Oral hygiene indices and chronic kidney disease in children: Systematic review and meta-analysis of case-control studies

Abstract

Background: Chronic kidney disease (CKD) is a disorder that causes numerous problems for children and affects many organs, as oral hard and soft tissues. The purpose of this study was to summarize the relationship between oral and dental health status and CKD in children. Materials and Methods: A systematic search of texts from 2000 to 2023 was conducted to gather all case control studies published in the English language related to the subject of this study in PubMed, Web of Science, Scopus and Cochrane electronic databases. The title, abstract and full text of the articles were examined according to inclusion criteria until relevant studies were selected. This process was carried out independently by two researchers. The quality of the selected studies was assessed by the National Institutes of Health (NIH) checklist. Results: A total of 768 articles were identified in electronic databases during the search process. Articles inconsistent with inclusion criteria and duplicate articles were removed and 8 studies were selected for metaanalysis. The results found no statistically significant difference in mean of decayed, missing and filled teeth in permanent (DMFT index) and primary teeth (dmft index) in CKD and healthy children with a mean difference of -0.433 (95 CI: -1.689 to 0.823; p-value = 0.500) and-0.095 (95 CI: -2.240 to 2.051; p-value = 0.931) respectively. However, CKD had a significant effect on the developmental defects of enamel (DDE) index in children with an effect size of 4.916 (95 CI: 1.752 to 13.799; p-value = 0.002). Conclusion: The presence of CKD can increase the incidence of DDE by 4.9 times, but it has no significant effect on the prevalence of dental caries in primary and permanent teeth.