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.
Similar content being viewed by others
Change history
30 January 2018
The journal had been advised to revise the title so that Clarivate Analytics can try to count the citations more accurately. There’s been confusion due to the existence of another journal with the same name.
References
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
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 74:1789–1795
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 64:150–154
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 17:108–114
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 69:962–966
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 38:241–246
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 68:713–719
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 29:295–299
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
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 5:79–83
Löe H, Silness J (1963) Periodontal disease in pregnancy, I: prevalence and severity. Acta Odontol Scand 21:533–551
Löe H, Theilade E, Jensen SB (1965) Experimental gingivitis in man. J Periodontol 36:177–187
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
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
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
Silness J, Löe H (1964) Periodontal disease in pregnancy, II: correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135
Siudikiene J, Maciulskiene V, Dobrovolskiene R, Nedzelskiene I (2005) Oral hygiene in children with type I diabetes mellitus. Stomatologija 7:24–27
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–33S
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 27:1047–1053
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
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest and sources of funding statement
The authors declare that there are no conflicts of interest in this study. This study was supported by the University of the State of Western Parana, Cascavel, Paraná, Brazil.
Additional information
The original version of this article was revised: Due to the existence of another journal with the same name, the Publisher has added a subtitle, “From Theory to Practice.” Effective as of January 2018, the new title of this Journal is Journal of Public Health: From Theory to Practice.
A correction to this article is available online at https://doi.org/10.1007/s10389-017-0893-1.
Rights and permissions
About this article
Cite this article
Hoshi, A.T., Steffen, P., Pawlak, L.C. et al. The effect of chlorhexidine on glycemic and inflammation control in children with type 1 diabetes mellitus. J Public Health 26, 23–28 (2018). https://doi.org/10.1007/s10389-017-0842-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-017-0842-z