Obesity and dental caries: systematic review

Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and meta-analysis

INTRODUCTION

Earlier studies reported inconsistent findings for the association of childhood obesity with the risk of dental caries. In this systematic review and meta-analysis, we aimed to summarize earlier studies on the association of overweight and obesity with risk of dental caries in children.

METHODS

Relevant studies published up to December 2023 were identified through searches in PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using suitable keywords. All observational studies, including cross-sectional or cohort or case-control studies, about the association of each obesity index with risk of dental caries in children which reported odds ratio (OR), hazard ratio (HR), or relative risk (RR) and 95% CIs, were included. Studies involving adults, randomized clinical trials, studies on animals or pregnant women, and studies on other dental disorders were excluded. Risk of bias was assessed using standard methods for observational studies. A total of 22 studies including 40673 participants were included. Studies were pooled using the random-effect model, and results were synthesized with subgroup analyses and assessments of heterogeneity. Limitations included potential publication bias and heterogeneity among study designs. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS).

RESULTS

Children at the highest category of BMI were 44% more likely to have early childhood caries (ECC) than those at the bottom (OR: 1.44; 95% CI: 1.16 to 1.78). Moreover, combined analysis also showed no significant association between waist circumference (WC) and risk of dental caries in children. However, significant linear and non-linear associations were found between BMI and risk of childhood dental caries. No publication bias was found for the relationship between BMI and the risk of ECC based on visual inspection of a funnel plot and Egger's test.

CONCLUSIONS

This study showed a significant direct association between BMI and the risk of dental caries in children. Non-linear analysis showed higher risk of dental caries in children with higher BMI and also among underweight children. Further prospective studies are required to expand current knowledge in this issue.

IMPACT STATEMENT

The findings of this study have significant implications for public health and dental care, suggesting association between BMI and the risk of dental caries in children. This comprehensive meta-analysis is among the first to summarize earlier publications on the association of obesity with risk of dental caries in children, highlighting the need for more accurate methods of obesity assessment and further research to understand this relationship better. These findings can help inform public health policies and interventions to reduce the prevalence of childhood obesity and dental caries.

Overweight/obesity and dental caries in Brazilian children and adolescents: a systematic review and meta-analysis

This review aimed to assess the association between overweight/obesity and dental caries in Brazilian children/adolescents. Searches were performed in the Web of Science, Scopus, Cochrane, PubMed, Embase and SciELO, Lilacs and Open Grey literature databases up to June 2022. The Joanna Briggs Institute checklist for analytical cross-sectional studies, the checklist for cohort studies, and the checklist for case-control studies were used. A total of 41 publications were included, and 15 meta-analyses were performed. The authors analyzed the differences in weighted mean difference (MD) and odds ratios (OR), and their corresponding confidence intervals (CI) (95%) for dental caries among eutrophic and obese and/or overweight children/adolescents. Meta-analyses showed that there was no association between overweight and/or obesity and dental caries in Brazilian children/adolescents for most anthropometric reference curves using BMI (Body Mass Index). A greater experience of dental caries was associated with well-nourished adolescents in permanent dentition, compared with obese individuals in the same dentition, as classified by the CDC 2000 curve (OR = 2.53, 95% CI;1.49-4.29; p = 0.0006; I2 = 0%) in dichotomous outcome studies, and (MD = 0.61, 95%CI: 0.08-1.15; p = 0.02; I2 = 0%) in continuous studies. The strength of the evidence of the results was classified as very low, low or moderate. It was concluded that there is no association between overweight and/or obesity and dental caries in Brazilian children/adolescents for most anthropometric reference curves using BMI. A greater experience of dental caries was associated with well-nourished adolescents in permanent dentition, compared with obese individuals in the same dentition, as classified by the CDC 2000 curve.

Adiposity is not associated with caries among youth in the United States

BACKGROUND

Body mass index has been traditionally used to determine the nutritional status of children in studies on obesity and caries. Imaging methods provide a superior assessment of body fat. This study investigated the relationship between measures of adiposity and caries in permanent teeth in children and adolescents.

METHODS

The analysis included 5,694 participants in the National Health and Nutrition Examination Survey from 2011 through 2018, aged 8 through 19 years. The body fat percentage (BF%) and fat mass index (FMI) were determined from whole-body dual-energy x-ray absorptiometry scans. Excess adiposity was defined as a sex- and age-specific value at or above the 75th percentile according to the US reference standards for BF% or FMI. Caries was measured with the decayed teeth and decayed, missing, and filled teeth indexes; prevalence of untreated dentin caries; and lifetime caries prevalence. The associations between adiposity and caries were tested in confounding variables-adjusted regression models.

RESULTS

The FMI score was associated with the decayed, missing, and filled teeth score (rate ratio, 1.03; 95% CI, 1.01 to 1.05) and lifetime caries prevalence (odds ratio, 1.06; 95% CI, 1.03 to 1.08), but the associations attenuated after adjustment for confounding variables. Neither the BF% score nor the presence of excess adiposity, defined according to the BF% or FMI reference standards, were associated with caries.

CONCLUSION

The authors found no association between measures of adiposity and caries among US children and adolescents.

PRACTICAL IMPLICATIONS

Caries is a multifactorial disease, and any observed association between obesity and caries is most likely due to the shared determinants and risk factors of both conditions.

Family income modifies the association between frequent sugar intake and dental caries

AIM

The aim of this cross-sectional study was to investigate whether family income modifies associations between dental caries and sex, age, mother's education, type of preschool, sugar intake, and toothbrushing.

BACKGROUND

Dental caries is a multifactorial dyanamic disease primarily mediated by biofilm and sugar.

DESIGN

A randomly selected sample of 308 Brazilian preschool children aged 1-3 years underwent a clinical oral examination for the assessment of moderate/extensive dental caries using codes 3-6 of the International Caries Detection and Assessment System. Mothers were asked to fill out a form addressing the child's demographic and socioeconomic characteristics as well as the frequency of sugar intake. Statistical analysis involved descriptive statistics, the chi-squared test, and Poisson regression models.

RESULTS

The prevalence of moderate/extensive dental caries was 42.5%. The adjusted model revealed that within low-income families (<2 times the monthly minimum wage), the prevalence of dental caries was higher among children with a high frequency of sugar intake (≥ twice per day) than in those with a low frequency of sugar intake (< twice a day) (RR = 1.79; CI: 1.38-2.33). In families with higher income (≥2 times the monthly wage), no significant association between sugar intake and dental caries was, however, found.

CONCLUSIONS

In conclusion, monthly family income can modify the association between the high frequency of sugar intake and dental caries.

Association between nutritional status and children and adolescents' dental caries experiences: an overview of systematic reviews

An increasing number of systematic reviews (SR) has investigated the association between dental caries and nutritional status in children and adolescents, thus requiring an overview to compile the information in a single piece of evidence. Therefore, this study aimed to evaluate and summarize evidence from published SR on the association between dental caries and nutritional status in children and adolescents. A wide search was conducted on May 29, 2023, in six databases (Medline via PubMed, Scopus, Web of Science, Cochrane library, Embase, and the Virtual Health Library - VHL). An additional search was performed in the gray literature (Open grey and Google Scholar), SR registration databases, and the list of references of the included SR. Our inclusion criteria were based on acronym PECOS. Overall, two reviewers independently extracted the data, evaluated the risk of bias (ROBIS), and assessed the quality of the chosen studies (AMSTAR-2). Data from the included meta-analysis were summarized and certainty of evidence using the GRADE approach was performed. After removing duplicates and applying our eligibility criteria, 19 SR from 2006-2022 were included. We found that 17 SR showed high risk of bias and critically low methodological quality. We observed an association between dental caries experiences and nutritional status since seven SR found an association between obesity/overweight and dental caries; one, an association between underweight and dental caries; and eleven, no associations. The meta-analysis showed divergent results according to the study designs, used indices, and participants' age group, and were scored as having a very low certainty of evidence. Therefore, based on the high risk of bias, low methodological quality, and very low certainty of evidence of the chosen SR, most studies found no association between children and adolescents' nutritional status and dental caries experience.

