Role of Immunological Markers in Diagnosis, Prognosis, and Treatment of Early Childhood Caries and Adult Caries: A Systematic Review.

Background: Dental caries is a common oral health problem that affects people all over the world. To detect and treat it early on, it is important to have a thorough understanding of its genesis and potential biomarkers. Objective: The objective of this systematic review is to answer the question: "Is there any role of immune status in the development of dental caries among children and adults, and is there any potential in using immunological markers for diagnosis, prognosis, and treatment of this condition?" Design: From 2016 to 2024, a thorough search approach adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria was used across several datasets (PROSPERO: CRD42024612045). To find pertinent publications, a total of 2,723 articles were searched using keywords associated with dental caries, immunity, and interventions. The inclusion criteria included papers that addressed the connection between immunity and the development of caries, interventions, and results, including alterations in basal metabolic rate (BMR), weight gain in patients, improvements in quality of life, and recurrence of carious lesions. Two reviewers independently extracted the data, assessed its quality, and assessed the risk of bias using validated instruments such as the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale. Results: The evaluation encompassed 10 articles in all, demonstrating noteworthy correlations between immunological indicators and dental caries. Results point to a favorable correlation between salivary immunoglobulin A (IgA) levels and the number of carious teeth, as well as an increase in proinflammatory cytokine concentrations in dental caries patients. Furthermore, the pulp tissue of dental caries patients has different bacterial communities and higher expression of proinflammatory cytokines, suggesting a possible connection between immune activation and dysbiosis. Conclusion: The findings highlight the significance of immune status/immunological indicators in the diagnosis and treatment of dental caries, emphasizing the necessity for additional study to corroborate these conclusions and improve treatment and preventative dental care practices. Clinical relevance: This work has got great relevance to pediatric dentists. The current work highlights a possible link between the immune status and the development of caries in pediatric and adult patients as well as the potential of immunological markers in the diagnosis, prognosis, and treatment of dental caries in both pediatric and adult patients. Prospero registration number: CRD42024612045.