Karjalainen K M, Knuuttila M L, Käär M L
Department of Periodontology and Geriatric Dentistry, Institute of Dentistry, University of Oulu, Finland.
Caries Res. 1997;31(1):13-18. doi: 10.1159/000262367.
The relationship between the occurrence of caries and diabetes was explored in 80 children and adolescents with insulin-dependent diabetes mellitus. The mean age of the subjects was 14.5 years (range 11.7-18.4 years) and duration of diabetes 0.3-15.0 years (mean 6.0 years). DFS indices in poorly controlled subjects (glycosylated haemoglobin, HbA1, values over 13%) were significantly higher than in moderately (HbA1 10.0-12.9%) or in well-controlled cases (HbA1 values < 10%). However, the difference was not statistically significant if adjustments were made for age, age at the onset of diabetes and duration of diabetes (p = 0.1, Ancova). Subjects with caries and/or fillings had significantly higher short- and long-term HbA1 values than subjects with intact teeth, both if all subjects or subjects with long-term disease (duration of diabetes of at least 2 years, n = 62) were included. This finding was valid after adjustments for age, duration of diabetes and age at the onset of diabetes. Association between poor control and the loss of intact dentition was also demonstrated in subjects whose diabetes was diagnosed before the age of 7. Presence of yeasts was highly associated with poor control of diabetes, and yeasts were more frequently found in the saliva samples of subjects with decayed and/or filled teeth. Instead, salivary flow rates, salivary lactobacilli and Streptococcus mutans counts, buffering capacity and pH were not different between the subjects. As well, home care practices were similar, and all subjects had received similar regular dental treatment. In conclusion, poor control of diabetes was found to be associated with caries. The presence of yeasts may be a caries risk indicator in subjects with diabetes, since diabetes may enhance yeast growth, particularly if poorly controlled.
在80名胰岛素依赖型糖尿病儿童和青少年中探讨了龋齿发生与糖尿病之间的关系。受试者的平均年龄为14.5岁（范围11.7 - 18.4岁），糖尿病病程为0.3 - 15.0年（平均6.0年）。血糖控制不佳的受试者（糖化血红蛋白，HbA1，值超过13%）的DFS指数显著高于血糖中度控制（HbA1 10.0 - 12.9%）或良好控制的病例（HbA1值<10%）。然而，如果对年龄、糖尿病发病年龄和糖尿病病程进行调整，差异无统计学意义（p = 0.1，协方差分析）。无论纳入所有受试者还是患有长期疾病（糖尿病病程至少2年，n = 62）的受试者，有龋齿和/或补牙的受试者的短期和长期HbA1值均显著高于牙齿完好的受试者。在对年龄、糖尿病病程和糖尿病发病年龄进行调整后，这一发现仍然成立。在7岁前被诊断为糖尿病的受试者中，也证明了血糖控制不佳与完整牙列丧失之间的关联。酵母菌的存在与糖尿病控制不佳高度相关，并且在有龋齿和/或补牙的受试者的唾液样本中更频繁地发现酵母菌。相反，受试者之间的唾液流速、唾液乳酸杆菌和变形链球菌计数、缓冲能力和pH值没有差异。同样，家庭护理措施相似，所有受试者都接受了相似的常规牙科治疗。总之，发现糖尿病控制不佳与龋齿有关。酵母菌的存在可能是糖尿病患者龋齿风险的一个指标，因为糖尿病可能会促进酵母菌生长，尤其是在控制不佳的情况下。
