The role of copper and zinc in the prevention of dental caries - A systematic review

Dental caries is one among the major public health problems and has been found to have a multifactorial etiology. Thus, understanding the role of trace elements such as Copper and Zinc in the prevention of dental caries is of utmost importance to the clinicians. The aim is to systematically review the literature on the role of Copper and Zinc in the prevention of Dental Caries. A literature review was performed in PubMed Central and Cochrane library, and Embase, Google Scholar were searched up to February 2019 to identify appropriate studies. Randomized controlled trials and crosssectional studies assessing the role of copper and zinc in the prevention of dental caries in the adult and pediatric population searched above were included. The methodological quality was assessed using a five and sevenpoint ordinal scale, respectively. The search was performed from 1990 to February 2019 for all the mentioned databases. There was no lower limit for the analyzed time frame and no language restrictions. In the various articles available through the electronic database, eight articles fulfilled the inclusion criteria and were selected for the review. The primary outcome measure was salivary concentrations of copper and zinc in caries free and caries active individuals as measured by the World Health Organization (1997) decayed, missing, and filled teeth/decayedextractedfilled teeth index. The limitations were that it cannot definitely establish the negative correlation of salivary concentrations of copper and zinc with caries activity due to the lack of studies done on these trace elements and the inconsistency of the data found in the existing literature. Of the total 58 articles which were searched, 8 articles fulfilled the criteria and were selected for the review. One article which was received through email was also included. It was found that the amount of copper and zinc in low carious individuals is high, whereas it is low in cases of high caries individuals. Copper and zinc have a negative correlation with dental caries activity. There are relatively few studies evaluating the role of Copper and Zinc in the prevention of dental caries. By analyzing the elements affecting caries activity, it can be derived that copper and zinc have a negative effect on the dental caries process.