Dietary and metabolic effects on the oral status of patients with phenylketonuria: a nation-based cross-sectional study

Abstract

Objectives The aim of this study was to compare the prevalence of oral diseases (caries, periodontal disease, enamel defects) between patients with phenylketonuria (PKU), their siblings, and a matched control group. Materials and methods A total of 109 patients with PKU, 14 siblings of PKU patients, and 100 healthy individuals aged 6 to 68 years were recruited. All participants completed a questionnaire based on their health status. The patients’ decayed/missing/filled teeth index (dmft/DMFT), gingival bleeding index (GBI), plaque control record (PCR), periodontal screening and recording index (PSR), and developmental enamel defects index (DDE) were recorded. Descriptive statistics and regression modeling were used to examine potential associations between the exposure and the outcomes of interest. Results Patients with PKU had 1.6 times more caries (95% confidence interval (CI) 1.22 to 2.20; p = 0.001), seven times more enamel defects (95% CI 3.94 to 14.21; p < 0.001), and four times higher PSR values (95% CI 2.26 to 7.15; p < 0.001) than the control group. The siblings had significantly fewer enamel defects but no significant differences in caries and periodontal parameters compared to the PKU patients. Conclusions The results showed a higher risk for the development of caries, periodontitis, and enamel defects in PKU patients. Clinical relevance Implementation of preventive measures and regular dental care is necessary for patients with PKU.

Oral microbiota of patients with phenylketonuria: A nation‐based cross‐sectional study

“…PKU patients exhibited worse dental health than controls, which was in part described for this cohort earlier (Bingol et al, 2023), with significantly higher PCR, GBI, PSI and DMFT values, the latter two applying only to the adult group (Table 1). Children with PKU had a significant higher prevalence of DDE than their age‐matched controls and PKU adults.…”

“…One‐hundred and nine PKU patients, aged 6–68 years, and 114 metabolically healthy age‐matched controls, 15 of whom were siblings of PKU patients from the cohort, were recruited and clinically examined as previously described (Bingol et al, 2023), according to the European guidelines on PKU (van Wegberg et al, 2017). This study followed the Declaration of Helsinki and STROBE protocol (Supplementary Methods) and was approved by the medical ethical committees of the Charité ‐ Universitätsmedizin Berlin (EA2/036/18) and the University of Leipzig (369/18‐Ik), registered in the German Clinical Trials Register and International Clinical Trials Registry Platform (DRKS00027482).…”

“…The subgingival plaque microbiota of PKU patients (PKU-SP) was less diverse and differed significantly from controls (Ctrl-SP), but less (Bingol et al, 2023).…”

“…PKU patients exhibit deteriorated oral health, including periodontitis, caries and enamel hypoplasia (Abola et al, 2022; Bingol et al, 2023). However, although high sugar consumption is causal for higher caries prevalence, the relationship between specific PKU diet and susceptibility to periodontitis is unclear.…”

Evaluation of Decayed, Missing Due to Caries, and Filled Teeth Index in Children with Phenylketonuria in Comparison to Normal Population

“…Regardless of the study limitations, the study findings reported by Ghasemi et al 1 really support the recently published observation that PKU patients have a higher risk to develop DC, enamel defects, and periodontitis. 3 …”