Association between gastroesophageal reflux disease and dental caries among adults in the Azar cohort population: A cross-sectional study

BACKGROUND

Considering the high prevalence of dental caries in adults, it is necessary to study its risk factors to prevent the disease. Gastroesophageal reflux disease (GERD) is a common chronic disease with an increasing incidence that may affect the quality and quantity of saliva.

OBJECTIVES

This study aimed to determine the association of gastroesophageal reflux disease (GERD) with dental caries according to the DMFT index in the Azar cohort population.

MATERIALS AND METHODS

This cross-sectional study was performed on data obtained from the enrollment phase of the Azar Cohort Study (ACS), conducted on 15,000 adults aged 35 to 70. Data of 905 subjects with gastroesophageal reflux disease in the ACS-without full denture-together with a control group of 1894 subjects, who were matched in terms of gender and age, were included in this study. Dental caries data and data on GERD, demographic and socioeconomic characteristics, individual and nutritional habits, BMI, and toothbrushing frequency were elicited from the databank of the ACS center. A Generalized Linear Models assuming negative binomial distribution with a log-link function was used for analytical statistics to examine the effect of possible confounding variables.

RESULTS

The DMFT index in the group with GERD was 15.09±6.18, and for the control group was 15.00±6.07. No statistical association was seen between GERD and dental caries. Among the variables included in the regression analysis, being younger and toothbrushing one or more times per day were associated with a lower DMFT index score.

CONCLUSION

According to the results, having GERD did not increase the risk of dental caries. However, due to the cross-sectional design of the study, the results should be interpreted cautiously. The results showed that oral hygiene is one of the most influential factors in reducing dental caries prevalence.

Association between sleep duration and dental caries in a nationally representative U.S. population

BACKGROUND

Dental caries is considered one of the most prevalent chronic diseases worldwide despite all dental public health efforts. Short sleep duration has been established as a risk factor for several medical conditions. In this study, we aimed to examine the relationship between sleep duration and dental caries.

METHODS

Data were collected from the 2017-2018 cycle of the National Health and Nutrition Examination Survey, a nationally representative health survey conducted in the United States. Participants who completed sleep questionnaires were examined by dentists using standardized clinical criteria. Analysis was limited to Individuals aged ≥ 16 years with complete clinical oral examination data and who completed the sleep questionnaire (N = 5,205). The data were weighted to provide a national estimate, and multiple potential covariates were included in the analysis to account for the complex sample design. The main outcomes of the study were untreated dental caries and dental caries experience. The main predictor variables were average sleep hours/night and a binary variable with 7 h/night as a cut off. Multiple weighted Poisson and logistic regression analyses were conducted to test the hypothesis that people with short sleep duration are more likely to exhibit dental caries.

RESULTS

This study showed a statistically significant negative relationship between sleep duration and dental caries amongst all weighted adjusted analyses conducted. For a one hour increase in average sleep hours, the Adjusted Odds Ratio (AOR) of having a dental caries experience might decrease by 0.86 (AOR = 0.86, 95% CI = 0.75-0.98, P < 0.05). Individuals who reported an average sleep of ≥ 7 h were less likely to have a dental caries experience compared to individuals who reported an average sleep of < 7 h (AOR = 0.52, 95% CI = 0.33-0.82, P < 0.05). For a one hour increase in average sleep hours, the Adjusted Mean Ratio (AMR) of having a dental caries experience might decrease by 0.97 (AMR = 0.97, 95% CI = 0.96-0.99, P < 0.05), and was lower for those who reported sleeping ≥ 7 h/night than individuals who reported sleeping < 7 h/night (AMR = 0.92, 95% CI = 0.87-0.99, P < 0.05).

CONCLUSION

Findings of this cross-sectional representative study of the U.S. population revealed a statistically significant negative association between sleep duration and dental caries. In this study, individuals who slept < 7 h/night were more likely to exhibit dental caries.

Exploring an Association between Body Mass Index and Oral Health-A Scoping Review

BACKGROUND

Basal metabolic index (BMI) is a unique anthropometric indicator used to define the relative amount of body fat on an individual's frame. There are many diseases and conditions associated with obesity and underweight. Recent research trials suggest that there is a significant association between oral health indicators and BMI as both are attributed to common risk factors such as dietary, genetic, socioeconomic, and lifestyle issues.

OBJECTIVES

The main objective of this review paper is to emphasize the association between BMI and oral health with available literature evidence.

METHODOLOGY

A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were "body mass index", "periodontitis", "dental caries", and "tooth loss".

RESULTS

In total, 2839 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 1135 articles were excluded. The main reasons for excluding the articles were: they were dietary guidelines and policy statements. A total of 66 studies were finally included in the review.

CONCLUSION

The presence of dental caries, periodontitis and tooth loss may be associated with a higher BMI or obesity, whereas, improved oral health might be associated with lower BMI. Promoting general and oral health should be a hand in hand feature, as common risk factors can be embattled.

Childhood obesity: overcoming the fear of having healthier weight conversations with families

Introduction Clinicians may find raising the issue of weight with patients or carers and having healthier lifestyle conversations uncomfortable, out of fear or experience of causing offence. A two-cycle audit was completed in a specialist paediatric dental service to ascertain whether healthier weight conversations were being had with patients and their carers.

Materials and methods The inclusion criteria for the audit were paediatric patients who were having a general anaesthetic assessment for dental extractions as a result of dental caries. A gold standard was set that all patients having a general anaesthetic assessment should have their body mass index (BMI) calculated and healthier weight conversations should be had with patients and carers and families signposted for further support when necessary.

Results Results for the first cycle found that only 7% of patients had their BMI recorded and there was no record of healthier weight conversations for any patient. After the results of the first cycle were shared and ways in which to have a helpful healthy weight conversation discussed, a second cycle was carried out. A significant improvement was made, with clinicians calculating the BMI for 65% of the patients and a healthier weight conversation being had when necessary.

Discussion Many of the clinicians voiced that as calculating a BMI and having healthier weight conversations is not something that they had previously routinely done, they often forget to do this. Others stated that they felt uncomfortable bringing up the topic in a way that wouldn't offend the patient or parent, so avoided doing so.

Conclusions As a result of the audit, it was strongly encouraged that all clinicians continue to calculate BMI as it was found to be a useful tool for introducing healthier weight conversations when necessary. The subject of healthier weight needs to be acknowledged in the dental setting and discussed with families in a non-judgemental and sensitive way. This paper aims to guide clinicians in how to sensitively broach this subject with children and carers and when and where to signpost if extra support is needed.

Childhood obesity is increasing as a result of the COVID-19 pandemic and childhood obesity is linked with dental decay.

Clinicians struggle to have the 'healthier weight' conversation with children and their carers out of fear of causing offence.

Further training and advice on how to sensitively broach the conversation regarding childhood obesity with carers may be necessary so that children and carers can receive support when needed.

The effect of unhealthy dietary habits on the incidence of dental caries and overweight/obesity among Egyptian school children (A cross-sectional study)

Background

Obesity and dental caries are public health problems in Egypt. Factors such as unhealthy diet, poor oral hygiene, and physical inactivity can play a major role in both problems. This study was carried out to illuminate the mutual unhealthy dietary risk factors associated with the incidence of both health conditions.

