ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Inadequate Evidence to Support a Correlation Between Maloccusion and Dental Caries Amongst Pediatric Patients
Clinical Question Is a pediatric patient with moderate to severe malocclusion at a higher risk of developing dental caries than a patient with normal occlusion?
Clinical Bottom Line There is insufficient evidence to support a correlation between malocclusion and dental caries in pediatric patients. Although there were multiple cross-sectional studies that showed a correlation between malocclusion and caries, there are no higher quality longitudinal studies with prolonged follow-ups that support this claim.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22999666Hafez/20128 cross-sectional observational studiesSystematic review of non-randomized trials
Key resultsIn this systematic review, 8 cross-sectional observational studies were assessed and included in the qualitative synthesis. No association between crowding and caries was found in 4 studies. Significant negative correlations were found in 2 studies, and 2 studies showed positive correlations between crowding and proximal caries.
#2) 26516712Feldens/2015509 adolescents aged 11-14Cross-sectional study
Key resultsThis cross-sectional study of 509 adolescents compared the presence of malocclusion (using the Dental Aesthetic Index (DAI)) to dental caries. 44.8% of the adolescents had dental caries (mean DFMT = 1.33). The DAI index ranged from 15 to 77, with a mean of 29. A total of 43.6% of the sample had severe malocclusion. The analysis showed that children with severe malocclusion had a 31% greater chance of having dental caries (prevalence ratio: 1.31, 95% CI: 1.02-1.67).
Evidence Search ("dental caries"[MeSH Terms] OR ("dental"[All Fields] AND "caries"[All Fields]) OR "dental caries"[All Fields]) AND ("malocclusion"[MeSH Terms] OR "malocclusion"[All Fields])
Comments on
The Evidence
Validity: The cross-sectional study has good validity, as the patient groups were similar at the start of the study, and they were treated the same. All 509 adolescents in the study were enrolled at public schools in the city of Osorio in Brazil. A trained examiner recorded malocclusion (DAI) and dental caries. All of the children seemed to be treated the same. Patient follow-up, compliance, recall bias, and the completion rate of participants did not play a role since this was just a single clinical examination and there was no need for follow-up. As for the systematic review, 8 cross-sectional studies were analyzed in the qualitative synthesis and there does not seem to be any concern for the validity of this evidence. Perspective: It seems as though long term studies with prolonged follow-ups are needed to determine if there is a connection between malocclusion and dental caries in pediatric patients.
Applicability Malocclusion in adolescents is a common problem all across the world, especially in developing countries. There has been a lot of speculation that dental caries is associated with malocclusion, but as of now there is not enough high-quality studies to support this claim.
Specialty/Discipline (Public Health) (Orthodontics) (Pediatric Dentistry)
Keywords Dental caries, Malocclusion, Pediatric patients
ID# 3002
Date of submission: 03/15/2016spacer
E-mail Misaqi@livemail.uthscsa.edu
Author Badi Misaqi
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Suman Challa, BDS, MS
Faculty mentor/Co-author e-mail challas@uthscsa.edu
Basic Science Rationale
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