Periodontal Status in Children With Primary Immunodeficiencies

 

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  • This cross-sectional cohort study reported on the periodontal status of 24 children with neutrophil-related primary immunodeficiencies (PID) as compared with 24 age-matched healthy children at a tertiary level care center. The findings revealed significantly higher odds of the presence of periodontal disease in patients with PID (OR, 10.0; P = .008) and a higher association with a history of oral ulcers (OR, 12.47; P = .001). Nonetheless, a significant improvement in periodontal parameters was achieved after oral hygiene instructions and nonsurgical periodontal therapy in children with PID.

  • This study found that, despite the high prevalence of periodontal disease in children with PID, severe periodontitis was uncommon. More importantly, when detected early, periodontal disease was very manageable with just oral hygiene and nonsurgical therapy, which underscores the need for closer monitoring of periodontal health in children affected with PID.
–  Tapan N. Koticha, BDS, MDS

OBJECTIVE

This study aimed to assess associations between neutrophil-related primary immunodefiencies (PIDs) and the presence of periodontal disease and other oral diseases and response to periodontal treatment.

BACKGROUND

Presence of neutrophil-related PIDs is thought to be a major risk factor for development of periodontitis.

METHODS

This study had both a cross-sectional and cohort design. Twenty-four children (age 4-16) with PIDs and 24 age-matched systemically healthy subjects received a dental clinical examination, including measures of probing pocket depths (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP). Those found to be affected by periodontal disease were offered periodontal treatment and reassessed 6 months later.

RESULTS

Diagnosis of PIDs was associated with increased odds of presence of periodontal disease (p = .008 adjusted for age, gender, plaque, OR = 10.0, 95% CI = 1.83-54.38) and with continuous measures of periodontal disease such as number of PPDs >4 mm, mean PPD and mean CAL (all p < .001) and BOP (p = .001). However, only 7 out of 24 children were diagnosed with periodontitis. PIDs were also associated with a history of oral ulcers (p = .001, OR 12.47, 95% CI 2.71-57.29). An improvement in periodontal parameters (PPD and CAL) was detected following oral hygiene instructions and non-surgical periodontal therapy.

CONCLUSION

Although children affected by neutrophil-associated PIDs exhibited a higher prevalence of periodontal disease compared with systemically healthy children, severe periodontitis was rarely seen. This suggests that good systemic control of the PIDs may reduce their impact on the periodontium.

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