Tip 1 Diyabetli ve Sağlıklı Çocuklarda Ağız-Diş Sağlığının ve Ağız Kokusunun Değerlendirilmesi
İşcan, Tayyibe Aslıhan
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Assessment of the Oral Health Status and Halitosis of Healthy and Type 1 Diabetic Children. Hacettepe University, Faculty of Dentistry, Specialty Thesis in Pediatric Dentistry, Ankara, 2018. Diabetes Mellitus is a chronic metabolic disease characterized by hyperglycemia with disturbed carbohydrate, fat and protein metabolism, which can be caused by environmental and genetic factors. In general, two subtypes of Diabetes Mellitus have been defined as insulin-dependent (type 1 diabetes) and non-insulin dependent (type 2 diabetes). Some findings related to the disease may also be observed in the mouth. In this study, it was aimed to evaluate the oral health status, oral health related habits and halitosis of children with and without type 1 diabetes. The study was approved by Hacettepe University, Non-invasive Research Ethics Committee. The children with type 1 diabetes who had been under control by the Department of Pediatric Endocrinology, in Hacettepe University Medical Faculty and healthy children who had referred to the Faculty of Dentistry were included in the study. Written informed consents were obtained from the parents and a questionnaire was filled out for the children and their parents. The children's oral and dental examinations were performed under dental unit lighting using a mirror and explorer and by air-drying the teeth. The oral health status was evaluated by dmft/s, DMFT/S, D0-D4, ICDAS II indices. The effect of untreated teeth on the soft tissues was determined by pufa index whereas plaque and gingival health were evaluated by plaque and gingival indices. In addition, halitosis was determined by organoleptic assessment and sulfur monitoring methods. The age range of all children was 6-13 years. The mean age of the 50 children with type 1 diabetes (24 boys, 26 girls) was 10.3 ± 2.1 whereas the mean age of 50 healthy children (30 boys, 20 girls) was 9.9 ± 1.5. The mean dmft, dmfs, DMFT and DMFS indices of the children with type 1 diabetes were 3.97 ± 3.71; 10.61 ± 9.41; 1.04 ± 1.50 and 1.34 ± 2.20, respectively. The mean dmft, dmfs, DMFT and DMFS indices of the healthy children were 4.85 ± 3.70; 12.51 ± 11.43; 0.82 ± 1.26 and 1.34 ± 2.26, respectively Cavitated caries lesions were observed in 60.0% of children with diabetes and in 58.0% of children without diabetes. İt was found that 42.0% of children with diabetes and 56.0% of children without diabetes had severe decay according to the ICDAS II index. The prevalence of pufa was found to be 20.6% in both groups. The mean plaque and gingival index of children with type 1 diabetes was 1.15 ± 0.83 and 0.50 ± 0.58, respectively. Those values were 1.40 ± 0.65 and 0.54 ± 0.58 for healthy children, respectively and there was a statistically significant difference between the two groups with respect to plaque index (p = 0.04). In 12.0% of children with type 1 diabetes and in 18.0% of healthy children, volatile sulfur compounds (VSC) were determined to be ≥150 ppb and the highest score in the organoleptic evaluation was 1 in both groups. As a conclusion, pediatric dentists should be aware of the symptoms related to the oral health problems accompanying type 1 diabetes. It is important to emphasize the importance of oral and dental health, regular oral care and dental visits both to the patients and parents. Key Words: Type 1 diabetes, children, oral health, halitosis.