Changes in the caries-associated microbiota and caries experience in children and adolescents with type 1 diabetes: A systematic review and meta-analysis

Objective

This systematic review aimed to determine the differences in the caries-associated microbiota and caries experience among children with type 1 diabetes (T1D) compared to healthy children in observational studies.

Design

Registered in PROPSERO (CRD42024529842), this review involved searching four electronic databases (PubMed, Embase, Scopus and Web of Science) from inception to April 2024. Citation searching was further performed on eligible studies from the database search. Observational studies comparing the cariogenic taxa between paediatric participants (0–18 years of age) with T1D and healthy paediatric participants were included. Caries experience was analysed where available in eligible studies. Outcomes were narratively and tabularly synthesised, and meta-analysis performed where appropriate. All studies were critically appraised using the relevant Joanna Briggs Institute appraisal tool.

Results

425 studies were identified, of which 14 studies were eligible. After assessing 534 citations, 2 additional studies were included. Overall, 16 studies (15 cross-sectional, 1 longitudinal) satisfied the inclusion criteria. Differences in cariogenic bacteria were observed when glycaemic control was considered. Children with T1D and poorer glycaemic control exhibited an increase in Streptococci and Lactobacilli taxa compared to those with improved glycaemic control and healthy children. A small number of studies also found increases in the caries experience with poorer glycaemic control.

Conclusion

Overall, the evidence indicates that children with T1D who have poorer glycaemic control exhibit an increase in cariogenic bacteria. Early evidence suggests that these children also experience more caries. However, further research with improved and longitudinal study designs are required to strengthen the existing evidence.