Dental caries and periodontal status in children and adolescents with type 1 diabetes mellitus: an umbrella review

To summarise and evaluate the evidence from systematic reviews on the oral health of children and adolescents with type 1 diabetes mellitus (T1DM).

A literature search was conducted in four databases for systematic reviews, with or without meta-analysis, reporting on dental caries experience and/or periodontal health of patients up to 19 years of age with T1DM, compared to healthy controls. Study selection and data extraction were performed independently by two reviewers and findings were synthesised descriptively. Overlap of primary studies was assessed using the Corrected Covered Area and methodological quality using the ROBIS tool.

Eleven systematic reviews were included, from a total of 3437 records identified. Each review included a range of initial studies (2–36), identifying a total of 82 primary studies (very high overlap). Most were cross-sectional with sample sizes ranging between 174 and 2519 in T1DM and 217– 2490 in healthy controls. Five reviews were of high risk of bias, with the remaining being either of low (n = 3) or unclear (n = 3) risk. Caries experience did not differ significantly in primary dentition, whereas in the permanent dentition, some reviews reported an increased experience prevalence, particularly in those with poorer glycaemic control. Greater gingival inflammation and periodontal tissue destruction were observed in children and adolescents with T1DM.

Children and adolescents with T1DM may be at greater risk of periodontal disease, while evidence on dental caries remains inconsistent. Methodological heterogeneity across studies emphasises the need for well-designed longitudinal research and high-quality systematic reviews with standardised outcome measures.