Prevalence of Dental Caries in Children and Adolescents With Type 1 Diabetes

A Systematic Review and Meta-analysis

Yan Wang; Lin Xing; Hui Yu; LiJuan Zhao

Disclosures

BMC Oral Health. 2019;19(213) 

In This Article

Abstract and Introduction

Abstract

Background: Dental caries and type 1 diabetes are responsible for a large burden of global disease; however, the exact prevalence of dental caries among children and adolescents with type 1 diabetes remains controversial, and no quantitative meta-analysis exists. Thus, we performed a meta-analysis to evaluate the prevalence of dental caries among children and adolescents with type 1 diabetes.

Methods: We performed a systematic search strategy using PubMed, EMBASE and China National Knowledge Infrastructure for relevant studies investigating the prevalence of dental caries in children and adolescents with type 1 diabetes from July 1971 until December 2018. The pooled prevalence with 95% confidence intervals (95%CIs) and subgroup analyses were calculated using a random effects model.

Results: After screening 358 non-duplicated articles, a total of 10 articles involving 538 individuals were included. The overall prevalence of dental caries among children and adolescents with type 1 diabetes was 67% (95% CI: 0.56–0.77%; I 2 = 83%). The prevalence was highest in South America (84%) and lowest in diabetic patients with good metabolic control (47%).

Conclusions: The prevalence of dental caries was high among children and adolescents with type 1 diabetes. Screening and preventive treatment should be included in dental clinical routines for diabetic children and adolescents, especially in those with poor metabolic control.

Introduction

Type 1 diabetes mellitus is a chronic autoimmune disease characterized by the destruction of pancreatic beta cells and insulin deficiency, and affects over half a million children worldwide.[1] The prevalence and incidence of type 1 diabetes is increasing, especially in European countries.[2] Numerous epidemiological studies have reported that type 1 diabetes increases the risk for cardiovascular diseases,[3] kidney disease[4] and cognitive decline[5] in children and adolescents. Additionally, a growing number of studies indicate an underlying link between type 1 diabetes and oral complications, including periodontal diseases[6] and dental caries.[7] Dental caries is the most common chronic infectious disease, and has posed an international public health challenge, especially in young children.[8] Additionally, it has become a major concern as it can begin early in life, progress rapidly in those individuals who are at high risk, and often goes untreated.[9] Its consequences can lead to poor food intake, poor school performance, and mental health problems, which can affect the quality of life of the child's family, and impact significant social and economic burdens as well.[10]

Clinical caries are diagnosed by the DMFT index (D = dentine caries lesion; M = missing due to caries; F = filled; T = tooth), according to World Health Organization (WHO) criteria.[11] Although dental caries have been declining, a national survey in the United States between 2001 and 2012 showed that approximately 37% of children aged 2–8 years and 60% of adolescents aged 12–19 years had experienced dental caries in their primary teeth.[12] One goal of the WHO is to reduce the DMFT index in 2020, and in particular, the D component, in high-risk groups.[13]

Screening and preventive treatment are necessary to avoid dental caries before they become incurable in the high-risk population. However, the exact prevalence of dental caries remains controversial in children and adolescents with type 1 diabetes,[14–17] especially in those with poor metabolic control.[18] Previous studies reported that the prevalence of dental caries in children and adolescents varies between 36% in Iran[19] and 92% in Chile.[20] Moreover, several studies have showed that a higher prevalence was observed in diabetic adolescents with poor metabolic control compared to patients with good metabolic control.[18,21] Therefore, we performed a meta-analysis using data available from access reports to estimate the overall prevalence of dental caries in children and adolescents with type 1 diabetes.

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