June 11, 2008
Mention diabetes and oral health, and the first thing that comes to mind is gum disease. People with diabetes are at increased risk of chronic periodontitis. But there is another possible oral manifestation. Children with diabetes who are shedding their deciduous, or baby, teeth seem to get their permanent teeth sooner than other kids. This little-investigated observation is worth further study because aberrations in tooth eruption can lead to a series of complications, such as malocclusion, crowding, and therefore difficulty in maintaining good oral hygiene and increased risk of decay and gum disease. At the same time, more definitive data might help doctors diagnose childhood diabetes.
In the May issue of the journal Pediatrics, NIDCR grantees produce some of the best data to date. In a study of 590 children, ages six to 18, they found those with diabetes had accelerated tooth eruption in the late mixed dentition period. The mixed dentition period occurs between the ages of six and 14, when children have a mix of deciduous and permanent teeth. The scientists noted no differences during the early stages of tooth eruption in the two groups. But significantly, they noticed an accelerated eruption of clinically visible tooth crowns in the children with diabetes. Focusing on the still poorly defined biology of tooth eruption, the scientists noted, “These findings suggest a dual complement of mechanisms influencing the intra- and extra-alveolar phases of eruption, the latter being modified in diabetes.” They added, “Whereas the intra-alveolar phase of eruption is shown to be primarily governed by molecular signals generated by the dental follicle proper, extra-alveolar eruption seems to depend more on root development and bone apposition in the apical region of the erupting tooth.”
Read more about this paper by Lal S, Lamster IB, et al.