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01-02-2018 | Original Article

The effect of chlorhexidine on glycemic and inflammation control in children with type 1 diabetes mellitus

Authors: Adriano Tomio Hoshi, Priscila Steffen, Laiane Carla Pawlak, Mônica Cavalheiro Persch, Franceline Gava de Morais, Geovana Rossetti Lavall, João Paulo Silva Leite, Carlos Augusto Nassar, Patrícia Oehlmeyer Nassar

Published in: Journal of Public Health | Issue 1/2018

Abstract

Aims

The aim of this study was to evaluate the effect of chlorhexidine 0.12% in periodontal parameters of dental plaque indices and gingival indices and in the glycemic control in children with type 1 diabetes mellitus (DM).

Methods

This crossover study was carried in two stages within a 6-month gap between them. We selected 16 volunteers with type 1 DM (aged from 6 to 14 years). These patients were randomly divided in two groups: group 1 (oral hygiene instruction; chlorhexidine 0.12% mouth rinse for 15 days); group 2 (oral hygiene instruction). In the second stage, the patients changed the groups. All patients received basic periodontal treatment and instruction to perform buccal hygiene using the scrubbing technique. After 3 and 6 months, the patients were instructed again and they received a periodontal maintenance therapy. The evaluation of periodontal parameters (dental plaque indices and gingival indices) and glycemic control (glycemic measures through fasting blood glucose levels and glycated hemoglobin levels - HbA1c) was carried out from 0, 3 and 6 months.

Results

Considering all parameters, only plaque indices presented a significant reduction after 6 months in group 1 and after 3 months in group 2, if compared with initial values. The groups did not present significant differences between them in all the assessed parameters.

Conclusion

The chlorhexidine solution did not provide benefits for periodontal parameters and for the glycemic control in children with type 1DM.

Addy M, Moran J (2010) Chemical control of the supragingival plaque (in Portuguese). In: Lindhe J, Lang NP, Karring T (eds) Clinical periodontology and implant dentistry, 5th edn. Guanabara Koogan, Rio de Janeiro, pp 706–736

American Diabetes Association (2010) Diagnosis and classification of diabetes mellitus. Diabetes Care 33:S62–S69. https://doi.org/10.2337/dc10-S062 CrossRefPubMedCentral

Aren G, Sepet E, Özdemir D, Dinççag N, Güvener B, Firatli E (2003) Periondontal health, salivary status, and metabolic control in children with type 1 diabetes mellitus. J Periodontol 74:1789–1795CrossRefPubMed

Arheian A, Omar S (2014) Dental caries experience and periodontal treatment needs of 10- to 15-year old children with type 1 diabetes mellitus. Int Dent J 64:150–154CrossRef

Botero JE, Yepes FL, Ochoa SP, Hincapie N, Roldan N, Ospina CA, Castrillon CA, Becerra MA (2013) Effects of periodontal non-surgical therapy plus azithromycin on glycemic control in patients with diabetes: a randomized clinical trial. J Periodontol Res 48:706–712. https://doi.org/10.1111/jre.12058

Claffey N, Nylund K, Kiger R, Garret S, Egelberg J (1990) Diagnostic predictability of scores of plaque, bleeding, suppuration, and probing pocket depths for probing attachment loss: 3 ½ years of observation following initial therapy. J Clin Periodontol 17:108–114CrossRefPubMed

Collin HL, Uusitupa M, Niskanen L, Kontturi-Närhi V, Markkanen H, Koivisto AM, Meurman JH (1998) Periodontal findings in elderly patients with non-insulin dependent diabetes mellitus. J Periodontol 69:962–966CrossRefPubMed

Fernandes PM, Rocha CT, Peixoto ITA, Queiroz IF, Nelson P, Queiroz AM (2010) Dental approach in patients with type 1 diabetes mellitus (in Portuguese). Pediatria 32:274–280

Gislen G, Nilsson KO, Matsson L (1980) Gingival inflammation in diabetic children related to degree of metabolic control. Acta Odontol Scand 38:241–246CrossRefPubMed

Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, Genco RJ (1997) Treatment of periodontal disease in diabetics reduced glycated hemoglobin. J Periodontol 68:713–719CrossRefPubMed

