Evaluation of caries risk factors and effects of a fluoride-releasing adhesive material in children with insulin-dependent diabetes mellitus (IDDM): initial first-year results.

The aims of this study were to evaluate the prevalence and risk factors of dental caries, and to determine whether there is any relationship between a fluoride-releasing adhesive material and the development of dental caries in the first year in children with insulin-dependent diabetics (IDDM). The average age of the subjects was 4-15 years, and they had been suffering from IDDM for at least 2 years. The DMF/df(t) indices of 70 patients were calculated and total HbA1 (%) (glucose levels of blood) values were recorded from the medical records after clinical examination. The mean DMF/df(t) values of poorly controlled subjects (HbA1 values over 13%) were significantly higher than those of moderately (HbA1, 10.0-12.9%) and well-controlled (HbA1 values, <10%) subjects. The levels of salivary mutans streptococci (MS) and lactobacilli (LB) and the pH of paraffin-stimulated whole saliva were measured in diabetic patients. Salivary MS and LB scores of the poorly controlled subjects were significantly higher (2.5+/-0.7 and 2.1+/-1.0) than those of the moderately (1.6+/-0.9 and 1.1+/-0.8) and well-controlled (1.2+/-1.0 and 0.8+/-0.8) subjects. The mean pH values among all subjects were not statistically significant. All dental caries were restored with a fluoride-releasing adhesive material. At the end of the first year, no new caries or lost restorations were observed in these patients. Moreover, the rate of MS in the poorly and moderately controlled subjects was considerably reduced. However, no significant statistical reduction of MS was determined in the well-controlled subjects. The level of lactobacilli in the poorly controlled, moderately controlled, and well-controlled subjects was reduced.