Methods

Between 1 October 2020 and 1 July 2021, 369 Egyptian children (5-10 years) were examined. Dental status was assessed using decayed, missing/extracted, and filled tooth indices (dmft, deft, and DMFT) for deciduous, mixed, and permanent dentitions, respectively. Moreover, the lifestyle, food habits, and body mass index (BMI) were recorded.

Results

A total of 342 (93.7%) of the included subjects suffered from caries, and only 27(7.3%) were caries-free. Based on BMI percentiles, 247 (66.9%) of the youngsters were overweight/obese, while 122 (33.1%) had normal weight. The mean dmft was 6.9 (±4.6), deft 4.2 (±3.3), and DMFT 0.1 (±1.7). In the primary dentition, a significant positive correlation was detected between dmft and BMI, legumes, sweetened milk and juice, soft drinks, and desserts, while a significant negative correlation was detected between dmft/deft, meat/poultry/fish, fresh fruits, and vegetables. A significant positive correlation was detected between deft and BMI, sweetened milk and juice, ice cream, candies, and crackers. In the permanent dentition, a significant positive correlation was detected between age, soft drinks, sweetened juice, desserts, and DMFT, while a significant negative correlation was detected with fresh fruits and vegetables. BMI was significantly negatively correlated with a healthy lifestyle, meat/poultry/fish consumption, and fresh fruits and vegetables while positively correlated with legumes, ice cream, soft drinks, granulated sugars, desserts, fast food, and caffeinated drinks.

Conclusion

Overweight/obesity was positively correlated with primary dentition dental caries. Desserts (sweetened snacks) and soft drinks could be the common risk factors associated with high caries and overweight/obesity incidence among Egyptian school children; conversely, consumption of fruits and vegetables could hinder both health conditions. Moreover, sweetened juices were associated with primary and permanent dental caries.

Relationship of BMI with the diet, physical activity and oral hygiene practices amongst the dental students

Background

Regardless of attaining adequate knowledge regarding oral hygiene, physical activity, and healthy eating habits, dental students still face oral health problems. This study was aimed to assess the association of oral hygiene habits, physical activity, and eating habits with the BMI in the dental students.

Method

This multi centric cross-sectional study was conducted from January to May 2021 in Pakistan. Three hundred and eighty-six study participants enrolled as undergraduate dental students, both males and females, were included in the study. A questionnaire used to gather data, was modified from a study conducted by Jouhar et al. Chi-square testing was used in order to assess the relationship between two categorical variables. Linear regression was performed to assess the association with putative confounders. Statistical significance was considered for p value < 0.05.

Results

Regarding brushing teeth, 57% of the underweight individuals brushed once daily, 69.8% of the healthy, 79.2% of overweight, and 48% of obese participants brushed twice. Horizontal brushing technique was performed by 50% of the underweight participants, followed by scrub technique. A soft bristled brush was frequently used by underweight (42.9%) and healthy (66%) individuals, while a medium textured bristle brush was used by overweight (62.3%) and obese (54.2%) participants. Majority of the underweight (64.3%), overweight (48.1%), and 45.8% of obese individuals had meals thrice a day, while healthy (62.3%) individuals had meals twice a day.

Conclusion

This study further intensified the contributing role of having an excessive dietary intake and sugar consumption in causing obesity and dental caries. Findings from the current study, identify a statistically significant relationship that exists between BMI levels with oral hygiene, eating habits and the physical activity.

ASSESSMENT OF DMFT INDEXES, SALIVARY FLOW RATE, PH, AND DETECTIONS OF S.MUTANS SALIVARY LEVELS BY A QUANTITATIVE REAL-TIME PCR IN POLYCYSTIC OVARY SYNDROME

Objectives: PCOS is an endocrine disorder that is common in women. However, PCOS effects on oral and dental health have not been stated clearly. The aim of this study is to examine the effects of Polycystic Ovary Syndrome (PCOS), which is common in women of reproductive age, on saliva and dental tissues in these women. Materials and Methods: One-hundred individuals who were / were not diagnosed with PCOS and insulin resistance were included in this study (n=100). Subsequently, individuals, with PCOS and insulin resistance (PCOSID +), with PCOS and non-insulin resistance (PCOSID-), without PCOS and insulin resistance (ControlID +) and without PCOS and non-insulin resistance (ControlID-) were divided into 4 groups (n=25). DMFT (Decayed, Missing, Filled Teeth) index was used for dental health evaluation, while pH meter was used for saliva pH measurement. Also, Streptococcus Mutans (S. Mutans) numbers were analyzed by the real-time Polymerase Chain Reaction (PCR) method. In statistical analysis p

Selecting Risk of Bias Tools for Observational Studies for a Systematic Review of Anthropometric Measurements and Dental Caries among Children

In conducting a systematic review, assessing the risk of bias of the included studies is a vital step; thus, choosing the most pertinent risk of bias (ROB) tools is crucial. This paper determined the most appropriate ROB tools for assessing observational studies in a systematic review assessing the association between anthropometric measurements and dental caries among children. First, we determined the ROB tools used in previous reviews on a similar topic. Subsequently, we reviewed articles on ROB tools to identify the most recommended ROB tools for observational studies. Of the twelve ROB tools identified from the previous steps, three ROB tools that best fit the eight criteria of a good ROB tool were the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies, and Agency for Healthcare Research and Quality (AHRQ) and the Effective Public Health Practice Project (EPHPP) for a cross-sectional study. We further assessed the inter-rater reliability for all three tools by analysing the percentage agreement, inter-class correlation coefficient (ICC) and kappa score. The overall percentage agreements and reliability scores of these tools ranged from good to excellent. Two ROB tools for the cross-sectional study were further evaluated qualitatively against nine of a tool's advantages and disadvantages. Finally, the AHRQ and NOS were selected as the most appropriate ROB tool to assess cross-sectional and cohort studies in the present review.

Databases Selection in a Systematic Review of the Association between Anthropometric Measurements and Dental Caries among Children in Asia

A comprehensive search for primary studies using a sufficient number and relevant databases is critical to minimise bias and increase the validity of a systematic review. We examined the frequency and choices of databases commonly used to provide an efficient search of primary studies for a systematic review of anthropometric measurements and dental caries among children in Asia. Twelve previous systematic reviews on a similar topic were retrieved from six databases. The frequency and choice of databases used by reviewers were determined from the methods sections. We also identified the lists of other databases usually searched in other reviews. Eligibility criteria for final databases selection were the database's scope, the topic of interest, design of the study, type of article, and the accessibility of the databases. Of the 77 databases identified, previous reviews on this topic used 21 databases, ranging from 2 to 12 databases in each review. Medline, Cochrane Library, Web of Science, and PubMed were employed most frequently. Twenty-six databases were eligible and selected for the present review. Twelve were regional databases to provide comprehensive coverage of primary studies. A systematic approach in selecting appropriate databases for searching primary studies is paramount to reduce errors, ensure coverage, and increase the validity of systematic reviews' conclusions.

Dental caries prevalence among elementary school students and its relationship with body mass index and oral hygiene in Ardabil in 2019

BACKGROUND AND AIM

Tooth decay as a significant but preventable public health priority continues to be a common disease in developing countries, including Iran, which is particularly prevalent among children. The present study aims to determine dental caries prevalence among elementary school students and its relationship with body mass index and oral hygiene in Ardabil, Iran in 2019.

MATERIALS AND METHODS

This cross-sectional study was conducted on 581 elementary school students selected through cluster random sampling method in Ardabil city in 2019. Demographic data was collected using questionnaire and anthropometric indices (height, weight) were measured using the weighing scale and stadiometer, and dental caries was evaluated using the decayed, missing, or filled teeth index (dmft for primary teeth and DMFT for permanent).

