Association of dietary calcium, phosphorus, and magnesium intake with caries status among schoolchildren

Association between dental caries and adherence to the Mediterranean diet, dietary intake, and body mass index in children

BACKGROUND

Children with healthier nutritional status are less likely to develop severe caries than those with a high-sugar content diet. Studies evaluating dental caries and nutritional status in school-age children have generally focused on dietary intake, diet quality, or anthropometric measures, and the number of studies evaluating them together is limited.

OBJECTIVE

It was aimed to evaluate the relationship between dental caries adherence to the Mediterranean Diet (MD), dietary intake, and Body Mass Index (BMI) in school-age children.

MATERIALS AND METHODS

This study was conducted with 300 healthy children (52.0% boys, 48.0% girls) aged between 6 and 12 years. The data collection forms included sociodemographic characteristics, oral health practices of children, Mediterranean Diet Quality Index for children and adolescents (KIDMED), and food consumption records. Anthropometric measurements (body weight and height) of the children were taken. Dental examinations were performed by a pediatric dentist.

RESULTS

While the DMFT mean score of the children was 1.7 ± 2.09, the mean dft score was 2.9 ± 3.29. The mean of KIDMED scores was 5.9 ± 3.32. DMFT and dft scores decreased statistically as maternal education increased (p < 0.05). DMFT and dft scores were not statistically different between BMI groups according to gender and age (p > 0.05). DMFT scores differed statistically between KIDMED groups (p < 0.05). This difference was between low-optimal and low-improvement-needed groups. While there was a low negative correlation (r=-0.169) between calcium intake and DMFT score, a low positive correlation was found between glucose (r = 0.172) and fructose (r = 0.149) intake and dft score (p < 0.05). In regression analysis, while the children's age related DMFT scores positively, maternal education and KIDMED scores related DMFT scores negatively. Also, children's age and maternal education related dft scores negatively.

CONCLUSION

In this study, adherence to the MD rather than nutrients was found to be important in dental caries. Also maternal education level was also found to be a determinant factor in dental caries in children. DMFT and dft did not differ between BMI groups.Further studies should be conducted to assess the impact of the MD on dental caries in children to develop dietary interventions for preventative purposes.

Combined effect of dietary calcium consumption and physical activity on dental caries in children and adolescents: a study of the NHANES database

BACKGROUND

Calcium (Ca) is a nutritional factor that associated with dental caries. A recent study showed that in the case of adequate Ca intake, a higher level of physical activity may contribute to bone mass accumulation. However, the combined effect between Ca intake and physical activity on caries experience is unclear. Herein, we aimed to explore the above combined effect on dental caries in children and adolescents.

METHODS

Data of 5,917 children and adolescents were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2015-2020 in this cross-sectional study. The NHANES assessed the dietary Ca intake through the 24-hour dietary recalls, and the physical activity level was self-reported using the questionnaires. Also, the dental caries was diagnosed according to the Decayed, Missing and Filled Teeth/Surfaces (DMFT/S) index. Weighted univariate and multivariate logistic regression analyses were utilized to screen the covariates and to investigate the associations of dietary Ca intake and physical activity with dental caries, respectively, and assess the combined effect between dietary Ca intake and physical activity on dental caries. The evaluation indexes were odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age, obesity, and total sugar intake were also performed.

RESULTS

Among the eligible participants, 2,687 had caries experience. After adjusting for the covariates, we found that children and adolescents who not reach the recommendation level of Ca intake combined with physical activity less than 7 time in 1 week seemed to have higher odds of dental caries [OR = 1.77, 95%CI: (1.38-2.27)], compared with those who reached the standards. In addition, this potential combined effect was also found in age < 12 years old [OR = 1.62, 95%CI: (1.23-2.14)], non-obesity [OR = 1.88, 95%CI: (1.49-2.35)], and total sugar intake (all P < 0.05) subgroups.

CONCLUSIONS

Ca intake and physical activity had a potential combined effect on dental caries in children and adolescents, but the causal relationships between them needed further clarification.

Risk factors for dental caries: A case study in peatlands and non-peatlands of West Kalimantan, Indonesia

The prevalence of dental caries in peatlands and non-peatlands in West Kalimantan require preventive acts based on its natural conditions and the behavior of local communities. The objective was to analyse risk factors for dental caries in communities living in peatlands and non-peatlands in West Kalimantan. The research is a causal comparative study with cross-sectional approach. The samples were chosen by purposive sampling technique among adolescents aged 17-27 years, who were domiciled in Pontianak City (peatland) and Bengkayang (non-peatland) all their lives. The results showed that dental caries is significantly correlated with debris in peatlands (rs = 0.289). On non-peatlands, dental caries is correlated with drinking water phosphate (rs = 0.313) and calculus (rs = 0.034). In West Kalimantan, dental caries is significantly correlated with drinking water minerals (fluoride rs = -0.243; phosphate rs = 0.260), drinking water pH (rs = 0.235), behavior (rs = -0.327), and debris (rs = 0.240). The risk factors for dental caries in peatlands and non-peatlands in West Kalimantan are pH and drinking water minerals (fluoride and calcium), debris, calculus, and behavior.

