Avaliação de fluxo, pH e glicose salivares e experiência de cárie em crianças com e sem diabetes mellitus tipo 1: estudo longitudinal

Abstract

Diabetes Mellitus type 1 (DM1) corresponds to diabetes associated with almost complete destruction of pancreatic beta cells, which results in an absolute insulin deficiency. The incidence of DM1 has increased mainly among preschool children, with increase of 5.4% in groups of 0 to 4 years old. The oral cavity is affected by some clinical manifestations caused by DM1 and caries can be highlighted. The aim of the present study, which is unprecedent, is to evaluate pH, salivary flow and glucose and caries experience in children with and without diabetes mellitus type 1. Thitry-nine children, both gender, aged 2 to 10 years with DM1 were selected and 56 children matched for gender and age to compose the control group. The volunteers were selected at two reference centers for the treatment of diabetes and at Dentistry college of Federal University of Ceará. Data were collected in 3 pre-determined periods: initial consultation (T0), after 6 (T6) and 12 months (T12) of the initial consultation. Initially, anamnesis was performed. Then, through the International System of Evaluation and Detection of Caries (ICDAS), the clinical examination was performed. The ICDAS allows the inclusion of new risk assessment tools that can help in making better decisions in clinical practice, as well as serving clinical and epidemiological research. Non-stimulated saliva was collected, then centrifuged and the supernatant lyophilized. The results showed significant differences in the treatment of the two groups in T0 and T6. The concentration of glucose in the saliva was higher, there was no group of diabetics in all periods, with the same result, and T6 and T12 did not have significant expressions. In the comparison of pH between the periods, a statistically significant correlation was found. Diabetic patients presented higher caries severity when compared to the group without diabetes. In conclusion, the results of the present study are particularly important for the successful use of the saliva for studies with patients with type 1 diabetes mellitus, although other studies are needed so to evaluate the possibility of relationship between variables and their applicability, with regard the early diagnosis and prognosis of Diabetes.