Twetman S, Johansson I, Birkhed D, Nederfors T
Paediatric Dentistry and Cariology, Department of Odontology, Umeå University, Sweden.
Caries Res. 2002 Jan-Feb;36(1):31-5. doi: 10.1159/000057587.
The aim of this study was to evaluate the caries incidence in a group of young patients with type 1 diabetes mellitus over a 3-year period from the onset of the disease in relation to metabolic control and to caries-associated risk factors. Sixty-four children and adolescents (8-15 years of age) had their diabetes treated and monitored according to a standard medical protocol and received extensive preventive oral health care based on individual needs. Data on blood glucose and glycosylated haemoglobin (Hb A(Ic)) were collected from the medical records. Whole saliva was collected every 3rd month and secretion rate, buffer capacity, glucose concentration, mutans streptococci and lactobacilli counts were determined. Dental examinations, including radiographs, were carried out once a year. Patients with less good metabolic control (>8.0% Hb A(Ic)) exhibited higher glucose levels in resting saliva (p < 0.05) and a significantly higher caries incidence (p < 0.05) compared to those with good metabolic control. The most influential determinants for high caries development during the 3-year follow-up period were metabolic control (odds ratio, OR = 5.7), poor oral hygiene (OR = 6.5), previous caries experience (OR = 5.3) and high levels of salivary lactobacilli (OR = 5.0). The findings suggest that the level of metabolic control and traditional caries risk markers are important factors for caries development in children and adolescents with type 1 diabetes mellitus.
本研究的目的是评估一组1型糖尿病年轻患者自疾病发作起3年内的龋齿发病率，及其与代谢控制和龋齿相关危险因素的关系。64名儿童和青少年（8 - 15岁）按照标准医疗方案接受糖尿病治疗和监测，并根据个人需求接受广泛的预防性口腔保健。从病历中收集血糖和糖化血红蛋白（Hb A(Ic)）数据。每3个月收集一次全唾液，测定分泌率、缓冲能力、葡萄糖浓度、变形链球菌和乳酸杆菌计数。每年进行一次牙科检查，包括X光检查。与代谢控制良好的患者相比，代谢控制较差（Hb A(Ic) > 8.0%）的患者静息唾液中的葡萄糖水平更高（p < 0.05），龋齿发病率显著更高（p < 0.05）。在3年随访期内，龋齿高发的最具影响力的决定因素是代谢控制（优势比，OR = 5.7）、口腔卫生差（OR = 6.5）、既往龋齿经历（OR = 5.3）和唾液乳酸杆菌水平高（OR = 5.0）。研究结果表明，代谢控制水平和传统的龋齿风险标志物是1型糖尿病儿童和青少年龋齿发生的重要因素。
