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Saúde oral em crianças com Diabetes tipo 1: necessidades específicas e abordagens terapêuticas – revisão sistemática
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Introdução: O Diabetes Mellitus tipo 1 é uma doença crónica autoimune que acomete predominantemente crianças e adolescentes. Esta condição pode impactar de modo significativo a saúde oral, estando associada a manifestações como cárie dentária, gengivite, periodontite, xerostomia e alterações na microbiota oral, especialmente em casos de controlo glicémico insatisfatório. Apesar da ampla investigação sobre o tema, a literatura apresenta resultados divergentes quanto à prevalência e gravidade dessas alterações, justificando a realização de uma revisão sistemática que permita consolidar evidências e propor abordagens clínicas e preventivas mais eficazes e direcionadas a esta população.
Objetivos: O objetivo desta revisão sistemática foi avaliar se as crianças com Diabetes Mellitus tipo 1 apresentavam alterações na saúde oral. Esta revisão sistematizada teve como objetivo responder à seguinte questão: Crianças com Diabetes Mellitus tipo 1 apresentam um risco aumentado de desenvolver patologias orais que justifiquem cuidados dentários específicos? Material e métodos: A metodologia foi realizada através de uma pesquisa nas bases de dados: PubMed, SciELO e Cochrane. Os termos de pesquisa utilizados de acordo com o MeSH foram “Diabetes Mellitus Type 1”, “Pediatric Dentistry”, “Dental Caries”, “Oral Health”, “Children” articuladas com o marcador booleano “AND” ou “OR”. Foram considerados elegíveis os estudos realizados com crianças e adolescentes com menos de 18 anos, com diagnóstico confirmado de Diabetes Mellitus tipo 1. Além disso, os estudos deveriam investigar alterações orais associadas ao Diabetes Mellitus tipo 1, como cárie dentária, doenças gengivais e periodontais, xerostomia, alterações salivares ou da microbiota oral. Também foram incluídos estudos que apresentavam grupo controlo composto por crianças saudáveis, ou que compararam diferentes níveis de controlo glicémico. Foram excluídos os estudos conduzidos apenas com adultos, aqueles que não permitiam a extração de dados específicos da população pediátrica, os que não tinham relação direta com a saúde oral ou apresentavam dados insuficientes.
Resultados: As evidências analisadas, dos 7 artigos incluídos, indicavam que crianças com Diabetes tipo 1 apresentam maior risco de cárie dentária, doenças gengivais, alterações salivares e desequilíbrios na microbiota oral, especialmente quando o controlo glicémico é inadequado.
Conclusão: O Diabetes Mellitus tipo 1 tem um impacto negativo na saúde oral das crianças, salientando a importância de uma abordagem clínica multidisciplinar e individualizada. Estes resultados reforçam a necessidade de estratégias preventivas específicas e de um acompanhamento em saúde oral adaptado às particularidades desta população.
Introduction: Type 1 Diabetes is a chronic autoimmune disease that predominantly affects children and adolescents. This condition can significantly impact oral health and is associated with manifestations such as dental caries, gingivitis, periodontitis, xerostomia, and changes in the oral microbiota, particularly in cases of poor glycaemic control. Despite extensive research on this topic, the literature presents conflicting results regarding the prevalence and severity of these oral alterations, thus justifying the need for a systematic review to consolidate the evidence and propose more effective and targeted clinical and preventive approaches for this population. Objectives: The aim of this systematic review was to evaluate whether children with Type 1 Diabetes Mellitus exhibit alterations in oral health. Specifically, the review sought to answer the following question: Do children with Type 1 Diabetes Mellitus have an increased risk of developing oral pathologies that warrant specific dental care? Materials and Methods: The methodology involved a search of the following databases: PubMed, SciELO, and Cochrane. The search terms used, according to MeSH, were: “Diabetes Mellitus Type 1”, “Pediatric Dentistry”, “Dental Caries”, “Oral Health”, and “Children”, combined using the Boolean operators “AND” and “OR”. Eligible studies included those conducted on children and adolescents under 18 years of age with a confirmed diagnosis of Type 1 Diabetes Mellitus. Furthermore, the studies had to investigate oral alterations associated with Type 1 Diabetes Mellitus, such as dental caries, gingival and periodontal diseases, xerostomia, salivary changes, or alterations in the oral microbiota. Studies were also included if they involved a control group of healthy children or compared different levels of glycaemic control. Studies conducted exclusively on adults, those that did not allow for the extraction of data specific to the paediatric population, those unrelated to oral health, or those with insufficient data were excluded. Results: The evidence analysed from the 7 included articles indicated that children with Type 1 Diabetes are at increased risk for dental caries, gingival diseases, salivary alterations, and imbalances in the oral microbiota, particularly when glycaemic control is inadequate. Conclusion: Type 1 Diabetes has a negative impact on the oral health of children, highlighting the importance of a multidisciplinary and individualised clinical approach. These findings underscore the need for specific preventive strategies and oral health monitoring tailored to the particular needs of this population.
Introduction: Type 1 Diabetes is a chronic autoimmune disease that predominantly affects children and adolescents. This condition can significantly impact oral health and is associated with manifestations such as dental caries, gingivitis, periodontitis, xerostomia, and changes in the oral microbiota, particularly in cases of poor glycaemic control. Despite extensive research on this topic, the literature presents conflicting results regarding the prevalence and severity of these oral alterations, thus justifying the need for a systematic review to consolidate the evidence and propose more effective and targeted clinical and preventive approaches for this population. Objectives: The aim of this systematic review was to evaluate whether children with Type 1 Diabetes Mellitus exhibit alterations in oral health. Specifically, the review sought to answer the following question: Do children with Type 1 Diabetes Mellitus have an increased risk of developing oral pathologies that warrant specific dental care? Materials and Methods: The methodology involved a search of the following databases: PubMed, SciELO, and Cochrane. The search terms used, according to MeSH, were: “Diabetes Mellitus Type 1”, “Pediatric Dentistry”, “Dental Caries”, “Oral Health”, and “Children”, combined using the Boolean operators “AND” and “OR”. Eligible studies included those conducted on children and adolescents under 18 years of age with a confirmed diagnosis of Type 1 Diabetes Mellitus. Furthermore, the studies had to investigate oral alterations associated with Type 1 Diabetes Mellitus, such as dental caries, gingival and periodontal diseases, xerostomia, salivary changes, or alterations in the oral microbiota. Studies were also included if they involved a control group of healthy children or compared different levels of glycaemic control. Studies conducted exclusively on adults, those that did not allow for the extraction of data specific to the paediatric population, those unrelated to oral health, or those with insufficient data were excluded. Results: The evidence analysed from the 7 included articles indicated that children with Type 1 Diabetes are at increased risk for dental caries, gingival diseases, salivary alterations, and imbalances in the oral microbiota, particularly when glycaemic control is inadequate. Conclusion: Type 1 Diabetes has a negative impact on the oral health of children, highlighting the importance of a multidisciplinary and individualised clinical approach. These findings underscore the need for specific preventive strategies and oral health monitoring tailored to the particular needs of this population.
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Diabetes Mellitus tipo 1 Saúde oral Cárie dentária Dentária pediátrica Crianças Diabetes Mellitus Type 1 Oral health Dental caries Pediatric dentistry Children