RESULTS

The mean age of students was 9.61 ± 1.76 years, and 50.8% of them were female. 20.7% (n = 120) were obese, and 19.1% (n = 111) were overweight. The overall prevalence of caries was 74.9% (n = 435) in primary teeth, 72.8% (n = 423) in permanent teeth, and 96.6% (n = 561) in all teeth. The average dmft and DMFT scores were 4.16 ± 3.72 and 1.96 ± 1.76, respectively. There was a significant inverse relationship between body mass index and dmft (r = -0.146, P < 0.0001) and DMFT (r = -0.111, P = 0.004).

CONCLUSION

The findings showed that prevalence of dental caries in elementary school children in Ardabil city is higher than global standards, obese and over-weight children experience fewer caries compared to normal-weight children, and there is a significant relation between not brushing the teeth and dental caries.

Assessing the Association Between Nutritional Status, Caries, and Gingivitis in Schoolchildren: A Cross-Sectional Study

Objective. To evaluate if nutritional status is associated with caries and gingivitis in Brazilian schoolchildren. Material and methods. Children of both genders, age ranging from 8 to 11 years old, were included in this study. Caries was diagnosed using ICDAS (International System for Detection and Assessment of Carious Lesions) and gingivitis was diagnosed using the Community Periodontal Index. The nutritional status of each child was defined by BMI Z-score calculation. Data on oral health behavior and dietary habit were collected through parent's questionnaires. Parametric analyzes were performed to compare the groups. The established alpha was 5%. Results. The sample consisted of 353 schoolchildren: 16 underweight children, 247 eutrophic children, 64 overweight children, and 26 were obese children. Overweight, Obese and Overweight + Obese children presented less cavitated caries lesion than Eutrophic children (P < .05). Gingivitis was not associated with nutritional status (P > .05). Conclusion. Caries was associated with overweight and obesity in Brazilian schoolchildren.

Association between Dental Caries, Obesity and Salivary Alpha Amylase in Adolescent Girls of Babol City, Iran-2017

Statement of the Problem

Adolescents are at risk of obesity and caries due to various factors such as diet and poor health habits; these factors may affect their body mass index (BMI) and salivary components. Therefore, it is necessary to assess these factors and their relationship in this age group.

Purpose

This study aimed to evaluate the association between decayed missing filled teeth index (DMFT), salivary alpha amylase (sAA) level and age-specific BMI in adolescent girls.

Materials and Method

A cross-sectional study was conducted on 81 females aged 13-15 years in 3 groups of BMI percentiles; "normal", "at risk for overweight" and "overweight" (n=27). DMFT was calculated and unstimulated saliva samples were collected. The sAA level was measured with a spectrophotometer. Data were analyzed using Kolmogorov-Smir-nov test, Kruskal- Wallis and Spearman correlation tests using SPSS (version 23) at p< 0.05.

Results

The concentration of sAA and mean DMFT were estimated 1326.56±4.73 U/L and 2.77±2.36, respectively. There was no significant difference in sAA level and mean DMFT among BMI groups. A positive and significant correlation was found between sAA and DMFT in overweight group (r 0.46, p= 0.014).

Conclusion

Within the limitation of this study, higher levels of sAA may be considered as an indicator for dental caries in overweight adolescent girls.

Associations between obesity, dental caries, erosive tooth wear and periodontal disease in adolescents: a case-control study

PURPOSE

To compare oral health [dental caries, periodontal status, and erosive tooth wear (ETW)], diet and oral hygiene habits between obese and normal weight adolescents, and to explore possible risk associations.

METHODS

In this case-control study, a convenience sample of 71 obese adolescents (age range 11-18) from a rehabilitation centre, and 54 age-sex-matched normal weight adolescents were selected for this study. Groups were defined using the Body Mass Index and growth curves for Flemish adolescents. Oral health was measured using DMFT, gingival, plaque and BEWE index. A validated questionnaire was utilized to assess diet and oral hygiene habits. Mann-Whitney U test was used to compare oral health between groups. Multivariate Firth's logistic regression analysis, conditional regression analysis and classification trees were used to detect associations between oral health and potential risk factors.

RESULTS

Prevalence of ETW did not differ significantly between groups, although obese adolescents presented a significantly higher caries experience, gingivitis, presence of plaque and periodontal problems, compared to normal weight adolescents. After adjusting for age and sex, obesity was associated only with the presence of dental plaque (p ≤ 0.001). Obese participants reported a significantly higher intake of sugar-rich and caloric food items than normal weight group. The consumption of acidic drinks, however, was similar.

CONCLUSION

Obese adolescents presented significantly higher caries experience, gingivitis and plaque, although after adjusting, obesity became significantly associated only with the presence of dental plaque.

Association of BMI, Diet, Physical Activity, and Oral Hygiene Practices with DMFT Index of Male Dental Students at King Faisal University, Al-Ahsa

Despite sufficient knowledge of good oral hygiene habits, dental students still suffer from oral health problems owing to dietary habits, obesity, and a sedentary lifestyle. This cross-sectional study was conducted to evaluate an association of BMI (body mass index), diet, physical activity, and oral hygiene practices with DMFT (decayed, missing, and filled teeth) of male dental students and interns at King Faisal University, Saudi Arabia, from August to September 2020. One hundred and eighty-five male participants completed the study questionnaire. The questionnaire consisted of sociodemographic information and nineteen close-ended questions about current diet, physical activity, and oral hygiene practices. Students’ height (cm) and weight (kg) were measured to calculate BMI. The principal investigator performed the oral clinical examinations for the DMFT status in the dental clinic. The chi-square test was used for the dichotomous variables and a t-test was used for the continuous variables. Linear and multinomial logistic regression were performed to detect the significant predictors of the DMFT score. The mean age of participants was 22.29 ± 2.13 years, and the BMI was 24.94 ± 3.36 (Kg/m²). Parents’ higher education and income levels were significantly (p < 0.001) associated with a higher BMI. Most dietary variables, especially sugar products, and low physical activity, were significantly (<0.047) associated with higher BMI. All oral hygiene practices, except miswak and mouthwash, were significantly (<0.003) associated with higher BMI. Decayed and missing teeth were significantly (<0.001) higher in the overweight and obese. A simple linear regression analysis demonstrated association between BMI and decayed teeth, with an R = 0.35 (<0.001); BMI and missing teeth had an R = 0.12 (p = 0.867); BMI and filled teeth had an R = 0.15 (p = 0.033), and BMI with DMFT had an R = 0.33 ((<0.001). This study demonstrated a strong significant association of the decayed and missing teeth with higher BMI levels. In addition, BMI was significantly associated with diet and physical activity, despite acceptable oral hygiene practices.

Childhood obesity and dental caries: an ecological investigation of the shape and moderators of the association

BACKGROUND

Despite sharing a common risk factor in dietary sugars, the association between obesity and dental caries remains unclear. We investigated the association between obesity and dental caries in young children in England in an ecological study.

METHODS

We analysed data from 326 lower tier English local authorities. Data on obesity and dental caries were retrieved from 2014/15 to 2016/17 National Child Measurement Programme and 2016/17 National Dental Epidemiology Programme. We used fractional polynomial models to explore the shape of the association between obesity and dental caries. We also examined the modifying effect of deprivation, lone parenthood, ethnicity, and fluoridation.

