Oral Complications in Diabetes

ies incidence that is higher, lower, or similar to that of nondiabetic children. This contradiction may possibly 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 caries. In the general population, the frequency of root caries increases with age and is three times more prevalent in those age ≥65 years compared with young adults. However, very few studies have reported on the incidence of root-surface caries as a significant problem in older patients with IDDM or NIDDM. Periodontal disease is the most prevalent oral complication in IDDM and NIDDM patients and has been labeled the "sixth complication of diabetes mellitus". Numerous studies have shown both increased prevalence and severity of periodontal disease in patients with IDDM. Diabetic children and adults with less than optimal metabolic control show a tendency towards higher gingivitis scores. Early case reports suggested that diabetic adolescents and teenagers may suffer from periodontitis. 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 diabetes. Most of the periodontal disease was found in those age 11-18 years (Figure 23.1). Chapter 23