Iughetti L, Marino R, Bertolani M F, Bernasconi S
Department of Paediatrics, University of Modena and Reggio Emilia, Italy.
J Pediatr Endocrinol Metab. 1999 Sep-Oct;12(5):603-10.
Children with insulin-dependent diabetes mellitus have a lower salivary flow rate, pH and buffer capacity, but a higher glucose content and peroxidase, IgA, magnesium and calcium concentration, in comparison with healthy children. Nevertheless the incidence of caries is lower than normal in diabetic children with good metabolic control. Periodontal disease usually starts at puberty as mild gingivitis with bleeding and gingival recession, and it may develop into severe periodontitis, especially in children with poor control of diabetes. Microangiopathy, impaired immune response, different bacterial microflora and collagen metabolism are involved in the pathogenesis of diabetic periodontal disease. The gingival flora is mostly composed of Gram-negative, anaerobic bacteria, while collagen has a lower solubility and is atrophic and inadequate to support the occlusion forces. For these reasons, prevention of periodontitis is important in diabetic children; they should receive oral hygiene instruction and visit a dentist at least twice a year.
与健康儿童相比，胰岛素依赖型糖尿病患儿的唾液流速、pH值和缓冲能力较低，但葡萄糖含量、过氧化物酶、免疫球蛋白A、镁和钙浓度较高。然而，代谢控制良好的糖尿病患儿龋齿发病率低于正常水平。牙周疾病通常在青春期开始，表现为轻度牙龈炎伴出血和牙龈退缩，可能发展为严重的牙周炎，尤其是糖尿病控制不佳的儿童。微血管病变、免疫反应受损、不同的细菌微生物群和胶原代谢参与了糖尿病牙周病的发病机制。牙龈菌群主要由革兰氏阴性厌氧菌组成，而胶原的溶解度较低，出现萎缩且不足以支撑咬合力量。基于这些原因，预防牙周炎对糖尿病患儿很重要；他们应接受口腔卫生指导，并且每年至少看两次牙医。
