Is Malocclusion Associated with Dental Caries among Children and Adolescents in the Permanent dentition? A Systematic Review

Objective To determine the association between malocclusion and the severity of dental caries among children and adolescents in the permanent dentition. Method. A search was conducted in Medlin, Cochrane databases, Google scholar, Scopus and Web of Science through October 2020 for studies of malocclusion and dental caries among children and adolescents using the Dental Aesthetic Index (DAI) and the Decayed, Missing, Filled Teeth (DMFT) index. Quality was evaluami using the Newcastle-Ottawa tool for cross-sectional studies. Data were extracted using the Cochrane Collaboration guidelines. Meta-analysis used the Cochrane Program Review Manager Version 5. A random effects model was used to assess the association among different categories of malocclusion with dental caries. GRADE analysis assessed the certainty of evidence. Results: Five studies met the inclusion criteria. Handicapping malocclusion was significantly associated with higher mean DMFT scores (Mean difference: 1.03, 95% CI, 0.61, 1.44). Participants with severe malocclusion had higher mean DMFT when compared to subjects with normal occlusion (0.32, 95% CI, 0.13, 0.51). Definite malocclusion was also associated with higher mean DMFT scores (Mean difference: 0.19, 95% CI, 0.03, -0.35). Conclusion: Malocclusion is associated with dental caries in the permanent dentition. DMFT scores and the strength of the association increased with severity of malocclusion. Low to moderate certainty of evidence was observed for association between handicapping, severe, and definite malocclusion with dental caries.