Abstract
Objective: The aim of this study was to determine the association between clinical manifestations of sickle cell anemia (including hospitalization and pain crisis) and dental caries in children in Bahia. Material and Methods: The study design was crosssectional, and the population included children aged from 6 to 96 months from August 2007 to July 2008 (N = 686). Interviews were performed to identify the sociodemographic profiles of the participants, and oral examinations were conducted by three examiners who were previously trained and calibrated to identify the presence of dental caries according to World Health Organization (WHO) criteria. Logistic regression analysis was performed for confirmatory analysis and estimation of confidence intervals (CIs). Results: The results showed that pain crises and hospitalizations were positively associated with caries (crude odds ratio (OR) = 2.11 and adjusted OR = 1.24; crude OR = 2.50 and adjusted OR = 1.46, respectively), but these associations were not statistically significant. Conclusion: The severity of the sickle cell condition alone was not sufficient to aggravate the prevalence of caries; thus, there are no major differences in caries prevalence between children with and without sickle cell disease.KEYWORDSSickle cell anemia; Dental caries; Epidemiology; Paediatrics.
Highlights
A s sickle-cell anemia is a disease that can cause systemic impairment, resulting in complications that usually require additional care such as hospitalizations and constant use of medications, it is necessary to pay greater attention to individuals with this condition because they are in a position of physical and social vulnerability [1]
The results related to the final model after the analysis showed that in the crude association, pain crisis is a factor associated with the occurrence of dental caries in children with sickle cell anemia (2.11-fold compared to the control)
As in the study by Laurence et al [4], in which the severity of sickle cell disease was analysed by the number of episodes of vasoconstrictive crisis, in the present study, it was observed that the severity of sickle cell disease alone did not aggravate the prevalence of caries
Summary
A s sickle-cell anemia is a disease that can cause systemic impairment, resulting in complications that usually require additional care such as hospitalizations and constant use of medications, it is necessary to pay greater attention to individuals with this condition because they are in a position of physical and social vulnerability [1]. Among the studies performed to establish a relationship between caries disease and sickle-cell anemia, Passos et al [2] reported the findings of a case-control study using the CPO-D index of adult individuals with and without the disease. The results showed that factors already known to cause caries had a greater influence than those directly related to the severity of sickle cell anemia evaluated by the frequency of the vasoconstrictive crisis, the presence of leg ulcers, jaundice, stroke and femoral necrosis. The severity of sickle cell disease, as assessed by the number of episodes of pain crises, number and duration of hospitalizations, comorbidities, presence of ulcers and transfusions, influenced the increased dental caries in children with sickle cell anemia, unlike socioeconomic characteristics
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