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Is there an association between early childhood caries and iron deficiency anaemia?

Abstract

Clinical question To determine the association between early childhood caries (ECC) and iron deficiency anaemia (IDA).

Data sources A systematic search was carried out in seven databases by two independent reviewers. Also, manual searching and grey literature screening were carried out.

Study selection Cross-sectional, case-control and cohort studies that evaluated the association between ECC and IDA were included. Only publications in the English language were considered for study eligibility.

Data extraction and synthesis The characteristics of the included studies - age, sex, sample size, diagnostic methods used, index used for ECC, blood parameters, odds ration/risk ratio, confidence interval, p value, outcomes and assessment of any confounders - were extracted from the included papers. The quality assessment for case-control and cohort studies was performed according to the Newcastle-Ottawa assessment scale, while the modified Newcastle-Ottawa assessment scale was used for the cross-sectional studies.

Results A total of 14 publications were included for qualitative review and seven of them were included in the meta-analysis. Children affected by ECC had an increased likelihood of IDA when compared to those not affected by ECC. However, the meta-analysis showed no statistical difference in blood parameters (haemoglobin, mean corpuscular volume and serum ferritin) in children with and without ECC.

Conclusions There is an association between ECC and increased odds of IDA; however, there is a lack of scientific evidence to determine a cause and effect relation or direction of association between ECC and IDA.

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References

  1. Pitts N, Baez R J, Diaz-Guallory C et al. Early Childhood Caries: IAPD Bangkok Declaration. Int J Paediatr Dent 2019; 29: 384-386.

  2. Gedfie S, Getawa S, Melku M. Prevalence and Associated Factors of Iron Deficiency and Iron Deficiency Anaemia Among Under-5 Children: A Systematic Review and Meta-Analysis. Glob Paediatr Health 2022; DOI: 10.1177/2333794X221110860.

  3. Miller J L. Iron deficiency anaemia: a common and curable disease. Cold Spring Harb Perspect Med 2013; DOI: 10.1101/cshperspect.a011866.

  4. Tinanoff N, Baez R J, Diaz Guillory C et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent 2019; 29: 238-248.

  5. Schroth R J, Levi J, Kliewer E, Friel J, Moffatt M E K. Association between iron status, iron deficiency anaemia, and severe early childhood caries: a case-control study. BMC Paediatr 2013; 13: 22.

  6. Tang R-S, Huang M-C, Huang S-T. Relationship between dental caries status and anaemia in children with severe early childhood caries. Kaohsiung J Med Sci 2013; 29: 330-336.

  7. Abed N T, Aly I A M, Deyab S M, Ramoon F M H. The relation between early dental caries and iron-deficiency anaemia in children. Med Res J 2014; 13: 108-114.

  8. Sadeghi M, Darakhshan R, Bagherian A. Is there an association between early childhood caries and serum iron and serum ferritin levels? Dent Res J (Isfahan) 2012; 9: 294-298.

  9. Nur B G, Tanrıver M, Altunsoy M, Atabay T, Intepe N. The prevalence of iron deficiency anaemia in children with severe early childhood caries undergoing dental surgery under general anaesthesia. Paediatr Dent J 2016; 26: 83-87.

  10. Page M J, McKenize J E, Bossuyt P M et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; DOI: 10.1136/bmj.n71.

  11. Balshem H, Helfand M, Schünemann H J et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011; 64: 401-406.

  12. Wells G A, Shea B, O'Connell D et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2013. Available at https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed September 2022).

  13. Modesti P A, Reboldi G, Cappuccio F P et al. Panethnic Differences in Blood Pressure In Europe: A Systematic Review And Meta-Analysis. PLoS One 2016; DOI: 10.1371/journal.pone.0147601.

  14. Deane S, Schroth R J, Sharma A, Rodd C. Combined deficiencies of 25-hydroxyvitamin D and anaemia in preschool children with severe early childhood caries: a case-control study. Paediatr Child Health 2018; DOI: 10.1093/pch/pxx150.

  15. Nagarajan U, Dhingra R, Chaudhuri P, Arora P. Influence of full mouth rehabilitation on iron deficiency anaemia status in children with severe early childhood caries. J Applied Dent Med Sci 2017; 3: 25-32.

  16. Shaoul R, Gaitini L, Kharouba J, Darawshi G, Maor I, Somri M. The association of childhood iron deficiency anaemia with severe dental caries. Acta Paediatr 2012; DOI: 10.1111/j.1651-2227.2011.02448.x.

  17. Bansal K, Goyal M, Dhingra R. Association of severe early childhood caries with iron deficiency anaemia. J Indian Soc Paedod Prev Dent 2016; 34: 36-42.

  18. Szeto A C, Harrison R L, Innis S M. Caries, iron deficiency and food security in low income, minority children. Can J Dent Hyg 2012; 46: 215-220.

  19. Clarke M, Locker D, Berall G, Pencharz P, Kenny D J, Judd P. Malnourishment in a population of young children with severe early childhood caries. Paediatr Dent 2006; 28: 254-259.

  20. Shamsaddin H, Jahanimoghadam F, Poureslami H, Haghdoost A A. The association between growth factors and blood factors with early childhood caries. J Oral Health Oral Epidemiol 2017; 6: 196-202.

  21. Singh R, Kumar M, Shenoy A, Khajuria R, Singh R, Verma S. Evaluation of interrelationship of early childhood caries and iron deficiency anaemia. Int J Current Res 2016; 8: 32622-32625.

  22. Iranna Koppal P, Sakri M R, Akkareddy B, Hinduja D M, Gangolli R A, Patil B C. Iron deficiency in young children: a risk marker for early childhood caries. Int J Clin Paediatr Dent 2013; 6: 1-6.

  23. Ahmed H A, Taha S E, El-Dokky N A. General health status of Egyptian children with early childhood caries. Egypt Dent J 2014; 60: 1-5.

  24. Higgins J P T, Thomas J, Chandler J et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.3. 2022. Available at www.training.cochrane.org/handbook (accessed September 2022).

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Hesse, D., Bonifácio, C. Is there an association between early childhood caries and iron deficiency anaemia?. Evid Based Dent 23, 146–147 (2022). https://doi.org/10.1038/s41432-022-0836-8

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