Caries in children with and without orofacial clefting: A systematic review and meta-analysis

Abstract

This systematic review compared children's primary dentition caries experience for those with cleft lip and/or palate (CL/P) and without. Four databases were searched without date restriction for; cross-sectional studies comparing caries experience for children with CL/P to those without. Screening, data extraction and risk assessment were carried out independently (in duplicate). Meta-analyses used a random-effects model. Twenty studies (21 reports) fitting the inclusion criteria comprised 4647 children in primary dentition from 12 countries. For dmft (n = 3016 children; 15 groups), CL/P mean = 3.2; standard deviation = 2.22 and no CL/P mean dmft = 2.5; sd 1.53. For dmfs (n = 1095 children; 6 groups), CL/P mean = 4; sd = 3.5 and no CL/P mean = 3; sd = 2.8. For % caries experience (n = 1094 children; 7 groups), CL/P mean = 65%; sd = 20.8 and no CL/P mean = 52%; sd = 28.1. Meta-analysis showed higher caries experience in children with CL/P, standardised mean difference = 0.46; 95% CI = 0.15, 0.77. Studies' risk of bias was high (n = 7), medium (n-10) and low (n = 3). Children with CL/P had higher caries experience compared to those without CLP.

Keywords: children; cleft lip; cleft palate; dental caries; primary dentition; systematic review.

FIGURE 1

PRISMA flow diagram

FIGURE 2

Forrest plot as part of random‐effects meta‐analysis portraying caries experience of CL/P children compared to non‐CL/P children in: 1.1.1 the primary dentition; 1.1.2 the primary and mixed dentition; and 1.1.3 the mixed dentition presented as standardised mean differences for dmft/DMFT and 95% confidence intervals (CI). Each subgroup has a black diamond to illustrate the point estimate and CI of effect, with the final diamond illustrating the overall difference in caries experience between the CL/P and non‐CL/P children

FIGURE 3

Funnel plot as part of random‐effects meta‐analysis to investigate publication bias across primary studies