RESULTS

Best fitting second order fractional polynomial models did not provide better fit than the linear models for the association between obesity and prevalence and severity of dental caries; therefore, the linear model was found suitable. Despite significant association, after adjusting for the effect of deprivation, obesity was neither associated with prevalence (coefficient = 0.2, 95% CI - 0.71, 0.75), nor with severity (coefficient = 0.001, 95% CI - 0.03, 0.03) of dental caries. In fully adjusted models, the proportion of white ethnicity and being in fluoridated areas were associated with a decrease in dental caries. The association between obesity and dental caries was moderated by the effect of deprivation, white ethnicity, and lone parenthood.

CONCLUSIONS

The association between obesity and dental caries was linear and moderated by some demographic factors. Consequently, interventions that reduce obesity and dental caries may have a greater impact on specific groups of the population.

The association between nutritional status and dental caries in low-income children: A multilevel analysis

BACKGROUND

The possible association between obesity, underweight, and dental caries remains in debate. In addition, the role of sugar consumption on the abovementioned relationship was little explored.

AIM

This study aimed to investigate the relationship between nutritional status and dental caries in 12-year-old low-income children.

DESIGN

This cross-sectional school-based study involved 406 12-year-old children living with limited economic resources. Dental caries was assessed using the decayed component of DMFT and PUFA/pufa index. Children were weighed and measured to assess nutritional status according to z-score/body mass index. Data on socio-economic and demographic characteristics, sugar consumption, sedentary behaviour, and psychosocial factors were collected through validated questionnaires. Multivariable multilevel Poisson regression was performed.

RESULTS

Underweight children had 60% (RR = 1.60; 95% CI 1.13-2.57) higher mean of decayed teeth and had mean PUFA/pufa 2.8 times higher than children with normal nutritional status. Underweight children with high annual sugar intake had a greater mean of decayed teeth (RR = 2.72; 95% CI 1.46-5.06) than underweight children with low sugar intake.

CONCLUSIONS

Our findings suggest that malnutrition is associated with dental caries among children from low-income families.

Association between body mass index and dental caries in the Kingdom of Saudi Arabia: Systematic review

OBJECTIVE

The Kingdom of Saudi Arabia (KSA) has one of the highest prevalence of both obesity and dental caries. To date, there has not been any documented evidence linking these two factors. Therefore, the objective was to conduct a systematic review of published studies that have analysed the association between body mass index and dental caries in the KSA for both children and adults.

METHODS

A systematic database search [PubMed, EMBASE, Web of Science, CINAHL and Cochrane Library] was conducted following the PRISMA guidelines. The inclusion criteria were observational studies, with no limit on the publication date. Search terms included: dental caries, obesity, overweight, body mass index, BMI 'AND' Saudi Arabia. The independent variable was body mass index (BMI), and the primary outcome measure was dental caries prevalence and severity.

RESULTS

From 951 search results, 935 citations were identified and excluded. Of the 16 potentially eligible studies, two citations were excluded, because the studies did not meet the inclusion criteria. This left fourteen studies meeting the criteria to be included in this systematic review. Ten studies outlined children, and four studies assessed adults. For children, two studies resulted in a positive association between high BMI and caries, six studies resulted in a negative association, and two studies had a non-significant association. For adults, two studies resulted in a positive association between high BMI and dental caries, and two studies had a non-significant association. These were rated as having low to moderate risk of bias.

CONCLUSION

As a result of this equivocal outcome within the systematic review, body mass index and dental caries present as a complex association. Further long-term studies are required to translate the findings into clinical practice.

Association of body mass index and gross national income with caries experience in children in 117 countries

Objective: To evaluate the association of body mass index (BMI) and gross national income (GNI) per capita with dental caries experience in children at population levels.Methods: This ecological study used global data of decay, missing, and filled teeth (DMFT), BMI, and GNI. DMFT data of 12 years old children from 117 countries were obtained from the World Health Organization. BMI data of children and adolescents from the same 117 countries were retrieved from the NCD Risk Factor Collaboration and GNI per capita from the World Bank. ANOVA test, Pearson's correlation coefficient (r), and multivariable linear regression were performed.Results: Globally mean BMI ranged from 16.1 to 22.2 in children. Low-income countries had the lowest BMI (17.41 ± 0.57) and high-income countries had the highest BMI (20.14 ± 0.87) (p < .001). The highest mean DMFT was observed in upper-middle-income countries (2.48 ± 1.16) and the lowest in low-income countries (1.22 ± 0.83) (p = .001). There was no significant correlation between BMI and dental caries (DMFT) (r = .063; p = .498). However, there were significant correlations between GNI per capita and BMI (r = 0.366; p < .001) and GNI per capita and DMFT (r= -0.252; p = .007). In multivariable linear regression, GNI per capita was negatively associated with caries experience in children (B= -1.83; p < .001).Conclusion: The study found that BMI was associated with income levels of the countries. GNI per capita significantly and negatively correlated with DMFT in children. Further investigation into the association between BMI and dental caries is warranted.

Obesity and dental caries in early childhood: A systematic review and meta-analyses

Obesity and dental caries in children are significant health problems. The aims of this review are to identify whether children aged 6 years and younger with overweight and/or obesity have higher dental caries experience compared with children with normal weight and, secondly, to identify the common risk factors associated with both conditions. Medline, Embase, and seven other databases were systematically searched followed by lateral searches from reference lists, grey literature, theses, conference proceedings, and contacting field experts. Longitudinal observational studies addressing overweight and/or obesity and dental caries in children aged 6 years and younger were included. A random effects model meta-analyses were applied. Nine studies were included in this review. Children with overweight and obesity had a significantly higher dental caries experience compared with children with normal weight (n = 6). The pooled estimates showed that difference in caries experience between the two groups was statistically significant. Low levels of parental income and education were identified to be associated with both conditions in the sample population. Children with overweight and obesity are more vulnerable to dental caries. Low levels of parental income and education influence the relationship between the two conditions. However, the quality of evidence varied considerably; therefore, findings should be interpreted cautiously.

Obesity and dental caries in early childhood: a systematic review protocol

OBJECTIVE

The objectives of this review are to examine whether overweight/obese children experience more dental caries compared with non-overweight/non-obese children, and to identify common risk factors associated with both conditions.

INTRODUCTION

Systematic reviews have shown that any evidence on a link between overweight and/or obesity and dental caries remains inconclusive. This relationship has not been assessed for children under six years of age with primary dentition. Therefore, an updated systematic review of this topic is necessary as its findings will be important for young children, clinicians, researchers and policy makers.

INCLUSION CRITERIA

Studies examining children under six years of age and with complete primary dentition at the time of dental caries assessment will be included. The exposure of interest is the overweight and/or obesity status of children under six years of age. The outcome is dental caries in children with complete primary dentition. There will be no restriction on setting, date or language.

METHODS

MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, ProQuest Central, Scopus, CINAHL, and Google Scholar will be searched for eligible studies. The electronic database search will be supplemented by OpenGrey and Grey Literature Report databases, ProQuest Dissertations and Theses Global, and the International Association for Dental Research conference websites. Two reviewers will independently screen and select studies, assess methodological quality and extract data. Meta-analysis will be performed, if possible, and the Grading of Recommendations Assessment Development and Evaluation (GRADE) Summary of Findings presented.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42018085292.

[Relation between body mass index and dental caries among adolescents]

BACKGROUND

Obesity and dental caries are both multifactorial diseases. Their prevalence is increasing among infants and adolescents. Research results on the association between dental caries and obesity are contradictory and the nature of factors involved remains unclear. The aims were to review and summarize the type of the relation between dental caries and obesity among infants and adolescents aged 8 to 18 years old and to identify factors contributing to the clarification of the relationship.

METHOD

Research of literature was undertaken on electronically databases Scholar Google, Medline, completed by manual searches from reference lists of studies. Review was based on cross sectional studies published between 2010 and 2015.

