Associations of early childhood caries with salivary beta defensin-3 and childhood anemia: a case–control study

Abstract

Background Human beta defensin-3 (HβD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HβD-3 levels and observe the association of HβD-3 levels with childhood anemia. Methods A total of 80 children admitted in a pediatric medical ward, age 48–71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HβD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05. Results The mean Salivary HβD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HβD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HβD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HβD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HβD-3 level and anemia (r = -0.479, p = 0.002). Conclusion Anemia may affect the innate immunity of children, and may result in a decreased level of salivary HβD3, thus increasing vulnerability to decay.

Effect of iron deficiency anemia on blood levels of interleukin 6 and infection rates in children: a pilot study

“…Children with iron-deficiency anemia have a higher prevalence of episodes of acute otitis media compared to healthy, non-anemic children, and there is a direct relationship between the degree of anemia and the number of episodes [16]. A further study shows that anemia may affect the innate immunity of children and may result in a decreased level of salivary human beta defensin-3 (HβD3), thus increasing vulnerability to decay [17]. In our study, the average number of viral diarrheas decreased significantly after the diagnosis of IDA compared to before the diagnosis.…”

Correlation between caries and hemoglobin level among primary school children suffering from iron deficiency anemia

“…A Saudi Arabian crosssectional study showed that the anemic children had significantly higher mean dmft indices (11.20±2.6) than non-anemic children (9.66±1.2%, p=0.05). 10 Another Pakistani study found that anemia may alter children's innate immunity, resulting in a lower amount of human beta defensin-3 (HD-3), an antimicrobial peptide presents in saliva that protects tooth surfaces from microbial attack. Salivary HD3 shortage, hence increasing degradation risk.…”

“…Salivary HD3 shortage, hence increasing degradation risk. 10 Moreover, another systematic review concluded that children with dental caries had a 4.5-fold higher prevalence of anemia diagnosis than children without. 11 The association between anemia and dental caries incidence has been explained by different ways.…”