Does Serum Ferritin Level Affect Early Childhood Caries?-A Review

Abstract

Background: Dental caries is a multifactorial infectious disease resulting from the interplay of microbial, dietary, and host-related factors. In young children, the occurrence of severe caries (SC) is characterized by the presence of one or more decayed lesions in the primary teeth before the age of six. A particularly aggressive variant, known as early childhood caries (ECC), emerges during infancy and early childhood. ECC is recognized as a significant global health concern, impacting both industrialized and developing nations alike. It often presents at an early stage, advances swiftly-particularly in high-risk populations-and frequently remains untreated.Beyond its immediate dental implications, ECC adversely affects a child's overall health and well-being, with potential repercussions for their family. The condition is associated not only with pain, infection, and compromised oral function but also with broader systemic outcomes, including nutritional deficiencies and growth disturbances. Children with ECC are frequently reported to have lower body weight, impaired growth patterns, and a higher prevalence of anemia and malnutrition.Among the nutritional deficiencies linked to ECC, iron deficiency anemia-and specifically diminished serum ferritin levels-has drawn particular attention. Ferritin, as an indicator of iron stores in the body, plays a crucial role in growth and development, and its depletion can influence both systemic and oral health. Despite the widespread prevalence of both dental caries and iron deficiency across the globe, limited research has been conducted to determine whether a correlation exists between the two.Given this context, the present study aims to examine the potential association between serum ferritin levels and the presence of ECC in pediatric patients. Establishing such a relationship could provide valuable insights into the shared risk factors and possible integrated strategies for prevention and management.

Methodology: A comprehensive literature search was conducted across several electronic databases, including PubMed/MEDLINE, EBSCO, Embase, Google Scholar, and other relevant platforms. The search strategy was designed to identify studies focusing on the relationship between ECC and iron status, particularly serum ferritin levels. Keywords and search terms included combinations such as "early childhood caries," "ECC and ferritin," and "ECC and iron deficiency." Studies were included if they examined the association between ECC and serum ferritin or other indicators of iron deficiency. Both observational and interventional studies involving pediatric populations were considered, with no restrictions placed on geographical location or study design.

Conclusion: Findings from the reviewed literature suggest a potential inverse relationship between ECC and serum ferritin levels, indicating that children with ECC may be at greater risk for iron deficiency. However, further investigations involving larger, well-defined sample populations are needed to draw more definitive conclusions and to better understand the underlying mechanisms of this association.

Clinical significance: Management of dental conditions, especially in young children, should extend beyond the oral cavity to consider the patient's overall health. The early pediatric age-group is particularly vulnerable, and dental professionals must recognize the importance of systemic factors-such as nutritional status and iron levels-in relation to oral disease. An integrated approach that includes routine screening for iron deficiency in children with ECC could contribute to more comprehensive care and better long-term health outcomes.

How to cite this article: Gupta M, Dinesh Rao B, Shah K, et al. Does Serum Ferritin Level Affect Early Childhood Caries?-A Review. Int J Clin Pediatr Dent 2025;18(4):487-490.

Keywords: Anemia; Dental caries; Early childhood caries; Hemoglobin; Iron deficiency; Serum ferritin; Serum iron; Severe early childhood caries.