Maternal risk behavior and caries incidence in children with sickle cell disease

Abstract

The aim of this study was to analyze the incidence of caries, in relation to maternal risk behaviors and clinical conditions representing different levels of sickle cell disease severity. A total of 295 children aged 6 to 60 months participated in this cohort conducted from August 2007 to December 2008. They were diagnosed and monitored by the referral service of the state. Interviews were made with families to identify sociodemographic variables, and an oral exam was performed to determine dental caries. The SRQ (Self Report Questionnaire) scale was used to diagnose the presence of common mental disorders, and the CAGE (Cut down, Annoyed, Guilty and Eye opener) was applied to determine abusive use of alcohol. The absolute and relative frequencies of the variables of interest were analyzed by Chi-square and Mann-Whitney, with a 5% significance level. The incidence variables were analyzed according to the logistic regression model, with a confidence interval of 95%. Caries incidence (1.98; SD = 4.68) was higher in the HbSS genotype. There was a statistically significant association between caries incidence and both abusive use of alcohol (32.43%, RR = 1.99; 1.05-3.78; 95%CI) and common mental disorders (8.77% RR = 0.37; 0.15-0.93; 95%CI). There was also an association between caries incidence and maternal risk behavior, indicating that the care network should be expanded to include patients with sickle cell disease.

Manejo odontológico del paciente con anemia falciforme: revisión integrativa

“…Además, los síntomas clínicos de la enfermedad son factores que contribuyen a la construcción de un entorno familiar negativo y, en consecuencia, al abandono de la salud oral, especialmente en pacientes pediátricos 4,5 . Esta situación resalta la importancia de las medidas educativas y preventivas en la vida de los pacientes con AF.…”

“…Furthermore, the clinical symptoms of the disease are factors that contribute to the construction of a negative family environment and, consequently, to the abandonment of oral health, especially in pediatric patients 4,5 . This situation highlights the importance of educational and preventive measures.…”

“…En la región maxilofacial, los pacientes con AF presentan características como retrusión mandibular, perfil convexo y protrusión maxilar 3 , palidez de la mucosa, anormalidades radiográficas, erupción dental retrasada, disturbios de la mineralización dental, hipercementosis, mayor incidencia de caries y periodontitis más severa que lo normal en niños [3][4][5] . Además, durante un episodio vaso-oclusivo dentro de la arteria alveolar inferior, puede ocurrir necrosis pulpar, incluso en dientes sanos6-8.…”

“…In the maxillofacial region, patients with FA present characteristics such as mandibular retrusion, convex profile and maxillary protrusion 3 , pallor of the mucosa, radiographic abnormalities, delayed dental eruption, disturbances of dental mineralization, hypercementosis, higher incidence of caries and more severe periodontitis than normal ones in children [3][4][5] . Furthermore, during a vaso-occlusive episode within the inferior alveolar artery, pulp necrosis can occur, even in healthy teeth6-8.…”

Sickle Cell Disease: An Overview of Oral Health Considerations for Pediatric Patients

“…In a study conducted by Luna et al [23] in Brazil, children with SCD in low-income families were reported to be more prone to dental caries due to lower chances of receiving treatment and adequate oral hygiene. Risk factors for caries activity in SCD children and adolescents are considered to be the prolonged use of drugs sweetened for children, the lower buffer capacity observed [15], [31], low socioeconomic status [23], and maternal risk behavior [32]. Most importantly, lack of access to preventive care, poor quality dental treatment and a possible neglect of dental care due to focusing on the treatment of systemic manifestations can make the management of dental caries a secondary issue for the SCD individuals [33].…”