RESULTS

The results showed that dental caries were associated with high and low body mass index. In addition to the socio-economic, environmental, behavioural, lifestyle factors, the review identified that the choice of instruments used to diagnose the dental caries and the obesity had impact on the results.

CONCLUSION

The present review has identified the impact of the indicators used for measuring obesity and dental caries other than the standard BMI or DMFT respectively. Future research should test if their use will change the conclusions on the association between obesity and dental caries.

Obesity and dental caries among South Brazilian schoolchildren: a 2.5-year longitudinal study

The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.

No consistent association found between dental caries and body mass index in children

Data sourcesPubMed, Embase, the Cochrane Library and reference lists of identified studies.Study selectionObservational studies comparing dental caries and body mass index (BMI) where BMI was clearly defined were considered.Data extraction and synthesisTwo reviewers independently abstracted data using standard forms with study quality being assessed using a modified version of the Agency for Healthcare Research and Quality (AHRQ) methodology checklist for cross-sectional studies. The weighted mean differences and corresponding 95% confidence intervals for dental caries between children with abnormal weight and those with normal weight were analysed.ResultsFourteen cross-sectional studies including 43,860 children (boys: 23,299; girls: 20,561) were included. Only two studies were considered to be of high quality, eight of medium quality and four of low quality. Four main patterns of associations between dental caries and BMI were found: five studies showed no association, five studies found a positive association, three an inverse association and one found a U-shaped pattern, which meant that the deft score was significantly higher in underweight children and there was a higher DMFT score in overweight and obese children.ConclusionsThis meta-analysis showed no differences in dental caries between underweight and normal weight children. Further studies are recommended using suitable sample sizes, to unify the criteria for BMI categorisation and the dental caries index, and investigate the confounding factors that might influence dental caries and BMI.

Association between Dental Caries and Obesity in Children and Young People: A Narrative Review

OBJECTIVES

To explore the association between obesity and dental caries in children and adolescents. Furthermore, to consider the possible reasons behind this relationship.

METHODS

A database search for papers published between January 2015 and May 2018, inclusive, addressing the association between obesity and dental caries was conducted. A review and critical appraisal of all included studies was performed.

RESULTS

Twenty-six studies were included in this review from different populations worldwide. Eight studies assessed the primary dentition, nine studies were conducted on permanent dentition, and remaining nine studies on both dentitions. The results regarding the association between obesity and dental caries were conflicting and inconsistent. Nine studies concluded that there was no relationship between obesity and dental caries. A positive association was reported in five studies, while the inverse association was reported in eleven studies. Studies included in this review had significant variations in methodology and the investigated cofactors. Possible explanations of the controversial association between obesity and dental caries are discussed in this review.

CONCLUSION

Both obesity and dental caries are multifactorial diseases, and their association is far more complex that can be explained by a single common risk factor, presenting evidence for the complexity of this association.

Body mass index and dental caries in young people: a systematic review

BACKGROUND

Obesity and caries in young people are issues of public health concern. Even though research into the relationship between the two conditions has been conducted for many years, to date the results remain equivocal. The aim of this paper was to determine the nature of the relationship between Body Mass Index (BMI) and caries in children and adolescents, by conducting a systematic review of the published literature.

METHODS

A systematic search of studies examining the association between BMI and caries in individuals younger than 18 years old was conducted. The electronic bibliographic databases PubMed, MEDLINE, Embase, CINAHL, CENTRAL and Google Scholar were searched. References of included studies were checked to identify further potential studies. Internal and external validity as well as reporting quality were assessed using the validated Methodological Evaluation of Observational Research checklist. Results were stratified based on the risk of flaws in 14 domains 10 of which were considered major and four minor.

RESULTS

Of the 4208 initially identified studies, 84 papers met the inclusion criteria and were included in the review; conclusions were mainly drawn from 7 studies at lower risk of flaws. Three main types of association between BMI and caries were found: 26 studies showed a positive relationship, 19 showed a negative association, and 43 found no association between the variables of interest. Some studies showed more than one pattern of association. Assessment of confounders was the domain most commonly found to be flawed, followed by sampling and research specific bias. Among the seven studies which were found to be at lower risk of being flawed, five found no association between BMI and caries and two showed a positive association between these two variables.

CONCLUSIONS

Evidence of an association between BMI and caries was inconsistent. Based on the studies with a low risk lower risk of being flawed, a positive association between the variables of interest was found mainly in older children. In younger children, the evidence was equivocal. Longitudinal studies examining the association between different indicators of obesity and caries over the life course will help shed light in their complex relationship.

Oral health and obesity in the SAYCARE study: reliability and internal validity of diagnostic methods

OBJECTIVE

The aim of this pilot study was to address the reliability, internal validity and viability of oral health methods used in the South American Youth/Child cARdiovascular and Environmental study.

METHODS

South American Youth/Child cARdiovascular and Environmental study was a multicentre feasibility observational study and conducted in seven South American cities. The training sessions were performed in two steps before data collection: the first verified the inter-rater reproducibility between the examiners of the six centres in relation to the gold standard, and the second one verified the inter-rater reproducibility between the examiners at each centre in relation to the main rater. The diagnostic methods used were International Caries Detection and Assessment System II and Pulpal Involvement, Ulceration, Fistula and Abscess for dental caries and Periodontal Screening and Recording and Index Plaque for periodontal disease. Anthropometric variables were measured and used to calculate the body mass index and were classified according to the cut-off points defined by the International Obesity Task Force. Cohen's kappa coefficient and proportions of agreement were calculated to report inter-rater and intra-rater reliability in the calibration process and pilot study.

RESULTS

The inter-rater weight kappa ranged from 0.78 to 0.88 and proportion of agreement from 96.07% to 98.10% for the International Caries Detection and Assessment System II and for the Periodontal Screening and Recording, 0.68 to 0.95 and 94.40% to 98.33%, respectively, in the calibration process. At the pilot study, a total of 490 children (40.8% overweight and 12.9% obese) and 364 adolescents (23.4% overweight and 4.3% obese) were examined. The prevalence of dental caries was 66% in children and 78% in adolescents, and gingival bleeding was 49% and 58.20%, respectively.

CONCLUSION

The results demonstrated good reliability and internal validity after the examiners were trained, as well as the feasibility of using the methods chosen for this multicentre study.

Dental caries and anthropometric measures in a sample of 5- to 9-year-old children in Dhaka, Bangladesh

AIM

This study aimed to assess associations between dental caries and anthropometric measures among a sample of children aged 5-9 years in Dhaka, Bangladesh.

METHODS

A cross-sectional observational study was conducted among 5- to 9-year-old children in Dhaka, Bangladesh. Data were collected from children and their parents attending the Dhaka Dental College Hospital and from three nearby primary schools. The outcome measures were as follows: age and sex adjusted height-z-scores (HAZ), weight-z-scores (WAZ) and BMI-z-scores (BAZ). Multiple linear regressions were used to assess the associations between caries and anthropometric measures, adjusted for maternal education, family income, study setting, birth weight and childhood diseases as potential confounders.

RESULTS

The final sample comprised 788 children, and the overall response rate was 96.7%. The majority (73.2%) had experience of dental caries. The mean dmft + DMFT score was 2.84 (95% CI 2.64, 3.03) and 35.8% experienced dental sepsis. Dental caries and sepsis were negatively associated with HAZ, WAZ and BAZ scores. After adjustment for potential confounders, children with severe levels of caries had lower HAZ scores (coefficient: -0.40; 95% CI -0.69, -0.10), lower WAZ scores (coefficient: -0.59; 95% CI -0.94, -0.24) and lower BAZ scores (coefficient: -0.50; 95% CI -0.87, -0.13) than those who were caries free. Children with moderate levels of caries also had lower WAZ scores (coefficient: -0.43; 95% CI -0.72, -0.15) and lower BAZ scores (coefficient: -0.43; 95% CI -0.72, -0.13) than caries-free children. Children with dental sepsis had lower HAZ (coefficient: -0.23; 95% CI -0.42, -0.03), WAZ (coefficient: -0.33; 95% CI -0.56, -0.10) and BAZ scores (coefficient: -0.29; 95% CI -0.53, -0.05) than dental sepsis-free children.

