Poster Presentation ESA-SRB 2023 in conjunction with ENSA
The impact of metabolic control and caregiver education level on the oral health of paediatric diabetic patients (#265)
Diabetes can worsen periodontal condition1, is a caries risk factor2,3, and may have a bidirectional relationship with periodontitis4. Educating diabetic patients about these risks, promoting good oral health, and facilitating dental care access is important5,6. This study assessed how metabolic control affects dental health.
A 12 question online survey was conducted in a California paediatric endocrine clinic. Caregivers of 203 children participated. Data included 105 children with type 1 diabetes and 13 children with type 2 diabetes. Questions included insurance type, caregiver education level, and the child's current HbA1c and oral health.
More children with higher HbA1c had at least one tooth filled or extracted, had bleeding gums, brushed less regularly, and ate more sugary snacks than children with lower HbA1c or without diabetes. At HbA1c of above 10%, oral health practices improve, perhaps due to urgent health education. Children with type 2 diabetes had a lower sugar intake, possibly due to health education linking type 2 diabetes and diet, but the sample was small. Caregiver's educational level did not affect sugar intake. More children of caregivers with higher educational levels attended a dentist at least twice a year in the past year and had at least one tooth filled or extracted, possibly due to being seen more regularly.
The study limitations include small sample size, lack of dental records, inaccurate recall, and false reporting. The recruitment mode excluded people without social media or internet access. Nevertheless, it underscores the need for dental health education, regardless of type or severity of disease and caregiver education level. Reducing sugar intake in type 1 diabetes is vital to combat obesity and improve oral health. Children from lower socio-economic backgrounds need better dental coverage. Social media can be an effective tool for educational intervention to improve oral health knowledge and behaviour of diabetic adults6,7.
- Lalla E, Cheng B, Lal S, Kaplan S, Softness B, Greenberg E, Goland RS, Lamster IB. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol. 2007 Apr;34(4):294-8. doi: 10.1111/j.1600-051X.2007.01054.x. PMID: 17378885.
- Twetman S, Johansson I, Birkhed D, Nederfors T. Caries incidence in young type 1 diabetes mellitus patients in relation to metabolic control and caries-associated risk factors. Caries Res. 2002 Jan-Feb;36(1):31-5. doi: 10.1159/000057587. PMID: 11961327.
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- Borgnakke WS, Ylöstalo PV, Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Clin Periodontol. 2013 Apr;40 Suppl 14:S135-52. doi: 10.1111/jcpe.12080. PMID: 23627324.
- Oral Health Status, Knowledge, and Behaviors of People with Diabetes in Sydney, Australia Int J Environ Res Public Health. 2021 Apr; 18(7): 3464. Published online 2021 Mar 26. doi: 10.3390/ijerph18073464
- Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review BMC Public Health. 2018; 18: 577. Published online 2018 May 2. doi: 10.1186/s12889-018-5485-7
- Improvement of oral health knowledge and behavior of diabetic patients: an interventional study using the social media BMC Oral Health. 2023; 23: 359. Published online 2023 Jun 3. doi: 10.1186/s12903-023-03007-w