With improvements in anti-retroviral therapies children born with HIV are now surviving into adolescence and early adulthood. Oral manifestations of HIV are common and it is suggested that HIV- infected children are at greater risk of dental caries.
Methods
Searches were conducted in the Medline, BIREME, Embase, Google Scholar, and SIGLE databases for observational studies of HIV-infected and non-infected children/adolescents between 0-18 years old. Two reviewers independently selected studies abstracted data and assessed study quality. An 11-point checklist was used to assess study quality. Meta-analysis was conducted for cavitated and non-cavitated lesions and for cavitated lesions only using a random effects model.
Results
5 case-controlled studies involving a total of 585 children (340 HIV +, 245 HIV -) were included
2 were considered to be at low risk of bias, 2 moderate risk and 1 high risk.
The meta-analysis excluded caries data on permanent teeth and showed a significant association between caries experience in primary dentition and HIV infection considering
- cavitated and non-cavitated lesions (OR = 2.33, 95% CI = 1.48-3.68) or
- only cavitated lesions (OR = 2.98, 95% CI = 1.59-5.59).
Conclusions
The authors concluded:
Our meta-analysis provides evidence of an association between HIV-infected children and the risk of dental caries disease in primary dentition.
Comments
While a wide search has been carried out for observational studies only a small number case-controlled studies were identified and only 2 of these were assessed as being at low risk of bias. This should be taken into consideration when considering the reviews findings. While appropriate preventive regimens are important for all children the additional burdens that living with HIV places on the child should highlight the importance of effective prevention for this group of children.
Links
Oliveira CA, Tannure PN, de Souza IP, Maia LC, Portela MB, Castro GF. Is dental caries experience increased in HIV-infected children and adolescents? A meta-analysis. Acta Odontol Scand. 2015 Mar 12:1-7. [Epub ahead of print] PubMed PMID: 25765439.
Don’t miss – Caries: higher risk in HIV-infected children http://t.co/NbGwK3ecMz #EBP
We thank Derek Richards for his relevant comments concerning the manuscript.
As there is a lack of systematic reviews in the dental literature investigating dental caries prevalence and incidence in HIV-infected pediatric patients
these observations reinforce the findings about the higher risk and higher caries experience in these special group, reinforcing the necessity of implementation of an oral health promotion program, specially designed to treat the special necessities showed by this group.
That’s sad