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Faé DS, de Aquino SN, Verner FS, Lemos CAA. Dental caries in HIV-infected children and adolescents: A systematic review with meta-analysis. Oral Dis 2024; 30:1756-1764. [PMID: 37357361 DOI: 10.1111/odi.14637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/12/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023]
Abstract
This study aimed to evaluate and compare the risk of dental caries in between human immunodeficiency virus (HIV)-infected and uninfected children and adolescents. An electronic search was performed on PubMed/MEDLINE, Web-of-Science, Scopus, LILACS, ProQuest, and ClinicalTrials.gov up to May 2022. The critical appraisal checklist developed by the Joanna Briggs Institute was used to evaluate the quality of the included studies. Meta-analysis was performed using the RevMan 5.4. Sixteen studies were included. A total of 3231 participants were evaluated, including 1701 and 1530 HIV-infected and uninfected children and adolescents, respectively. The meta-analysis revealed a higher risk of dental caries for primary dentitions in HIV-infected children and adolescents by decayed, missing, filled tooth (dmft) (SMD:0.34; p = 0.006) and decayed, missing, filled surface (dmfs) scores (SMD:0.37; p = 0.001). Similar results were observed for permanent dentition, with increased dental caries in HIV-infected children and adolescents with DMFT (SMD:0.32; p = 0.003) and DMFS (SMD:1.78; p < 0.0001) scores. Regarding the quality assessment, most of the included studies were moderate or good quality. However, the certainty of the evidence of the outcomes was very low. This systematic review and meta-analysis showed higher caries severity in permanent and deciduous teeth among HIV-infected children and adolescents.
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Affiliation(s)
- Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Governador Valadares, Brazil
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Onyia NE, Osagie E, Akhigbe P, Idemudia NL, Obuekwe O, Omoigberale A, Richards V, Coker MO. Impact of perinatal HIV exposure and infection on salivary properties among Nigerian children. BMC Oral Health 2024; 24:460. [PMID: 38627731 PMCID: PMC11020910 DOI: 10.1186/s12903-024-04159-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND There is growing evidence that perinatal HIV infection and exposure affect salivary pH and flow rate in children in most parts of the world, but not against the background of caries and the African demographic. This study aimed to evaluate the impact of HIV infection as well as exposure on salivary properties and their influence upon the dental caries experience among school-aged children in Nigeria. METHOD This cross-sectional study assessed the salivary flow rates and salivary pH of HIV infected and exposed school-aged (4-11) children receiving care at a Nigerian tertiary hospital. A total of 266 consenting participants which comprised of three groups as follows: (1) HIV Infected (HI) (n = 87), (2) HIV Exposed and Uninfected (HEU) (n = 82) and (3) HIV Unexposed and Uninfected (HUU) (n = 97) were recruited for the study. Questionnaires completed by parents/guardians were used for data collection. Three calibrated dentists performed oral examinations for dental caries. International Caries Detection and Assessment Scores (ICDAS) was used and presented as dmft/DMFT. Salivary pH was measured using MColourpHast™ pH indicator strips, while salivary flow rate was determined by collecting unstimulated whole saliva using the suction method. Data analysis relied on comparative statistics to determine the correlation between HIV exposure and infection on salivary pH and flow rates. RESULT Across the groups, (HI, HEU, and HUU) mean pH of the HI was significantly less than that of HEU and HUU. Similarly, there was a statistically significant difference in the SFR across the three groups (p = 0.004). Other variables such as gender, age and oral hygiene status expressed by the gingival inflammatory scores had no significant influence on the pH and SFR of study participants. There was a rather unexpected positive correlation of DMFT of HI and HEU groups with increasing salivary flow rate; though, the relationship was weak and not significant. CONCLUSION Perinatal HIV exposure and infection significantly impact salivary pH and flow rate among school-aged children in Nigeria. The findings of this study imply that HIV infection influenced the salivary pH, while HIV maternal exposure (without infection) impacted salivary flow rates when compared to the controls.
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Affiliation(s)
- Nonso E Onyia
- Department of Oral Pathology Oral Medicine Oral Diagnosis, University of Calabar, Calabar, Cross River State, Nigeria
| | - Esosa Osagie
- Research Department, Institute of Human Virology, Abuja, Nigeria
| | - Paul Akhigbe
- Research Department, Institute of Human Virology, Abuja, Nigeria
| | - Nosakhare L Idemudia
- Medical Microbiology Division, Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Ozo Obuekwe
- Department of Oral and Maxillofacial Surgery, University of Benin, Benin City, Nigeria
| | | | - Vincent Richards
- Department of Biological Sciences, Clemson University, Clemson, SC, USA
| | - Modupe O Coker
- Department of Oral Biology, Rutgers University, Newark, NJ, USA.
