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Table of Contents Introduction ............................................................................................1 Abstract................................................................................................. 2 Diabetes Mellitus .................................................................................. 3 Dental Caries ........................................................................................ 4 Diabetes Mellitus and Dental Caries ..................................................... 5

Significance ......................................................................................... 6 Conclusion .......................................................................................... 7 References ......................................................................................... 8

1 Introduction This is non-interactive qualitative research about the dental health of children who were born with diabetes mellitus . this research was to see the factors co-related with this disease and how it affects the oral health of the patient in general and his teeth specially. Diabetes is a common hereditary disease in our community now a days . .

People with diabetes mellitus appear to have predisposing factors that may place them at an increased risk for dental caries. people with diabetes may also be more prone to infections. In addition.2 Abstract Increasing prevalence of diabetes mellitus. the relationship between diabetes mellitus and dental caries prevalence is less clear. While the relationship between diabetes mellitus and periodontal disease has been previously established. along with its co-morbidities. including dental abscesses that result from progressive dental caries . in the population has made it an important public health issue.

or environmental in nature. Type 1 diabetes (formerly known as insulin-dependent diabetes mellitus). Among adults. and protein metabolism. Type 1 diabetes accounts for 5 to 10 percent of diagnosed cases. environmental toxins (nitrosamines) and food (early exposure to milk proteins in cow’s milk.3 Diabetes mellitus Diabetes mellitus consists of a set of symptoms associated with abnormal carbohydrate. which is inherited. insulin action. a single unifying theory of disease causation has not been found. or both. congenital rubella).3 Although there has been increased understanding of the pathogenesis of Type 1 diabetes mellitus. usually affects children and young adults.2 These “triggers” may include viruses (enteroviruses. which is caused by a deficiency of insulin.2 Risk factors for Type 1 diabetes may be genetic.1 The current theory for the pathogenesis of Type 1 diabetes assumes that everyone is born with a degree of susceptibility to the disease. which secrete insulin. autoimmune. cereals.1 The absolute insulin deficiency observed among patients with Type 1 diabetes results from destruction of the pancreatic β-cells. due to defects in insulin production. initiating the destruction of the pancreatic β-cells. Exposure to one or more environmental “triggers” alters the immune function. fat. coxsackie.4 . or gluten).

4 Dental Caries Dental caries.6 Without remineralization from saliva acting as buffer and restoring pH. This causes a drop in local pH in the mouth below a critical value. This occurs earlier in the stage of caries development. this process will eventually result into cavitation. but as the area is softened.5 . or tooth decay. Recession of the gingival margin from poor oral hygiene and loss of attachment from periodontal disease exposes the tooth root surface to the development of more dental caries. In the tooth enamel. and Lactobacilli spp. which results in demineralization of the tooth structures. In root surfaces.5 Endogenous bacteria.. primarily Steptococcus mutans. is the localized destruction of susceptible dental hard tissues by acids produced by bacterial fermentation of dietary carbohydrates. dental caries first manifests as white spot lesions which are small areas of sub-surface demineralization. in the dental plaque produce weak organic acids from as by-products of fermentable carbohydrates from our diets. caries also starts as demineralization. Dental caries is a multi-factorial disease that commonly affects people of all ages throughout their lifetimes. it is further penetrated by bacteria. Streptococcus sobrinus.

The reduction in saliva thus decreases resistance to caries-producing bacteria. leading to production of acidic by. high glucose levels in the saliva can increase the amount of fermentable carbohydrates by oral bacteria.5In addition. .5Abundant glucose in the saliva may also promote the growth of cariogenic bacteria and facilitate the frequency and duration of acidic episodes. which has been associated with persistent poor glycemic control.7 Periodontal disease can lead to recession of the gingival margin.8 Hyperglycemia in children. and alveolar bone loss.5 Diabetes Mellitus and Dental Caries People with diabetes are at an increased risk of developing oral conditions such as gingivitis. saliva also contains components that can directly attack cariogenic bacteria. adolescents. and adults with insulin-dependent diabetes mellitus have also been associated with decreased salivary secretion and high salivary glucose.products that cause teeth demineralization in dental caries. which can expose more tooth surfaces to caries attack. periodontal disease.5 People with diabetes can also experience hyposalivation and they may suffer from salivary dysfunction. Aside from calcium and phosphates that help remineralize tooth enamel. The absence of copious saliva may result in minimizing buffer activity which promotes remineralization of tooth structures early in the caries process.

