Relationship Between Salivary Nitric Oxide Concentration and Dental Caries in Children: A Systematic Review and Meta-analysis

Abstract

Context: Conflicting results have been reported in the literature concerning the relationship between salivary nitrous oxide concentration and dental caries in children. Metaanalysis studies aim to combine different studies and reduce the difference between the parameters by increasing the number of studies involved in the analysis process. Objectives: Accordingly, this meta-analysis study aimed at determining the relationship between salivary nitrous oxide concentration and dental caries in children. Methods: Databases were searched using the keywords “nitric oxide”, “salivary”, “Caries”, “DMFT Index”, “children”, “early childhood caries” and OR, AND and NOT operators. Quality assessment was then performed based on the Newcastle-Ottawa scale (NOS) checklist. The standardized mean difference (SMD) of DMFT, dmft, and salivary nitric oxide (NO) concentration was estimated. Results: Seven studies made a comparison between the mean salivary NO concentration in children with dental caries and that in the control group. In four studies, the mean salivary NO concentration in children with dental caries was lower, as compared to that in the control group. This difference was significant in all four studies. Also, the mean standardized difference of the salivary NO index was also estimated to be-0.11 (CI 95%:-1.77, 1.55). Conclusions: This meta-analysis study demonstrated that salivary NO concentration was not significantly related to dental caries. Moreover, since salivary NO concentration is affected by various factors, it is not sufficient to determine the likelihood of the inci-dence of caries.