Investigation of the oral status and microorganisms in children with phenylketonuria and type 1 diabetes

The aim of this study was to investigate the oral parameters that influence the caries risk and risk of developing periodontal disease in children with phenylketonuria (PKU) and type 1 diabetes compared to healthy children. Two hundred and thirty-eight children between the ages of 3 and 18 years were recruited in the PKU, diabetes and healthy group. The decayed, missing and filled surfaces (dmfs/DMFS) index, papillary bleeding index (PBI) and the Silness & Loe Index were assessed. Quantitative real-time polymerase chain reaction (PCR) was used for the detection of Streptococcus mutans (Sm), Lactobacillus casei (Lca), Lactobacillus species (Lac), Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Tannerella forsythensis (Tf). A statistically significant difference in the dmfs index value was found between the three groups. The mean dmfs index value for the PKU children (4.18) was found to be relatively high. Comparing the three groups, diabetics showed statistically significant higher values for the Silness and Loe Index. Comparing the diabetics to just the healthy children, the diabetics revealed a small statistically significant difference in the PBI score. A statistically significant difference was found between Lac, Lca and Pg in the three groups. Counts of Lac were the lowest in the PKU children. The diabetics showed the highest counts of Lca but lowest for Pg. Comparing the three groups, children with PKU revealed a higher caries experience in their primary dentition. While the diabetic children showed a lower one in their primary dentition, they were found to possess a slightly higher risk of developing periodontal disease. It is proposed that both groups of child patients be encouraged to seek early dental advice and be incorporated in a meticulous prevention programme.