Aguirre-Ipenza Rubén, Nieto-Gutiérrez Wendy, Contreras Winnie, Contreras Pavel J, Curioso Walter H
Faculty of Health Sciences, Universidad Continental, Lima, Perú.
Unidad de Investigación para la Generación de Síntesis de Evidencia en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú.
Glob Pediatr Health. 2024 Sep 6;11:2333794X241273130. doi: 10.1177/2333794X241273130. eCollection 2024.
To evaluate the evidence regarding the association between iron deficiency anemia (IDA) and dental caries in children and adolescents. Searches were conducted in 4 international databases from the beginning of records until October 2023. Studies evaluating the association between IDA and dental caries in individuals aged 6 months to 18 years were included. Risk of bias was assessed using the Newcastle Ottawa Scale. Quantitative synthesis was performed using the inverse variance or Mantel-Haenzel method, depending on the type of outcome analyzed. Measures of association included odds ratios and mean differences, employing a random-effects model with a 95% confidence interval. A total of 1161 studies were identified, of which 12 were selected for qualitative review and 9 for meta-analysis. A significant association was found between IDA and dental caries (odds ratio of 3.54; 95% CI: 2.54-4.94) and a higher rate of dental caries in the presence of IDA (mean difference of 1.96; 95% CI: 1.07-2.85). The certainty of evidence according to GRADE was rated as very low. Despite the limited certainty, the findings indicate a significant association between IDA and dental caries. It is prudent to interpret these results with caution, considering the methodological limitations of the studies. However, given the potential relevance of this association for public health, recommending oral health strategies, including preventive and corrective dental interventions, for anemia control programs underlines the importance of more rigorous future research to strengthen the certainty of the evidence and guide the implementation of these strategies.
评估关于儿童和青少年缺铁性贫血（IDA）与龋齿之间关联的证据。从各数据库有记录开始至2023年10月，在4个国际数据库中进行了检索。纳入了评估6个月至18岁个体中IDA与龋齿之间关联的研究。使用纽卡斯尔-渥太华量表评估偏倚风险。根据所分析结局的类型，采用逆方差法或曼特尔-亨塞尔法进行定量合成。关联度量包括比值比和均值差，采用具有95%置信区间的随机效应模型。共识别出1161项研究，其中12项被选作定性综述，9项被选作荟萃分析。发现IDA与龋齿之间存在显著关联（比值比为3.54；95%置信区间：2.54 - 4.94），且在存在IDA的情况下龋齿发生率更高（均值差为1.96；95%置信区间：1.07 - 2.85）。根据GRADE标准，证据确定性被评为极低。尽管确定性有限，但研究结果表明IDA与龋齿之间存在显著关联。鉴于这些研究的方法学局限性，谨慎解读这些结果是明智的。然而，考虑到这种关联对公共卫生的潜在相关性，为贫血控制项目推荐包括预防性和矫正性牙科干预在内的口腔健康策略，凸显了未来进行更严格研究以加强证据确定性并指导这些策略实施的重要性。
