Comparative evaluation of oral microbiologic profile in children with Type 1 Diabetes Mellitus versus healthy controls and its relation to oral health status.

Background: Oral health is a key indicator of one's overall health and is vitally affected by systemic diseases. A bidirectional relationship is assumed to exist between oral health and Type 1 Diabetes Mellitus. Differences in oral cariogenic microbes and their relation to metabolic control show inconsistent results. Additionally, the relation between diabetes and dental caries is inconclusive. The aim of the present study is to investigate the relation of oral health to microbiologic profile in youngsters with Type 1 Diabetes Mellitus.

Methods: Sixty-three children were recruited including 22 diabetic children with poor glycemic control, 18 diabetic children with good glycemic control and 23 non-diabetic children. Oral health status was assessed using Caries Assessment Spectrum and Treatment (CAST) and oral hygiene index simplified (OHIS). Salivary and plaque samples were collected and microbiologically analyzed for identification and live colony counting of Mutans Streptococci, Lactobacilli, and different Candida species. The relation of different oral pathogen types and abundances with caries status and diabetes severity was assessed.

Results: Salivary Mutans Streptococci were isolated at the rate of 82.5%, lactobacilli at the rate of 74.6%, C. albicans at the rate of 58.7%, and other Candida species collectively at the rate of 46%. The occurrence of salivary Mutans Streptococci was significantly higher in uncontrolled cases compared to healthy subjects. Salivary C. albicans occurred at a significantly lower frequency among controlled cases. C. dubliniensis and C. tropicalis occurred more frequently in the saliva of children with poor glycemic control. We observed higher counts of plaque Mutans Streptococci in children with poorer oral hygiene and poorer glycemic control. Both salivary and plaque C. albicans counts were higher in worse caries status regardless of glycemic status. Salivary Lactobacillus count appears as a marker of caries status.

Conclusion: Although diabetes did not show significant effect on increasing risk of dental caries, the oral microbiologic profile was different among healthy and diabetic children and was affected by the level of glycemic control.