Hortense SR, Carvalho ER, Carvalho FS, Silva RPR, Bastos JRM, Bastos RS (2010) Use of chlorhexidine as a preventive and therapeutic agent in dentistry (in Portuguese). Rev Odontol Univ São Paulo 22:178–184

Lalla E, Cheng B, Lal S, Tucker S, Greenberg E, Goland R, Lamster IB (2006) Periodontal changes in children and adolescents with diabetes: a case-control study. Diabetes Care 29:295–299CrossRefPubMed

Lang NP, Brägger U, Salvi G, Tonetti MS (2010) Support periodontal therapy. In: Lindhe J, Lang NP, Karring T (eds) Clinical periodontology and implant dentistry, 5th edn. (in Portuguese). Guanabara Koogan, Rio de Janeiro pp, pp 1247–1270

Llambés F, Silvestre F-J, Hernández-Mijares A, Guiha R, Caffesse R (2008) The effect of periodontal treatment on metabolic control of types 1 diabetes mellitus. Clin Oral Investig 12:337–343. https://doi.org/10.1007/s00784-008-0201-0 CrossRefPubMed

Löe H, Schiött CR (1970) The effect of mouth rinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J Periodontol Res 5:79–83CrossRef

Löe H, Silness J (1963) Periodontal disease in pregnancy, I: prevalence and severity. Acta Odontol Scand 21:533–551CrossRefPubMed

Löe H, Theilade E, Jensen SB (1965) Experimental gingivitis in man. J Periodontol 36:177–187CrossRefPubMed

Nassar PO, Andrade L, Konrad FH, Serraglio AP, Balotin A, Colet D, Nassar CA (2008) Glycemic control in patients with diabetes mellitus and periodontal disease (in Portuguese). Rev Bras Ciências Saúde 12:21–30

Orbak R, Simsek S, Orbak Z, Kavrut F, Colak M (2008) The influence of type-1 diabetes mellitus on dentition and oral health in children and adolescents. Yonsei Med J 49:357–365. https://doi.org/10.3349/ymj.2008.49.3.357 CrossRefPubMedPubMedCentral

Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G, EURODIAB Study Group (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 373(9680):2027–2033. https://doi.org/10.1016/S0140-6736(09)60568-7 CrossRefPubMed

Perry DA (2007) Plaque control for the periodontal patient. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA (eds) Clinical periodontology, 10th edn. (in Portuguese). Elsevier, Rio de Janeiro, pp 733–744

Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R (2012) Periodontitis and diabetes: a two-way relationship. Diabetologia 55:21–31. https://doi.org/10.1007/s00125-011-2342-y CrossRefPubMed

Silness J, Löe H (1964) Periodontal disease in pregnancy, II: correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135CrossRefPubMed

Siudikiene J, Maciulskiene V, Dobrovolskiene R, Nedzelskiene I (2005) Oral hygiene in children with type I diabetes mellitus. Stomatologija 7:24–27PubMed

Van Der Weijden F, Echeverría JJ, Sanz M, Lindhe J (2010) Mechanic control to supragingival plaque. In: Lindhe J, Lang NP, Karring T (eds) Clinical periodontology and implant dentistry, 5th edn. (in Portuguese). Guanabara Koogan, Rio de Janeiro, pp 678–68

Vernillo AT (2003) Dental considerations for the treatment of patients with diabetes mellitus. J Am Dent Assoc 134:24S–33SCrossRefPubMed

Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27:1047–1053CrossRefPubMed

Xavier ACV, Silva IN, Costa FO, Correa DS (2009) Periodontal condition of children and adolescents with type I diabetes mellitus (in Portuguese). Arq Bras Endocrinol Metab 53:348–354

Title: The effect of chlorhexidine on glycemic and inflammation control in children with type 1 diabetes mellitus
Authors: Adriano Tomio Hoshi
Priscila Steffen
Laiane Carla Pawlak
Mônica Cavalheiro Persch
Franceline Gava de Morais
Geovana Rossetti Lavall
João Paulo Silva Leite
Carlos Augusto Nassar
Patrícia Oehlmeyer Nassar
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Public Health / Issue 1/2018
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-017-0842-z

At a glance: The STEP trials

Springer Medicine

The effect of chlorhexidine on glycemic and inflammation control in children with type 1 diabetes mellitus

Abstract

Aims

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Aims

Methods

Results

Conclusion

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