Oral Complications in Diabetes

Children with IDDM have been reported to have car-ies incidence that is higher1, lower2-4, or similar to that of nondiabetic children. This contradiction may pos-sibly be explained by cohort characteristics, degree of diabetes control, and degree of adherence to dietary prescriptions. Adult patients with poor control of their IDDM seem to have more coronal caries5-7. In the general population, the frequency of root caries in-creases with age and is three times more prevalent in those age ≥65 years compared with young adults8. However, very few studies have reported on the inci-dence of root-surface caries as a significant problem in older patients with IDDM or NIDDM9. Periodontal disease is the most prevalent oral compli-cation in IDDM and NIDDM patients and has been labeled the "sixth complication of diabetes melli-tus"10. Numerous studies have shown both increased prevalence and severity of periodontal disease in pa-tients with IDDM. Diabetic children and adults with less than optimal metabolic control show a tendency towards higher gingivitis scores11-17. Early case reports suggested that diabetic adolescents and teenagers may suffer from periodontitis18. In a more recent study, the prevalence of periodontal disease was 9.8 % in 263 patients with IDDM, compared with 1.7 % in people without diabetes19. Most of the periodontal disease was found in those age 11-18 years (Figure 23.1)