Asssociation between Early Childhood Caries, Thalassaemia Disease and Dental Parameters in Transfusion Dependent Thalassaemia Patients

Background: Prevention of dental caries is of utmost importance in thalassaemia patients because the risk of infection from a dental origin is a serious potential threat to the general wellbeing of these patients. Although ECC in thalassaemia children has been extensively reported previously, whether thalassaemia per se increases the risk to dental caries remains inconclusive.

Method: This was a case-controlled cross-sectional study conducted at Thalassaemia Centre of two local hospitals. Caries experience in deciduous teeth was measured using decayed, filled teeth and surfaces index (dft/dfts).

Results: A total of 37 transfusion dependent HbE/Beta and Beta-thalassaemia (TDT) patients and 40 healthy children participated in the study. The age ranged from four to 10 years old. The median total dft and dfs scores for deciduous teeth in TDT patients were significantly higher than in controls (p<0.001). Within TDT patient and control groups, distribution of dft and dfs scores were similar between different groups for demographic characteristics, dental attendance patterns and type of caries preventive therapy received (p>0.05). No statistically significant association was found between study participants’ health status and dental attendance pattern or caries preventive therapy prescribed. For thalassaemia disease parameters, the lowest mean pre-transfusion haemoglobin level group (less than seven g/dl) was found to have the highest median of total dft score (p=0.04). There is a possibility that the high decayed teeth and surfaces found in our TDT patients could be the failure of dentists to provide restorative treatment. In general, there seemed to be a trend of high unmet treatment needs for decayed deciduous teeth.

Conclusion It is important especially in children with special needs such as TDT patients, to be seen by a Paediatric Dentist regularly for oral health reinforcement and treatment of carious teeth considering the more serious effects badly carious teeth can have to their general condition.