Oral pathology in young people with insulin dependent diabetes mellitus

The oral pathology that affects young people with insulin dependent diabetes mellitus (IDDM) is little known, but represents a non-marginal aspect of the disease and is important for a good quality of life. We have studied the oral health and the composition of the saliva of a group of young people of age ranging from 5 to 17 years (mean 11.74; SD ± 3.17), 15 boys and 8 girls who have been affected by IDDM for a minimum of 26 to a maximum of 72 months (mean 41.22; SD ± 41.14). The IDDM group was compared to 24 healthy subjects of the same age (p = 0.33) ranging from 5 to 16 years (mean 10.79; SD ± 3.44), 14 boys and 10 girls. Salivary composition, during fast, of IDDM differentiates from the saliva of healthy subjects for a more alkaline pH and for a higher concentration of glucose. Among bacteria notoriously related to caries, Lactobacilli are significantly higher in IDDM and Streptococcus mutans is extremely variable but higher on average, also if without statistical significance, than healthy subjects. The presence of Candida albicans is similar in the two groups. Salivary IgA are higher in the IDDM. Odonto-stomatological health reveals in the IDDM a higher approximal plaque and sulcus bleeding indexes; the latter is related to mean HbA(1c) of the last 12 months. In one case of IDDM there are wide gingival pouches and in another one there is loss of bone bearing with dental mobility. In IDDM decay indexes are slightly lower, probably in relation to the diet of the diabetic patient; gingivitis and tartar are more frequent in diabetics. These data, that need to be confirmed by an increase of the number of cases, show, in the young diabetic, a good dental health with precocious periodontal disease inversely proportional to the glycemic balance probably due to the damage of the connective and vascular tissues in IDDM. It follows that an antibacterial prevention and periodical odonto-stomatological examinations are necessary.