CONCLUSIONS

Dental caries was associated with lower height, weight and BMI among this sample of Bangladeshi children, even after adjusting for age and sex and a number of potential confounders.

Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India

Introduction

Childhood obesity, dental caries, and periodontal disease are major public health problems due to their adverse impact on the growth and development of children. Obesity and oral health are associated as both share some common risk factors.

Aim

The specific aim of the study was to determine the correlation, if there is any, between obesity and oral health in children.

Materials and methods

A cross-sectional survey was conducted in five districts of West Bengal, India. A total of 1,227 school-going children of 6 to 12 years were examined from the districts of Howrah, Hooghly, West Midnapore, South 24-parganas, and North 24-parganas. Following indices were analyzed: Decayed-missing-filled teeth (DMFT), decayed, extracted, filled teeth (deft), simplified oral hygiene index (OHI-S). Depending on their nutritional status, subjects were categorized as being normal weight, overweight, and obese. Logistic regression analysis were applied to the study to find out the association between the above-mentioned dental indices and independent variables: Gender and nutritional status.

Result

A positive association was found between obesity and oral health status in children.

Conclusion

Considering the results of this study, it was concluded that obesity is related to oral hygiene status of children. In order to improve oral hygiene status in children, dietary modifications need to be done.

How to cite this article: Halder S, Kaul R, Angrish P, Saha S, Bhattacharya B, Mitra M. Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India. Int J Clin Pediatr Dent 2018;11(3):233-237.

Body Mass Index and Dental Caries: A Systematic Review

Introduction

This review was undertaken to analyze the relationship between body mass index (BMI) and dental caries with the available literature evidence.

Materials and methods

The articles were searched from Medline/PubMed and Journal of Web published between 2005 and 2016.

Results

Out of the 146 references obtained, 16 articles in English language were read in full, which fulfilled the inclusion criteria after assessing by Down and Black criteria.

Conclusion

No consensus was reached in the relationship between BMI and dental caries in the present review due to varied associations

How to cite this article: Shivakumar S, Srivastava A, Shivakumar GC. Body Mass Index and Dental Caries: A Systematic Review. Int J Clin Pediatr Dent 2018;11(3):228-232.

Effect of body weight and behavioural factors on caries severity in Mexican rural and urban adolescents

OBJECTIVES

To investigate if, in Mexican adolescents, body weight and caries severity are associated, and if this association differs between rural and urban populations.

METHODS

Adolescents from the rural area of Tepancan and the city of Veracruz were enrolled. Caries was recorded using the International Caries Detection and Assessment System and the body mass index (BMI) was calculated. Oral habits (toothbrushing, flossing, dental check-ups) and dietary patterns (sweets intake) were assessed. A dummy variable between BMI and living area (BMI/Area) was generated. Data were analysed using STATA and a multinomial logistic regression model was run, using caries severity as the dependent variable.

RESULTS

Four-hundred and sixty-four subjects, 12-15 years of age, participated (rural = 240; urban = 224). The BMI and area of residence were significantly associated (χ² = 12.59, P < 0.01). Area was also associated with caries severity (χ² = 24.23, P < 0.01), with the highest number of caries in dentine recorded in participants from the rural area. The dummy variable BMI/Area was related to caries severity (χ² = 27.47, P < 0.01): overweight adolescents with caries in dentine were most frequently found in the rural area. A higher prevalence of caries in enamel and a lower prevalence of caries in dentine (P < 0.01) were recorded in adolescents from the urban area, where better oral habits, but higher sweets intake (P = 0.04), were encountered. According to the multinomial logistic regression model, BMI/Area was significantly associated with caries severity (P < 0.01).

CONCLUSIONS

Overweight was not associated with caries severity in the overall population, but it became a statistically significant risk indicator in adolescents living in the rural area.

Relationship of Body Mass Index with Dental Caries among Children attending Pediatric Dental Department in an Institute

INTRODUCTION

Oral health, the mirror of general well being, is altered by many mediators like infection, chronic inflammation, and genetic predisposition. Apart from these mediators, nutrition has been postulated as an alternative mediator. The present dietary pattern among children is contributing to childhood overweight as well as increasing the risk for developing dental caries. The food habits contributing to dental caries as well as obesity are similar. Undernutrition has also shown to be associated with the dental caries. The study was conducted to investigate the relationship of body mass index to dental caries.

METHODS

A cross sectional clinical study was conducted on 7 to 12 year old children, studying in public schools, visiting the Department of Pediatric Dentistry for a routine dental check up. The study evaluated the nutritional status by calculating the body mass index using the formula BMI= Weight (kg)/Height2 (m2). Then their Body Mass Index was correlated with the Dental caries status using WHO criteria for decayed, missing and filled teeth index. Data analysis was done by SPSS 20 software program.

RESULTS

Total of 251 children between 7 to 12 years were evaluated. The mean age of the participants was 9.12 years. No statistically significant result was found on comparing the nutritional status to dental caries (P=0.43). A statistically significant difference though was found on comparing dental caries status among gender (P=0.021) as well different age groups (P=0.031).

CONCLUSIONS

The study showed the presence of more normal and underweight children but there was no statistically significant association between body mass index and decayed, missing and filled teeth index.

Association Between Dental Caries and Body Mass Index in Schoolchildren Aged Between 14 and 16 Years in Riyadh, Saudi Arabia

Background

Dental caries and obesity are multifactorial diseases that have common risk factors. Studies worldwide reported varied outcomes about the association between dental caries and obesity. There is no published study that investigates this association among schoolchildren in Arabic countries. The aim of this study was to evaluate the relationship between dental caries (DMFT) and body mass index (BMI) for children aged between 14 and 16 years old in Riyadh, Saudi Arabia. The role of oral hygiene habits, parent’s education, sugar consumption and physical activity in causing both diseases was also evaluated.

Methods

This is a cross-sectional study that involved 610 schoolchildren aged between 14 and 16 years. The children were selected from 12 boy’s intermediate schools distributed in Riyadh city. A questionnaire that asked about demographic data, oral hygiene habits, parents’ education, sugar consumption and physical activity was distributed. Then, the mean DMFT and BMI were calculated by collecting the information from dental examination, body weight and height. Multivariate logistic regression model was used to explain the relationship between the teeth health and the BMI. Moreover, multivariate linear regression was conducted to model the relationship between DMFT and BMI and the socioeconomic score, sugar consumption and physical activity.

Results

The prevalence of dental caries (DMFT > 0) was 54.1%. Around 32% of the schoolchildren were either overweight or obese. A statistically significant association between dental caries (DMFT) and BMI was found (P = 0.008). It was found that obese schoolchildren are 1.79 times higher to be with healthy teeth (P = 0.02). In addition, it was found that schoolchildren with higher socioeconomic status are 1.26 times higher to be with healthy teeth group (P = 0.005). Similarly, schoolchildren who reported that they are using the fluoridated toothpaste were 1.63 times higher to be within the healthy teeth group (DMFT = 0) when everything else is controlled. Physical activity level affects the schoolchildren BMI significantly (P < 0.001).

Conclusions

The study showed a statistically significant association between dental caries and BMI for this study sample. Obese schoolchildren showed healthier teeth than others did. Fluoride toothpaste usage and socioeconomic score were associated significantly with dental caries.