may increase one’s susceptibility to dental caries. such as agreater prevalence of severe dental caries among diabetic patients. and tooth loss. abscess and infection. including dental abscesses that result from progressive dental caries.10 Dental caries and its sequelae can cause severe pain. oral disease is among the most expensive disease to treat in most industrialized countries. and reduction of tooth extractions as a consequence of dental caries among adults by 15 percent are among the Healthy People 2010 objectives for oral health.6 Significance The prevalence of dental caries and its burden on the general population is of significant public health interest since dental caries is the most common infectious disease known to man.10 Unfortunately. Reduction of untreated dental caries among adults. . Diabetes mellitus. there is sparse longitudinal populationbased data that would allow a temporal evaluation of the association between diabetes diagnosis and subsequent risk of dental caries. cross-sectional data may provide information regarding this relationship that may prove valuable for clinical practitioners to identify subpopulations at high risk of suboptimal oral health. However. the expenditures for oral health care was 81. orofacial pain can adversely impact the quality of life of an individual. a significant public health problem in its own right. Therefore.9 In addition.5 Untreated dental caries can lead to pain. and according to the report of the Surgeon General.5 billion dollars.10 In 2004. people with diabetes are also more prone to infections. it is important to identify patients who may be at particularly high risk of dental caries. In addition.

and patients with diabetes should be using topical fluoride treatment (mouth rinses. The medical practitioner has a key role in advising patients with dry mouth about their increased risk for caries and recommending use of the over-the-counter (OTC) products containing fluoride as well as referral for dental management.7 Conclusion Dental caries is not a specific complication of diabetes. pastes) on a daily basis. . gels. Prevention is essential. but dry mouth greatly increases the risk for caries as a result of loss of the re-mineralizing and buffering properties of saliva and increased plaque accumulation. Dental caries has been reported to be a particular problem in older patients with poorly controlled diabetes.

3) Robles DT. 2001. 2008. 2004. 5) Selwitz RH. Eisenbarth GS. Recent Prog Horm Res. of Health and Human Services. 4) Daneman D. 2007 Jan p-51 6) Featherstone JD. US Dept. 10) Bakhshandeh S. editor. Suomalainen K.p-58. . Dental caries. p-73. 2007. Ann Periodontol. 2000. 2001 Feb. Fain PR. Caries Res. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 7) Grossi SG. Lancet. Eisenbarth GS. Borrell LN. Treatment of periodontal disease and control of diabetes: an assessment of the evidence and need for future research. 2006 Mar 11. Taylor GW. National Institutes of Health. p 56:69-89.8 References 1) National diabetes statistics. p-42. 2001 May. In: Services UDoHaH. Type 1A diabetes induced by infection and immunization. 9) Oral health in America: a report of the surgeon general. Dental findings in diabetic adults.: National Institute of Dental and Craniofacial Health.6 -p138 8) Chavez EM. J Autoimmun. Mofid R. 2) Redondo MJ. 2001 Dec. National Institute of Diabetes and Digestive and Kidney Diseases. Murtomaa H. J Dent Res. National Institutes of Health. Type 1 diabetes. p. A longitudinal analysis of salivary flow in control subjects and older adults with type 2 diabetes.16 p-62. Genetics of type 1A diabetes. Ismail AI. p-8. Lancet. The continuum of dental caries--evidence for a dynamic disease process. Pitts NB. Ship JA.24. Vehkalahti MM.

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