Dental Caries in Children with Sickle Cell Disease and Its Association with the Use of Hydroxyurea and Penicillin Prophylaxis in Dar Es Salaam

Abstract

Purpose

This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants.

Methods

This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record sociodemographic details including mean age in months and sex and on haemoglobin genotype for all the participants. Specifically, for the participants with HbSS, information on their whether they are taking hydroxyurea (HU), and penicillin chemoprophylaxis was recorded. To assess the prevalence of dental caries, clinical examination of all primary maxillary and mandibular teeth to determine the presence or absence of dental caries lesions was also recorded.

Results

A total of 1197 teeth from 93 children were examined, whereby, 45 (2.4%) of them had dental caries. The participating children with HbAA genotype (6.6%, N=21) had more dental caries than their HbSS counterparts (2.0%, N=24), while none of the participants with HbAS exhibited dental caries. Among the participants with HbSS, males and those who use HU were 3.79 and 3.07 times more likely to have dental caries than their counterparts, female and non-users of HU, respectively.

Conclusion

Dental caries was observed to be low among participants with HbSS when compared to those with HbAA. More research utilizing more robust methodologies is recommended.

Keywords:

• caries
• dental health
• hemoglobin
• oral health
• sickle cell anaemia
• sickle cell disease

Acknowledgments

The authors would like to thank parents/guardians and children for their participation, and members of staff-Sickle cell clinics at Muhimbili National Hospital, Temeke, and Amana Regional Referral Hospitals for their support during data collection. We would also like to thank Mr. John Charles, Mr. Amon Exavery – Pact. Inc. and Prof. Stein Artle Lie – University of Bergen for assisting in data analysis.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number U24 HL135881 (Sickle Pan-African Research Consortium – SPARCO) and U01 HL156853 (SPARO-Tanzania). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.