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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

IMPACT FACTOR 2017: 1.086

CiteScore 2017: 1.07

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Source Normalized Impact per Paper (SNIP) 2017: 0.580

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Volume 30, Issue 11


Oral health status of children with type 1 diabetes: a comparative study

Ahmad Faisal Ismail
  • Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, P.R. China
  • Kulliyyah of Dentistry, International Islamic University Malaysia, Kuala Lumpur, Malaysia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Colman Patrick McGrath
  • Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, P.R. China
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Cynthia K.Y. Yiu
  • Corresponding author
  • Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, P.R. China
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-10-09 | DOI: https://doi.org/10.1515/jpem-2017-0053



The aim of this study was to compare the oral health status of children with type 1 diabetes and healthy controls.


This comparative study involved 64 children, 32 children with type 1 diabetes and 32 age- and gender-matched controls. Oral health examination was conducted using WHO criteria. Dental caries experience was recorded using DMFT/dmft index and periodontal parameters were assessed using plaque, gingivitis, gingival bleeding and calculus indexes. Dental caries and periodontal parameters between the two groups were compared using the Mann-Whitney U-test.


Children with diabetes exhibited significantly greater plaque deposits (p=0.01) and a higher mean plaque index (p<0.01), when compared to healthy subjects. No significant difference in DMFT and dmft scores, mean bleeding index, calculus index and gingival index was found between the two groups.


Children with type 1 diabetes had a poor oral health status with greater plaque accumulation than children without diabetes.

Keywords: caries; children; oral health; periodontal health; type 1 diabetes


  • 1.

    Karam JH. Pancreatic hormones and diabetes mellitus. In: Greenspan FS, Strewler GJ, editors. Basic and clinical endocrinology. 5th ed. New Jersey: Appleton and Lange, 1997:595–663.Google Scholar

  • 2.

    Alemzadeh R, Wyatt D. Diabetes mellitus. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia, PA: WB Saunders, 2004:1947–72.Google Scholar

  • 3.

    Karvonen M, Tuomilehto J, Libman I, LaPorte R. A review of the recent epidemiological data on the worldwide incidence of type 1 (insulin-dependent) diabetes mellitus. World Health Organization DIAMOND Project Group. Diabetologia 1993;36:883–92.PubMedCrossrefGoogle Scholar

  • 4.

    Harjutsalo V, Sjoberg L, Tuomilehto J. Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study. Lancet 2008;371:1777–82.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 5.

    Ehehalt S, Blumenstock G, Willasch AM, Hub R, Ranke MB, et al. Continuous rise in incidence of childhood type 1 diabetes in Germany. Diabet Med 2008;25:755–7.PubMedCrossrefGoogle Scholar

  • 6.

    Fourlanos S, Varney MD, Tait BD, Morahan G, Honeyman MC, et al. The rising incidence of type 1 diabetes is accounted for by cases with lower-risk human leukocyte antigen genotypes. Diabetes Care 2008;31:1546–9.Web of ScienceCrossrefPubMedGoogle Scholar

  • 7.

    Cherian MP, Al-Kanani KA, Al Qahtani SS, Yesurathinam H, Mathew AA, et al. The rising incidence of type 1 diabetes mellitus and the role of environmental factors–three decade experience in a primary care health center in Saudi Arabia. J Pediatr Endocrinol Metab 2010;23:685–95.Google Scholar

  • 8.

    Dorman JS, LaPorte RE. Mortality in insulin-dependent diabetes. In: Diabetes in America, United States Department of Health and Human Services 1985:1–9. (NIH Publication No. 85–1468).Google Scholar

  • 9.

    Castle WM, Wicks AC. A follow-up of 93 newly diagnosed African diabetics for 6 years. Diabetologia 1980;18:121–3.CrossrefPubMedGoogle Scholar

  • 10.

    Samardzic M, Tahirovic H, Popovic N, Popovic-Samardzic M. Health-related quality of life in children and adolescents with type 1 diabetes mellitus from Montenegro: relationship to metabolic control. J Pediatr Endocrinol Metab 2016;29:663–8.Web of SciencePubMedGoogle Scholar

  • 11.

    Jayashree M, Singhi S. Diabetic ketoacidosis: predictors of outcome in a pediatric intensive care unit of a developing country. Pediatr Crit Care Med 2004;5:427–33.CrossrefGoogle Scholar

  • 12.

    Orbak R, Simsek S, Orbak Z, Kavrut F, Colak M. The influence of type-1 diabetes mellitus on dentition and oral health in children and adolescents. Yonsei Med J 2008;49:357–65.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 13.

    Listgarten MA, Ricker FH Jr, Laster L, Shapiro J, Cohen DW. Vascular basement lamina thickness in the normal and inflamed gingiva of diabetics and non-diabetics. J Periodontol 1974;45:676–84.CrossrefPubMedGoogle Scholar

  • 14.

