Iron Deficiency Anemia in Children with and Without Dental Caries: A Systematic Review and Meta-Analysis

Abstract

Context: Dental caries is a complication affecting the health of society, so it is vital to manage. Most children with early childhood caries (ECC) are believed to undergo anemia, altered physical growth patterns, and low weight. Objectives: This study aimed to evaluate the relationship between dental caries and iron deficiency anemia (IDA) in children. Evidence Acquisition: The medical subject headings (MeSH) and non-MeSH were applied to choose the search terms. English language case-control studies assessing blood factors associated with IDA in children with and without dental caries were potentially eligible. Two independent researchers carried out an electronic search to retrieve studies published in the English language on Scopus, ProQuest, PubMed, and Web of Science databases in October 2020. Initially, 494 articles were obtained. Of them, 17 were eligible for inclusion, of which eight studies were eliminated. The meta-analysis was done using the comprehensive meta-analysis software (version 2, Biostat). The forest plots estimated the mean difference and depicted the results of the meta-analysis. The Egger's and Begg's tests assessed the publication bias. Results: A significant difference was observed in serum ferritin levels between the case and control groups, with a mean difference of -0.230 (95% confidence interval (CI): -0.446 to -0.015; P value = 0.008). Blood hemoglobin and mean corpuscular volume (MCV) levels indicated significant mean differences of -0.991 (95% CI: -1.813 to -0.169) and -0.807 (95% CI: -1.336 to -0.279), respectively (P value < 0001). In the case group, all three blood parameters were significantly lower. Conclusions: Hemoglobin, serum ferritin, and MCV levels are lower in children with dental caries than in caries-free children.