Influence of body mass index on severity of dental caries: cross-sectional study in healthy adults

BACKGROUND

The relationship between body mass index (BMI) and dental caries is still undetermined.

OBJECTIVE

This study aimed to assess the relationship between the dental status by decayed, missed, filled teeth index (DMFT), and BMI by age and gender among healthy adults.

DESIGN

Analytical, cross-sectional study.

SETTINGS

University dental hospital in Riyadh.

SUBJECTS AND METHODS

Healthy adults aged between 18 and 35 years were recruited during the 10-month period from March 2015 to December 2015. Dental caries severity was estimated using the DMFT index.

MAIN OUTCOME MEASURE

The prevalence of overweight/obesity and the association of BMI category with the DMFT index.

RESULTS

The mean age of 502 subjects was 24.3 (4.9) years. The caries severity of the study population was considered moderate according to the WHO caries severity scale (mean [standard deviation] DMFT 13.3 [3.8]). The mean (SD) DMFT of male and female subjects was 13.1 (4.0) and 13.36 (3.7), respectively. No significant association was seen between dental caries and BMI. Logistic regression analysis showed that males had two times more risk of developing dental caries compared to females. In addition, the risk of caries development was increased by about 5 times for every year of age.

CONCLUSION

Dental caries was not associated with BMI but age significantly influenced the DMFT index and gender was associated with more missing teeth. Further longitudinal studies with larger cohorts from several geographic regions are warranted.

LIMITATION

Convenience sampling and recruitment from a single dental center may have some impact on the generalization of data.

Obesity is inversely related to the risks of dental caries in Korean adults

OBJECTIVE

This study investigated whether obesity is linked with dental caries. This study hypothesized that obesity may influence the number or prevalence of dental caries in Korean adults.

SUBJECTS AND METHODS

Data were derived from Korea National Health and Nutrition Examination Survey performed at 2008-2010. Lifestyle, sociodemographic, and biochemical variables were analyzed. Indices related to obesity, sarcopenia, and metabolic syndrome were investigated. Finally, caries index and oral health behaviors were included for the analysis.

RESULTS

The caries index was inversely associated with increasing body mass index (BMI) and body fat quartile (all p-values <.01). Subjects with high waist circumference who met the inclusion criteria of metabolic syndrome were less likely to have decayed tooth (p-value = .0009). Subjects with a BMI of 25 or more showed about 20% less prevalence of dental caries experience than normal individuals with a BMI of 18.5 to 23 glucose (odds ratio [95% confidence intervals] = 0.808 [0.684-0.956]). Similarly, subjects with total body fat in the highest quartile revealed about 20% less prevalence of caries experiences that those with body fat proportion in the lowest quartile (0.84 [0.672,1.049]).

CONCLUSIONS

Obesity was inversely associated with occurrence or severity of dental caries in Korean adults.

The relationship between childhood body weight and dental caries experience: an umbrella systematic review protocol

BACKGROUND

Obesity and dental caries are global public health problems which can impact in childhood and throughout the life course. In simple terms, childhood dental caries and body weight are linked via the common risk factor of diet. An association between dental caries and obesity has been described in a number of studies and reviews. However, similarly, a relationship has also been noted between low body weight and caries experience in children. This protocol will provide the framework for an umbrella review to address the following question: Does the available evidence support a relationship between dental caries experience and body weight in the child population?

METHODS

This review protocol outlines the process to carry out an umbrella systematic review which will synthesise previous reviews of childhood dental caries experience and body weight. An umbrella review methodology will be used to examine the methodological and reporting quality of existing reviews.

DISCUSSION

The final umbrella review aims to aggregate the available evidence in order to provide a summary for policymakers and to inform healthcare interventions.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42016047304.

Relationship between dental caries and metabolic syndrome among 13 998 middle-aged urban Chinese

BACKGROUND

The association between dental caries and metabolic syndrome (MetS) is inconsistent. The aim of the present study was to assess the relationship between dental caries and MetS and its components in a middle-aged Chinese population.

METHODS

A cross-sectional analysis was performed of 13 998 participants aged 45-65 years undergoing a health check during 2013-14. An index variable of decayed, missing, and filled teeth (DMFT) was calculated. Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) after adjustment for sex, age, education level, dietary habits, alcohol use, smoking, physical activity, and periodontitis.

RESULTS

Of the 13 998 participants, 6164 had dental caries and 7834 did not; 3571 had MetS, whereas 10 427 did not. Participants with severe caries showed a higher prevalence of MetS, abdominal obesity, elevated blood pressure, dyslipidemia, and hyperglycemia than those with mild or no caries (all P < 0.01). Adjusted ORs for MetS for those with two or more dental caries and those with two or more DMFT were 1.12 (95 % CI 1.14-1.74) and 1.09 (95 % CI, 0.89-1.21), respectively (P _trend  < 0.001). Stratified analysis by individual MetS components showed that caries were associated with MetS among subjects with hyperglycemia (OR 1.14 [95%CI, 0.98-1.34]; P < 0.001). However, there was no significant relationship between caries and abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and elevated blood pressure (adjusted ORs [95 % CIs] 0.98 [0.82-1.16], 1.01 [0.85-1.19], 0.84 [0.70-1.00], and 0.96 [0.86-1.13], respectively; all P > 0.05).

CONCLUSIONS

Dental caries were associated with MetS among middle-aged Chinese in the present study.

Relationship between body mass index and dental caries in children, and the influence of socio-economic status

OBJECTIVES

To determine the association of body mass index (BMI) with dental caries in Indian schoolchildren, and to analyse the influence of socio-economic status (SES).

METHODS

The study population consisted of 11- to 14-year-old children from Medak District in Telangana State, India. The Indian Academy of Paediatrics 2015 growth charts were used to categorise children as underweight, overweight, normal or obese, based on their BMI. Data on the SES of the family were collected through questionnaires. Clinical examination for dental caries was performed by a single examiner.

RESULTS

A total of 1,092 subjects returned questionnaires and were clinically examined (giving a response rate of 85%). There were no significant differences in caries prevalence and experience across the categories of BMI. However, caries prevalence and experience in overweight children were 24.8% and 0.69 ± 1.51, respectively, while the corresponding values in normal-weight children were 35% and 0.85 ± 1.50, respectively. Among children of high-SES families, overweight children had approximately 71% fewer caries than did those who were normal weight [incidence rate ratio (IRR) = 0.29; 95% CI: 0.11-0.78)].

CONCLUSIONS

BMI was not associated with dental caries prevalence and experience in this population. The association of BMI with dental caries varied across SES categories. In the high-SES category, overweight children experienced fewer caries than did normal-weight children.

A scoping review of the implications of adult obesity in the delivery and acceptance of dental care

Background Due to the increasing prevalence of obesity within the general population it is presumed that the prevalence of overweight and obese adults accessing dental services will also increase. For this reason dentists need to be aware of implications of managing such patients.Methods A scoping review was carried out. Both Medline via OVID and Scopus databases were searched along with grey literature databases and the websites of key organizations. Inclusion and exclusion criteria were established. The data were collected on a purpose-made data collection form and analysed descriptively.Results The review identified 28 relevant published articles and two relevant items of grey literature. Following review of this literature three themes relating to adult obesity in the delivery and acceptance of dental care emerged; clinical, service delivery and patient implications. The majority of the papers focused on the clinical implications.Conclusion On the topic of adult obesity and dental care, the majority of published and grey literature focuses on the clinical implications. Further research is needed on both the patients' perspectives of being overweight or obese and the delivery and acceptance of dental care and the service delivery implications.