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Kikuchi K, Tuot S, Yasuoka J, Murayama M, Okawa S, Shibanuma A, Nanishi K, Eng S, Huot C, Yi S. Impact of oral intervention on the oral and overall health of children living with HIV in Cambodia: a randomized controlled trial. BMC Med 2023; 21:162. [PMID: 37118817 PMCID: PMC10144884 DOI: 10.1186/s12916-023-02862-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Maintaining oral health is essential for improving overall health of children living with HIV. Therefore, we evaluated the effectiveness of an oral health intervention for improving their oral and overall health. In addition, we examined their longitudinal association between changes in oral and overall health. METHODS We conducted a 2-year randomized controlled trial involving children living with HIV in Cambodia. Children aged 3-15 years and their caregivers were randomly allocated either to the intervention (group A) or control (group B) arm. A second control arm (group C) included children without HIV. The group A children received oral health education sessions and practiced home-based daily care. RESULTS In the baseline survey, 482 children participated (group A: n = 160, group B: n = 168, group C: n = 154), and 350 completed the endline survey. An interaction effect in teeth brushing duration was observed in children in group A relative to group B (AOR = 2.69, 95% CI: 1.37-5.31) and group C (AOR = 3.78, 95% CI: 1.70-8.40). Longitudinal associations were observed between changes in oral hygiene and overall health, as presented by alterations in dental caries in permanent teeth with viral load detection (adjusted odds ratio = 3.58, 95% CI: 1.10 - 11.73), in salivary flow quantity with the overall quality of life (β = 0.07, 95% CI: < 0.01 - 0.13), as well as in dental caries, salivary pH, debris index with body mass index for age among group A children. CONCLUSIONS Oral health intervention may improve oral care behaviors and potentially enhance overall health among children living with HIV in antiretroviral therapy in a resource-constrained setting. TRIAL REGISTRATION ISRCTN 15177479.
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Affiliation(s)
- Kimiyo Kikuchi
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Faculty of Social Science and Humanity, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Junko Yasuoka
- Center for Infectious Disease Epidemiology and Prevention Research, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | | | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiko Nanishi
- Office of International Academic Affairs, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sothearith Eng
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Department of Global Public Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Center for Global Health Research, Touro University California, Vallejo, CA, USA
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Wang Y, Ramos-Gomez F, Kemoli A, John-Stewart G, Wamalwa D, Benki-Nugent S, Slyker J, Seminario A. Oral Diseases and Oral Health-Related Quality of Life among Kenyan Children and Adolescents with HIV. JDR Clin Trans Res 2023; 8:168-177. [PMID: 35354307 PMCID: PMC10026160 DOI: 10.1177/23800844221087951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Children and adolescents living with HIV (CALHIV) have a higher risk of hard and soft oral tissue diseases as compared with their healthy peers. It is important to increase awareness regarding the need to integrate oral health within medical care among pediatric HIV populations. Studies on associations of oral diseases with oral health-related quality of life (OHRQoL) in CALHIV are lacking. This study examined the association between oral diseases and OHRQoL in Kenyan CALHIV. METHODS This cross-sectional analysis was nested in a longitudinal cohort study of CALHIV in Nairobi. CALHIV received oral examinations, and the World Health Organization's Oral Health Surveys and Record Form was administered. OHRQoL was measured with the Parental-Caregiver Perceptions Questionnaire, with the subdomains of global, oral symptoms, function limitations, and emotional and social well-being, with higher scores indicating poorer OHRQoL. Linear regression was used to model associations between OHRQoL and oral diseases, adjusting for age at the time of oral examination, CD4 counts, and caregiver's education. RESULTS Among 71 CALHIV, the mean age was 12.6 y (SD, 2.9; range, 10 to <21), and the mean composite OHRQoL score was 12.6 (SD, 11.2). Ulcers (not herpes simplex virus or aphthous) were associated with the worst overall OHRQoL (mean, 21.8; SD, 11.1; P = 0.055) and oral symptoms subdomain (mean, 7.0, SD, 2.5; P = 0.003). Children with dry mouth and untreated caries had significantly higher mean global OHRQoL scores than those without disease (P < 0.0001). In the multivariate analysis, the OHRQoL composite score was 6.3 units (95% CI, -0.3 to 12.9) higher for those who had dry mouth and untreated dental caries; dry mouth accounted for the highest percentage of variability of OHRQoL (9.6%) and the global subdomain (31.9%). Ulcers accounted for the highest percentage of variability of the oral symptoms domain (15.4%). CONCLUSIONS Oral ulcers, dry mouth, and untreated caries were associated with poorer OHRQoL in CALHIV. Integrating oral health into the primary care of CALHIV may improve their OHRQoL. KNOWLEDGE TRANSFER STATEMENT This study aimed to determine the association of oral diseases with the oral health-related quality of life of children and adolescents living with HIV (CALHIV). The findings will form part of the evidence to incorporate oral health protocols into care programs for CALHIV. Oral health monitoring has the potential to increase the surveillance of HIV clinical status, monitor the effectiveness of antiretroviral therapy, and improve the oral health-related quality of life of CALHIV.
