Association between asthma and oral conditions in children and adolescents: a systematic review with meta-analysis

Abstract Objective To investigate the association between asthma and oral conditions in children and adolescents. Material and methods Observational studies that evaluated the association between asthma and oral conditions in children and/or adolescents were retrieved from five databases, grey literature and reference lists up to April 7th, 2022. Meta-analyses were performed, and I2 statistics were calculated. The mean difference was used as a measure of effect for continuous variables. Event frequencies were evaluated to determine odds ratios for dichotomous variables. Publication bias was investigated using Egger’s test. The methodological quality (JBI) and certainty of the evidence (GRADE) were assessed. Results Forty-two studies were eligible, and sixteen were included in the meta-analysis. Mean dmft (MD: 1.11, 95%CI: 0.48–1.73), DMFT (MD: 1.01, 95% CI: 0.45–1.56), dmfs (MD: 3.62, 95%CI: 2.60–4.63) and DMFS (MD: 4.47, 95%CI: 0.98–7.96) indices were significantly higher in asthmatic children and adolescents compared to those without asthma. In the analysis of biofilm, asthmatic children and adolescents had a higher Plaque Index compared to those without asthma (MD: 0.18, 95%CI: 0.03–0.33). Conclusion Asthmatic children and adolescents may be more likely to develop tooth decay and build up biofilm compared to those without asthma. It is suggested that there are no differences between asthmatic and non-asthmatic children and adolescents regarding gingivitis, developmental defects of enamel or erosive tooth wear. The certainty of the evidence was classified as ‘very low’. Clinical relevance Knowledge of the risks that asthma and asthma medications for oral health can assist in counselling families of children and adolescents with this condition in terms of control and prevention measures for oral problems.