Association between type 1 diabetes mellitus and dental caries: A systematic review and meta-analysis

Mahmoud Nassar , Omar Nassar , Hazem Abosheaishaa , Nahla Elhakim
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Abstract

Objective

To assess the correlation between patients with type 1 diabetes mellitus (T1DM) and dental caries outcomes, including missing teeth, missing surface, filling teeth, filling surface, plaque index, gingival index, and calculus index.

Methods

A comprehensive search was performed across EMBASE, Medline/Pubmed, and Web of Science databases from inception until February 20, 2023. Observational and interventional studies reporting dental caries outcomes in patients with T1DM were included. A random effects meta-analysis was performed to estimate the pooled effect sizes and 95 % confidence intervals.

Results

Thirty-three studies met the criteria for inclusion in the meta-analysis, which revealed that patients with T1DM had a reduced risk of missing teeth in comparison to those without diabetes (control group), with a mean difference (MD) of -0.03, CI 95 % [-0.03, -0.03]. No significant differences were found in missing surface, filling teeth, filling surface, or calculus index between T1DM and non-diabetic groups. However, patients with T1DM had a significantly higher plaque index (MD: 0.47, CI 95 % [0.06, 0.89]) than the non-diabetic group. The overall MD in DFMT between the DM and non-DM groups was 0.47 (95 % CI: 0.13, 0.82). The gingival index showed no significant difference between the groups.

Conclusion

This meta-analysis suggests that patients with T1DM have a higher plaque index than the non-diabetic group, whereas no significant differences were observed in other dental caries outcomes. Because of the considerable variability identified in certain analyses, additional research employing more extensive sample sizes and rigorous methodologies is required to validate these results.

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1 型糖尿病与龋齿之间的关系:系统回顾和荟萃分析
目的 评估 1 型糖尿病(T1DM)患者与龋齿结果(包括缺失牙、缺失面、充填牙、充填面、牙菌斑指数、牙龈指数和牙结石指数)之间的相关性。方法 在 EMBASE、Medline/Pubmed 和 Web of Science 数据库中进行全面检索,检索时间从开始到 2023 年 2 月 20 日。纳入了报告 T1DM 患者龋齿结果的观察性和干预性研究。结果33项研究符合纳入荟萃分析的标准,荟萃分析结果显示,与非糖尿病患者(对照组)相比,T1DM患者缺失牙齿的风险降低,平均差异(MD)为-0.03,CI 95 % [-0.03,-0.03]。在缺失面、充填牙、充填面或牙结石指数方面,T1DM 组和非糖尿病组之间没有发现明显差异。但是,T1DM 患者的牙菌斑指数(MD:0.47,CI 95 % [0.06,0.89])明显高于非糖尿病组。糖尿病组和非糖尿病组之间 DFMT 的总体 MD 为 0.47(95 % CI:0.13,0.82)。结论这项荟萃分析表明,T1DM 患者的牙菌斑指数高于非糖尿病组,但在其他龋齿结果方面未观察到显著差异。由于在某些分析中发现了相当大的差异,因此需要采用更广泛的样本量和更严格的方法进行更多的研究,以验证这些结果。
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