Oral health and salivary inflammatory markers in children and adolescents with type 1 diabetes: A cross-sectional study

PURPOSE: To evaluate the oral health status of children and young adults with type 1 diabetes (T1D) compared with healthy controls (HC), and its association with clinical parameters and salivary inflammatory markers. METHODS: Seventy-two subjects with T1D and 86 HCs underwent a clinical oral examination. Salivary cytokines were measured using multiplex immunoassays. Differences between oral conditions, clinical parameters and cytokines were tested and mediation models were used to evaluate the role of T1D and HbA1c. RESULTS: T1D subjects showed significantly higher frequencies of caries (67% vs. 28.5%) and gingivitis (76% vs. 42%) compared with HC (p < 0.001), independently by oral hygiene habits. In T1D, the presence of caries and gingivitis is associated with unfavourable clinical outcomes, including higher HbA1c, triglycerides, and urinary creatinine (p-value < 0.05). Salivary cytokine profile differed according to oral condition: caries was associated with reduced IL-4, IL-10, and IFN-γ; gingivitis with elevated IL-1Ra and RANTES; and both conditions with increased IL-1β (p-value < 0.05). Mediation analyses revealed no significant influence of HbA1c. CONCLUSION: Children and young adults with T1D show a higher prevalence of oral diseases and distinct inflammatory profile, regardless of metabolic status. These findings call for routine integration of oral assessment in T1D management.