differences were observed in the levels of other cytokines between the two groups. However, for each salivary mediator evaluated, diabetic children had higher levels of the respective mediator. CONCLUSION: Salivary cytokines levels were higher in diabetic type 1 children than in nondiabetic children.
Subject(s)
Cytokines/analysis , Diabetes Mellitus, Type 1/immunology , Saliva/immunology , C-Reactive Protein/analysis , Case-Control Studies , Chemokine CXCL10/analysis , Child , Dental Calculus/classification , Dental Plaque Index , Female , Gingival Diseases/immunology , Humans , Inflammation Mediators/analysis , Interleukin-17/analysis , Interleukin-6/analysis , Male , Matrix Metalloproteinase 2/analysis , Matrix Metalloproteinase 9/analysis , Periodontal Index , Pilot Projects , Puerto Rico , Tumor Necrosis Factor-alpha/analysisABSTRACT
OBJECTIVE: Children with type 1 diabetes have infrequently been the subjects of studies examining oral health status (caries and gingival diseases); in addition, no study of this type has ever been on Puerto Rican children. The purpose of this study was to evaluate the oral health status of Puerto Rican children (ranging in age from 6 to 12 years) either with or without type 1 diabetes and compare the two groups with regard to that status. METHODS: This was a matched case-control study. A convenience sample of 25 children with type 1 diabetes (cases) and 25 non-diabetic children (controls), all ranging in age from 6 to 12 years and matched by age and gender, was evaluated by a calibrated dentist for caries, bleeding on probing, and plaque and calculus indexes. A sample of saliva was taken from each subject and analyzed to determine Streptococcus mutans and Lactobacillus counts. Descriptive statistics, chi-square test, and t-test were used to describe and assess the data. RESULTS: We used the caries index to evaluate the teeth of the children participating in our study; we found significant differences in the number of lesions in the permanent teeth of diabetic children compared to the number found in the permanent teeth of non-diabetic children (1.43 and 0.56, respectively; p = 0.05). The mean number of sites of bleeding on probing for diabetic children was 23.9; for non-diabetic children it was 4.2. Diabetic children had more plaque than did the control children (plaque index = 2.5 vs. 0.8; p = 0.007) and more bleeding on probing (p = 0.001). High levels of glycosylated hemoglobin in diabetic children were statistically significantly associated with a greater number of sites with bleeding on probing. CONCLUSION: Diabetic children are at higher risk for caries and gum disease than are non-diabetic children.