Relationship Between Celiac Disease and Dental Caries in Children and Adolescents: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To assess the relationship between celiac disease and the prevalence of dental caries in children and adolescents and also evaluate if dental enamel defects in celiac children predispose to dental caries. Material and Methods: Searches were performed in the following databases: PubMed, Scopus, Cochrane Library, Latin American and Caribbean Literature on Health Sciences, and OpenGrey. The risk of bias was assessed using the Newcastle-Ottawa Scale. DMFT/dmft and DMFS/dmfs data of observational studies that compared the prevalence of caries between children and adolescents with celiac disease and healthy individuals. Meta-analysis was performed using a random effects model. Heterogeneity between studies was estimated using Cochran's Q test, and inconsistency was measured using I2 statistics. Results: Of the 121 studies retrieved, 17 were selected, and 12 were included in the meta-analysis. The prevalence of caries in the primary dentition (dmft) did not differ between celiac patients and controls [SMD = -0.35; 95% CI (-0.83; 0.13); p = 0,15; I2 = 89%]. There was also no difference in the prevalence of caries in permanent teeth (DMFT) between groups [SMD = -0.44; 95% CI (-1.02; 0.14); p = 0.14; I2 = 95%]. Conclusion: Celiac disease is not a determinant factor in the development of dental caries in children and adolescents compared to the control group.

Identification and Analysis of the Fluoride Concentration in Toothpastes Intended for Children

Objective: To identify the commercially available toothpastes intended for children and their total soluble fluoride concentrations (TSF). Material and Methods: Twelve brands of toothpastes intended for children marketed in supermarkets and pharmacies were found and analyzed: Bitufo®; Colgate Smile®; Lilica Ripilica®; Even Baby®; Turma da Mônica Baby®; Loney Tunes®; Loney Tunes Baby®; Malvatrikds Baby®; Oral B Stages®; Sanifil Kids®; Tandy®; Tra-lálá Baby®. Duplicate samples of each toothpaste were weighed (+/- 90 to 110 mg) and diluted in 10 mL of distilled water under stirring. To evaluate soluble fluoride, duplicate aliquots of supernatant suspensions were evaluated on specific ion fluoride electrode calibrated with fluoride standard solutions and results expressed in ppm F according to established protocol. Results: According to information provided by manufacturers, 5 non-fluoridated toothpastes, 3 toothpastes with less than 1000 ppm F and 4 toothpastes with conventional fluoride concentration (1100 ppm F) were identified. After analysis of soluble fluoride of fluoridated toothpastes, only 02 presented TSF concentration equal to or greater than 1000 ppm F. The TSF concentration (mean ± SD) for all samples ranged from 8.2 ± 0.1 to 1065.9 ± 24.7 ppm F. Conclusion: Few toothpastes intended for children presented soluble fluoride concentrations capable of preventing dental caries. Additionally, regulatory measures need to be implemented for the marketing of toothpastes intended for children with at least 1000 ppm of soluble fluoride, especially in locations without other sources of fluoride (fluoridated water) for the population.