Caries Experience Among Children with Type 1 Diabetes in Kuwait

Objective: To investigate the association between type 1 diabetes mellitus (DM) and caries experience among 12-15-year-old children in Kuwait. Subjects and Methods: Children aged 12-15 years with DM, selected from Amiri Hospital,Kuwait were divided into two groups. The first group comprised 14 children with controlled DM (glycated haemoglobin, HbA1c =<8), while the second group included 39 children with uncontrolled DM (HbA1c>8). Fifty three age- and sex-matched clinically healthy children served as control. The children's caries experience, at pre-cavitation level (decayed, missing and filled teeth, DMFT), and at cavitation stage (D2MFT), was measured using the International Caries Detection and Assessment System, ICDAS, and posterior bitewing radiographs. In addition, the children's frequency of sugar consumption, plaque index, salivary flow rate and buffering capacity, as well as their mutans streptococci, lactobacilli and yeast count were recorded. Results: DMFT and D2MFT were not significantly different between the controlled and uncontrolled DM children, but D2MFT was significantly higher among the DM children than the control group (p<0.01). The DM children also had significantly higher number of filled teeth (p<0.01). Multivariate logistic regression analysis showed statistically significant association among age, HbA1c, caries activity, buffering capacity, salivary glucose and D2MFT. There was weak correlation (r=0.3, p=0.06) between blood and salivary glucose among DM children. Conclusion: Caries experience, at cavitation stage, was significantly associated with resting salivary flow rate, salivary glucose, frequency of sugar consumption, glycemic control, and was more severe in the diabetic children than the control group. This work was supported by Kuwait University Research Administration, Grant RD 01/07