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Affiliation(s)
- Y. Wang
- Division of Infectious Diseases,
University of California Los Angeles, Los Angeles, CA, USA
| | - F. Ramos-Gomez
- Division of Preventative and
Restorative Sciences, School of Dentistry, University of California Los Angeles, Los
Angeles, CA, USA
| | - A.M. Kemoli
- Department of Paediatric Dentistry and
Orthodontics, University of Nairobi, Nairobi, Kenya
| | - G. John-Stewart
- Departments of Global Health, Medicine,
and Pediatrics, University of Washington, Seattle, WA, USA
| | - D. Wamalwa
- Department of Pediatrics and Child
Health, University of Nairobi, Nairobi, Kenya
| | - S. Benki-Nugent
- Department of Global Health, University
of Washington, Seattle, WA, USA
| | - J. Slyker
- Departments of Epidemiology and Global
Health, University of Washington, Seattle, WA, USA
| | - A.L. Seminario
- UW Timothy A. DeRouen Center for Global
Oral Health, School of Dentistry, University of Washington, Seattle, WA, USA
- Department of Pediatric Dentistry,
Universidad Peruana Cayetano Heredia, Lima, Peru
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Akhigbe P, Chukwumah NM, Folayan MO, Divaris K, Obuekwe O, Omoigberale A, Jedy-Agba E, Kim M, Charurat ME, Richards VP, Coker MO. Age-specific associations with dental caries in HIV-infected, exposed but uninfected and HIV-unexposed uninfected children in Nigeria. BMC Oral Health 2022; 22:429. [PMID: 36167498 PMCID: PMC9512979 DOI: 10.1186/s12903-022-02421-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background HIV infection and its management confer a substantial health burden to affected individuals and have been associated with increased risk of oral and dental diseases. In this study, we sought to quantify HIV-associated differences in the prevalence and severity of dental caries in the primary and permanent dentition of 4–11-year-old Nigerian Children. Methods We used clinical, laboratory, demographic, and behavioral data obtained from an ongoing cohort study of age-matched HIV-infected (HI, n = 181), HIV-exposed-but-uninfected (HEU, n = 177), and HIV-unexposed-and-uninfected (HUU, n = 186) children. Measures of dental caries experience (i.e., prevalence and severity) were based on dmft/DMFT indices recorded by trained and calibrated clinical examiners. Differences in primary and permanent dentition caries experience between HI, HEU, and HUU were estimated using multivariable logistic and negative binomial regression modeling. Results HI children had significantly higher caries experience (33%) compared to HEU (15%) and HUU (22%) children. This difference persisted in fully adjusted analyses [odds ratio (OR) = 1.6; 95% confidence interval (CI) = 1.0–2.6], was most pronounced in the permanent dentition (OR = 3.4; 95% CI = 1.2–9.5), and mirrored differences in caries severity. While molars were predominantly affected in both primary and permanent dentitions, caries lesion patterns differed between dentitions. Caries severity was significantly associated with hypoplastic primary teeth, gingival inflammation, and lower CD4 counts. Conclusions We found that the higher prevalence and severity of dental caries among HI children was driven by increased burden of permanent dentition caries compared to their uninfected counterparts. The dentition-specific associations identified in this study highlight the need to design and implement age-specific caries prevention strategies. These may include intensified oral hygiene regimens aimed at mitigating the cariogenic impact of hyposalivation among HI children. Similarly, the long-lasting impacts of developmental defects of the enamel in the primary and permanent dentitions must not be ignored. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02421-w.
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Affiliation(s)
- Paul Akhigbe
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Nneka M Chukwumah
- Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Ozoemene Obuekwe
- Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin, Edo State, Nigeria.,Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | - Augustine Omoigberale
- Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin, Edo State, Nigeria.,Child Health Department, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Michael Kim
- Department of Oral Biology, School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - Manhattan E Charurat
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MA, USA
| | | | - Modupe O Coker
- Department of Oral Biology, School of Dental Medicine, Rutgers University, Newark, NJ, USA. .,Department of Epidemiology, School of Public Health, Rutgers University, Newark, NJ, USA. .,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
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