# Evaluation of Systemic Inflammation in Children with Untreated Dental Caries

## TL;DR

This study found that children with untreated dental caries have higher systemic inflammation markers compared to healthy children, suggesting a link between oral health and overall health.

## Contribution

The study provides new evidence that untreated dental caries in children are associated with elevated systemic inflammation markers.

## Key findings

- Children with untreated caries had significantly higher levels of NEU%, NLR, PLR, and SII compared to controls.
- Lymphocyte counts were significantly lower in children with untreated caries.
- No significant correlations were found between caries severity indices and systemic inflammation markers.

## Abstract

To analyse the relation between dmft/DMFT and pufa/PUFA indices and markers of systemic inflammation, such as SII, NLR, PLR NEUT, LYMPH and PLT.

The study sample consisted of 59 children with untreated dental caries (patient group) and 59 healthy children without caries (control group). Complete blood count (CBC) parameters were collected from both groups, and systemic inflammation markers, such as the Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR), were calculated. Additionally, the study utilised the decayed, missing and filled teeth (dmft/DMFT) and pulpal involvement, ulceration, fistula, abscess (pufa/PUFA) indices to assess the severity of caries and pulp disease. Normality was checked using the Shapiro-Wilk test. For non-normally distributed data, the Mann-Whitney U-test was used to compare two independent groups. Pearson’s chi-squared test analysed relationships between categorical variables when expected values exceeded 5. Spearman correlation was applied for continuous variables without normal distribution. All statistical analyses were performed using IBM SPSS 25.

The results demonstrated statistically significant differences in systemic inflammation markers between the two groups. Specifically, children with untreated caries showed statistically significantly higher levels of neutrophils (NEU%), SII, NLR, and PLR compared to the healthy control group. (p < 0.01). Furthermore, a statistically significant decrease in lymphocyte count (LYMPH#) was observed in the patient group compared to the control group. However, no statistically significant correlations were found between the clinical severity of caries (as measured by the dmft/DMFT and pufa/PUFA indices) and systemic inflammation markers.

The results of our study indicated that the inflammatory parameters, including NEU%, NLR, PLR, and SII, were elevated in children with untreated caries compared to those without caries. It has been observed that oral health may affect systemic health in children, thus reconfirming the importance of maintaining good oral and dental health.