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IlustracijaIlustracija: DentalEdu (AI)
ZnanostClinical oral investigations

People with neurofibromatosis type 1 have a higher DMFT: 18.5 against 12.6

In a matched study, 42 people with neurofibromatosis type 1 had a mean DMFT of 18.5 against 12.6 in the control group (p = 0.001). Hyposalivation was found in 57.1 percent of them, and in 2.4 percent of controls.

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Dry mouth and thicker saliva alongside a markedly worse picture

Researchers around E. B. Luna published in Clinical Oral Investigations a matched study in which 42 people with neurofibromatosis type 1 (NF1) were compared with 42 controls matched for age and sex. Caries was diagnosed by World Health Organization criteria and caries experience measured with the DMFT index. Oral hygiene was recorded with the simplified OHI-S index, tongue coating from standardised photographs, the frequency of cariogenic diet, and the education, housing status and income of the family.

Saliva was measured in detail: unstimulated and chewing-stimulated flow, pH, buffering capacity, viscosity, and calcium, phosphorus, potassium, magnesium, amylase and lipase.

The NF1 group had a higher DMFT (18.5 ± 8.6 against 12.6 ± 7.4; p = 0.001). Hyposalivation was considerably more frequent, 57.1 percent against 2.4 percent for unstimulated flow and 40.5 percent against 0 percent for stimulated flow, as was high saliva viscosity (71.4 percent against 11.9 percent; all p < 0.001). Within the NF1 group, DMFT correlated positively with the tongue coating index (ρ = 0.312; p = 0.044). In multiple regression, NF1 was independently associated with a higher DMFT (p < 0.001), and alongside it lower family income (p < 0.001) and poorer oral hygiene (p = 0.016).

Limitations

A matched study with 42 participants per group shows association, not causation, and the authors themselves state that the power for comparing salivary flow within the NF1 group was only 20.4 percent.

For the practice

  • Treat a patient with NF1 as high caries risk from the first visit: shorter recall, more intensive biofilm control, topical fluorides.
  • Check salivary flow and viscosity and ask about the sensation of dry mouth. Hyposalivation was the rule in this group, not the exception.
  • Tongue coating is not a cosmetic detail: it tracked a higher DMFT, so tongue cleaning is worth including in home care instructions.