1 型糖尿病児と健常児の口腔保健と口臭

Oral health and halitosis among type 1 diabetic and healthy children.

• Tayyibe Aslihan Iscan
• Cansu Ozsin-Ozler
• Tulin Ileri-Keceli
• Bahar Guciz-Dogan
• Ayfer Alikasifoglu
• Meryem Uzamis-Tekcicek

抄録

AIM:

1型糖尿病の子供とそうでない子供の口腔保健状態、口腔保健関連習慣、口臭を評価する。

AIM: To evaluate the oral health status, oral health related habits and halitosis of children with and without type 1 diabetes.

材料と方法:

本研究では、1型糖尿病の有無にかかわらず、さまざまな指標（dmft/DMFT、国際カリエス検出評価システム（ICDAS）II、プファ、歯肉および歯周病指標）を用いて、1型糖尿病の有無にかかわらず、小児の口腔内の健康状態を評価した。口臭は有機嗅覚評価と硫黄モニタリングにより評価した。

MATERIALS AND METHODS: In this study the oral health status of children with and without type 1 diabetes were evaluated by using different indices (dmft/DMFT, International Caries Detection and Assessment System(ICDAS) II, pufa, gingival and periodontal indices). Halitosis was determined by organoleptic assessment and sulfur monitoring.

結果:

本研究では，6～13歳の100名の小児を対象に，平均年齢10.3±2.1歳の1型糖尿病患者50名（男児24名，女児26名）と平均年齢9.9±1.5歳の健常者50名（男児30名，女児20名）を対象に，口内の健康状態と口臭の関連性を評価した．1型糖尿病患者ではDMFTとDMFSの中央値が低かったが，DMFTとDMFSの中央値は健常者と同程度であった．虫歯病変は糖尿病児の60.0％、健常児の58.0％で認められた。ICDAS II指数では，糖尿病児の42.0％，健常児の56.0％に重度の虫歯が認められた．平均プラーク指数は糖尿病児で統計学的に有意に低かった（p＝0.04）。1型糖尿病児の12.0％、健常児の18.0％では、両群ともに揮発性硫黄化合物（VSC）が150ppb以上と判定され、最も診断スコアが高かったのは1であった。また，HbA1cのカットオフ値が7.5%の糖尿病児では，口腔保健指標の結果と揮発性硫黄化合物（VSC）スコアに統計学的に有意な差は認められなかった．

RESULTS: One hundred children with the age range between 6-13 years, 50 type 1 diabetics (24 boys,26 girls) with mean age (±sd) of 10.3 ± 2.1 years and 50 healthy (30 boys, 20 girls) with mean age (±sd) of 9.9 ± 1.5 years, participated in the study. The median values of dmft and dmfs was lower in children with type 1 diabetes, while for DMFT and DMFS indices were similar with the healthy group. Cavitated caries lesions were observed in 60.0% of children with diabetes and in 58.0% of healthy children. According to the ICDAS II index, 42.0% of children with diabetes and 56.0% of healthy children had severe decay. The mean plaque index was statistically significantly less in diabetic children (p = 0.04). In 12.0% of children with type 1 diabetes and in 18.0% of healthy children, volatile sulfur compounds (VSC) were determined to be ≥150 ppb and the most diagnosed score was 1 in both groups. In diabetic children with the cut off value of 7.5% HbA1c, there was no statistically significant difference in oral health indices results and VSC scores.

結論:

本研究の結果は，糖尿病が口腔・歯周病リスクを増加させるという有意な効果を支持するには不十分である．それにもかかわらず，1型糖尿病患者とその親御さんの口腔・歯の健康，定期的な口腔ケア，歯科受診の重要性を強調することが重要である．

CONCLUSION: Findings of the present study are insufficient to support a significant effect of diabetes on increasing the risk of oral and periodontal diseases. Nonetheless, it is important to emphasize the importance of oral and dental health, regular oral care and dental visits both to the patients with type 1 diabetes and their parents.