Asthma doubles the risk of caries in both primary and permanent dentition

shutterstock_3275732-caries -9-10yr old

Asthma and caries are two of the commonest health problems affecting children.  This review and meta-analysis was conducted to synthesize the evidence on the relation between asthma and caries.

The authors searched Medline, Government reports and conference proceedings for case-control, cohort, or cross sectional studies   that provided relevant and applicable quantitative information on the relation between asthma and caries. Quality was assessed using the Newcastle-Ottawa Quality Assessment Scale.   Both fixed and random effects models were used to calculates summary effects estimates with heterogeneity being studies in meta-regression analysis.

18 studies were included with the meta-analysis being based on 11 articles providing estimates of the effect of asthma on primary dentition and 14 articles on permanent dentition.

The summary estimates for the relation between asthma and caries from the random-effects models were

  • Primary dentition        2.73 (95% confidence interval:1.61, 4.64)
  • Permanent dentition  2.04 (95% confidence interval: 1.44, 2.89)

Factors identified as determinants of heterogeneity were geographic region for primary dentition and publication year, sample size, asthma definition, and information on the use of asthma medication for permanent dentition.

They concluded:-

Evidence from this analysis suggests that asthma doubles the risk of caries in both primary and permanent dentition. Publication bias diagnostics and simulation suggested possible overestimation of the summary odds ratio for permanent dentition but not for primary dentition. Physicians and dentists should recommend preventive measures against caries for persons with asthma.

Alavaikko S, Jaakkola MS, Tjäderhane L, Jaakkola JJ. Asthma and Caries: A Systematic Review and Meta-Analysis. Am J Epidemiol. 2011 Aug 9. [Epub ahead of print] PubMed PMID: 21828369.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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