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

Abstract

Irene Kida Minja,1,2,* Evarist Mulyahela Wilson,1,2,* Ferdinand M Machibya,3 Agnes Jonathan,2 Fortunata Cornel,1 Paschal Ruggajo,2,4 Julie Makani,2,5 Emmanuel Balandya2,6 1Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 2The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 3Department of Orthodontics, Pedodontics and Community Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 4Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 5Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 6Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania*These authors contributed equally to this workCorrespondence: Irene Kida Minja, Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, P. O. Box 65014, Dar es Salaam, Tanzania, Tel [phone], Fax [phone], Email [email protected]: 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

Keywords

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