Purpose or Case Report: Poor oral health is associated with increased risk of cardiovascular disease in adults. Periodontal disease is linked with increased local and circulating inflammatory markers. Carotid intima-media thickness (IMT) is a radiological technique used to detect subclinical atherosclerosis in adults and children. A meta-analysis of 11 studies showed significant increase in IMT in the presence of periodontal disease in adults. The objective of this systematic review is to assess the evidence between periodontal disease and increased IMT in children.
Methods & Materials: The systematic review was done according to Cochrane Handbook of Systematic Reviews and reported according to the PRISMA checklist. We aimed to answer the following PICO for a qualitative systematic review study: Population : children or adolescents, Interest : poor oral health or poor oral hygiene or poor dental health, Context : cardiovascular risk such as increased intima-media thickness. We looked at all the available publications in English and French, from inception until September 2022, on Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, and CINHAL. Inclusion criteria were: (i) study on children/teenagers, (ii) oral or dental health assessment described by self-report or by a trained professional, (iii) carotid IMT. Exclusion criteria included: (i) case-report studies, (ii) letters to the authors, (iii) unpublished studies, (iv) studies on newborns and toddlers, (v) studies on young adults. Two researchers independently reviewed each article and screened for eligibility with the inclusion and exclusion criteria.
Results: The literature search retrieved 41 articles. After screening with titles, abstracts, or full-text articles, 3 articles were evaluated for eligibility and only 2 were included. Age range was 6-12 and 6-17 years old respectively. The first included article found a correlation coefficient between IMT and gingivitis of 0.135 (p<0.05) and dental caries of 0.144 (p<0.05). The second article found a correlation coefficient between IMT and dental bleeding on probing of 0.196 (p>0.05) and dental caries of 0.174 (p>0.05). Both studies concluded that there was an association between IMT and local chronic buccodental status in children. Moreover, oral infections in childhood were associated with subclinical atherosclerosis in adulthood.
Conclusions: This association has clinical implication on treatment and preventive measures when considering risk factor assessment of early cardiovascular disease in children.