Associations Between Dermatoglyphic Patterns and Oral Diseases in Children: A Systematic Review and Meta-Analysis

Dermatoglyphics - the scientific study of epidermal ridge patterns - develops during the same embryonic period as the oral-craniofacial complex and remains unchanged throughout life. Because of this developmental parallelism, dermatoglyphic traits have been explored as potential non-invasive associations of oral diseases in children. This systematic review and meta-analysis, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines (PROSPERO ID: CRD42022322563), evaluated associations between dermatoglyphic features and three pediatric oral conditions: dental caries, malocclusion, and nonsyndromic cleft lip and/or palate (NSCL/P). Electronic searches across Medline, Ovid, Cochrane CENTRAL, and Google Scholar (January 1990-August 2025) identified cross-sectional and case-control studies with ≥ 200 participants assessing qualitative (loops, whorls, arches) and quantitative (atd angle, ridge counts) traits. Fifteen studies comprising approximately 7,300 children were included; 12 contributed to quantitative synthesis and nine to meta-analysis. In dental caries cohorts, pooled percentage-point differences showed that whorls were more frequent in affected children (mean difference (MD): 6.86; 95% CI: 6.67-7.05; p < 0.01; I² = 90), whereas loops were less frequent (MD: -6.41; 95% CI: -6.56 to -6.26; p < 0.01; I² = 98); arches showed smaller but significant variation (MD: -0.26; 95% CI: -0.49 to -0.04; p = 0.04). In NSCL/P studies, lower total ridge count, higher a-b ridge counts, and greater fluctuating asymmetry were observed (p < 0.001). Malocclusion investigations demonstrated class-specific pattern shifts with inconsistent significance. Substantial heterogeneity (I² ≈ 78-98%) and moderate methodological quality were observed. Collectively, dermatoglyphic traits - particularly whorls, loops, and atd angles - show possible associations with pediatric oral conditions. Although not diagnostic, these traits may serve as low-cost indicators warranting validation through large, multicenter, and longitudinal studies while considering potential publication bias, limited representativeness, and geographic concentration of existing evidence.