    Al-Khabbaz AK, Al-Shammari KF, Hasan A, Abdul-Rasoul M. Periodontal health of children with type 1 diabetes mellitus in Kuwait: a case-control study. Med Princ Pract 2013;22:144–9.Web of ScienceCrossrefPubMedGoogle Scholar

  • 15.

    El-Tekeya M, El Tantawi M, Fetouh H, Mowafy E, Abo Khedr N. Caries risk indicators in children with type 1 diabetes mellitus in relation to metabolic control. Pediatr Dent 2012;34:510–6.PubMedGoogle Scholar

  • 16.

    Siudikiene J, Maciulskiene V, Dobrovolskiene R, Nedzelskiene I. Oral hygiene in children with type I diabetes mellitus. Stomatologija 2005;7:24–7.PubMedGoogle Scholar

  • 17.

    Alves C, Menezes R, Brandao M. Salivary flow and dental caries in Brazilian youth with type 1 diabetes mellitus. Indian J Dent Res 2012;23:758–62.PubMedCrossrefGoogle Scholar

  • 18.

    Rai K, Hegde AM, Kamath A, Shetty S. Dental caries and salivary alterations in type I diabetes. J Clin Pediatr Dent 2011;36:181–4.PubMedCrossrefGoogle Scholar

  • 19.

    Siudikiene J, Machiulskiene V, Nyvad B, Tenovuo J, Nedzelskiene I. Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease. Eur J Oral Sci 2006;114:8–14.PubMedCrossrefGoogle Scholar

  • 20.

    Tagelsir A, Cauwels R, van Aken S, Vanobbergen J, Martens LC. Dental caries and dental care level (restorative index) in children with diabetes mellitus type 1. Int J Paediatr Dent 2011;21:13–22.CrossrefWeb of SciencePubMedGoogle Scholar

  • 21.

    Swanljung O, Meurman JH, Torkko H, Sandholm L, Kaprio E, et al. Caries and saliva in 12-18-year-old diabetics and controls. Scand J Dent Res 1992;100:310–3.PubMedGoogle Scholar

  • 22.

    Firatli E. The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years. J Periodontol 1997;68:136–40.CrossrefPubMedGoogle Scholar

  • 23.

    WHO. Oral health surveys-basic methods. 3rd ed. Geneva: World Health Organization 1987.Google Scholar

  • 24.

    Silness J, Loe H. Periodontal disease in pregnancy. ii. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121–35.CrossrefPubMedGoogle Scholar

  • 25.

    Loe H, Silness J. Periodontal disease in pregnancy. i. Prevalence and severity. Acta Odontol Scand 1963;21:533–51.CrossrefPubMedGoogle Scholar

  • 26.

    Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975;25:229–35.PubMedGoogle Scholar

  • 27.

    Greene JC, Vermillion JR. The oral hygiene index: a method for classifying oral hygiene status. J Am Dent Assoc 1960;61:172–9.CrossrefGoogle Scholar

  • 28.

    Rankin G, Stokes M. Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses. Clin Rehabil 1998;12:187–99.CrossrefPubMedGoogle Scholar

  • 29.

    Huen KF, Low LC, Wong GW, Tse WW, Yu AC, et al. Epidemiology of diabetes mellitus in children in Hong Kong: the Hong Kong childhood diabetes register. J Pediatr Endocrinol Metab 2000;13:297–302.Google Scholar

  • 30.

    Huen KF, Low LCK, Cheung PT, Wong GW, But WM, et al. An update on the epidemiology of childhood diabetes in Hong Kong. HK J Paediatr 2009;14:252–9.Google Scholar

  • 31.

    Lalla E, Cheng B, Lal S, Tucker S, Greenberg E, et al. Periodontal changes in children and adolescents with diabetes: a case-control study. Diabetes Care 2006;29:295–9.CrossrefPubMedGoogle Scholar

  • 32.

    Goteiner D, Vogel R, Deasy M, Goteiner C. Periodontal and caries experience in children with insulin-dependent diabetes mellitus. J Am Dent Assoc 1986;113:277–9.CrossrefPubMedGoogle Scholar

  • 33.

    Oral Health Education Unit, Department of Health. Hong Kong SAR. www.toothclub.gov.hk. Oral health survey: Chapter 4. 2011:63–96.

  • 34.

    Carranza FA, Newman MG. [Current concepts about dental plaque]. Rev Asoc Odontol Argent 1980;68:293–4.PubMedGoogle Scholar

  • 35.

    Bolgul BS, Celenk S, Ayna BE, Atakul F, Uysal E. Evaluation of caries risk factors and effects of a fluoride-releasing adhesive material in children with insulin-dependent diabetes mellitus (IDDM): initial first-year results. Acta Odontol Scand 2004;62:289–92.CrossrefPubMedGoogle Scholar

About the article

Corresponding author: Professor Cynthia K.Y. Yiu, Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, P.R. China, Phone: 852 2859 0256, Fax: 852 2559 3803

Received: 2017-02-02

Accepted: 2017-08-28

Published Online: 2017-10-09

Published in Print: 2017-10-26

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 30, Issue 11, Pages 1155–1159, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2017-0053.

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