Impact of Dairy Products and Plant-Based Alternatives on Dental Health: Food Matrix Effects

The impact of dairy products on dental health has been researched widely and shows an important role of various constituents, as well as the specific product matrix, in maintaining and improving dental health. These include, for instance, the position of lactose as the least cariogenic fermentable sugar, the high levels of calcium and phosphate, the presence of phosphopeptides as well as the antibacterial peptides lactoferrin and lysozyme and high buffering capacity. With plant-based alternatives for dairy products being developed and marketed these days, the specific benefits of dairy products in relation to dental health are often overlooked and most products contain more cariogenic carbohydrates, lack phosphopeptides, and have fewer minerals and less buffering capacity. Comparative studies performed to date indeed suggest that plant-based products do not match dairy counterparts when it comes to maintaining and improving dental health. Careful consideration of these aspects is required in relation to future developments of products and human diets. In this paper, we review the impact of dairy products and plant-based dairy alternatives on dental health.

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.

Associations of diet quality, food consumption, eating frequency and eating behaviour with dental caries experience in Finnish children: a 2-year longitudinal study

We examined cross-sectional and longitudinal associations of dietary factors with caries experience in a population sample of 487 children aged 6-9 years at baseline examinations of the Physical Activity and Nutrition in Children (PANIC) Study. Altogether, 406 of these children attended 2-year follow-up examinations. Food consumption and eating frequency were assessed using 4-day food records, diet quality using the Baltic Sea Diet Score (BSDS) and eating behaviour using the Children's Eating Behavior Questionnaire. Caries experience was examined clinically. The cross-sectional associations of dietary factors with caries experience at baseline were analysed using linear regression and the longitudinal associations of dietary factors with a change in caries experience over follow-up using generalised mixed-effects regression adjusted for other risk factors. A higher consumption of high-fibre grain products (standardised regression coefficient β = -0·16, P = 0·003) and milk (β = -0·11, P = 0·025) and higher BSDS (β = -0·15, P = 0·007) were associated with lower caries experience, whereas a higher consumption of potatoes (β = 0·11, P = 0·048) and emotional overeating (β = 0·12, P = 0·025) were associated with higher caries experience. Higher snacking frequency (fixed coefficient β = 0·07, P = 0·033), desire to drink (β = 0·10, P = 0·046), slowness in eating (β = 0·12, P = 0·027) and food fussiness (β = 0·12, P = 0·018) were associated with higher caries experience, whereas enjoyment of food (β = -0·12, P = 0·034) and higher BSDS (β = -0·02, P = 0·051) were associated with lower caries experience.

A decision tree to identify the combinations of non-communicable diseases that constitute the highest risk for dental caries experience: A hospital records-based study

To investigate whether dental status, represented by the DMFT score, was affected by the presence of NCDs and determined the NCDs that had a greater impact on the DMFT score. This retrospective cross-sectional study included a total of 10,017 individuals. The presence of NCDs was investigated based on self-reported medical history recorded on each patient's dental hospital record. Individual DMFT score was evaluated on the basis of the dental records and panoramic radiographs. The data were further analyzed using multiple regression analysis and chi-squared automatic interaction detection (CHAID) analysis. A total of 5,388 individuals had more than one NCD among hypertension (HT), diabetes mellitus (DM), hyperlipidemia, cardiovascular disease (CVD), and osteoporosis. The average DMFT score was 8.62 ± 7.10 in the NCD group, significantly higher than that in those without NCD (5.53 ± 5.48) (P < 0.001). In the regression analysis, age, NCDs, and psychiatric problems were selected as risk factors of DMFT score. In the CHAID decision tree analysis, age was the risk factor that most influenced the DMFT score. HT was the most influential factor in a newly generated decision tree excluding age, and osteoporosis, DM, and CVD were important risk factors acting in the subgroups. Patients with NCD had worse dental conditions than those who did not, and some combinations of NCDs related highest risk for a dental caries-related index. In clinical practice, dentists should provide meticulous care for dental caries in elderly patients with NCDs, especially when certain diseases, such as HT, osteoporosis, DM, and CVD, are present together.

Association between sugary drinks consumption and dental caries incidence among Taiwanese schoolchildren with mixed dentition

OBJECTIVES

Dental caries is a multifactorial disease, and a sugary diet can generate an acidic plaque environment that advances its development. However, the specific effect of sugary drinks on the subsequent oral health of schoolchildren with mixed dentition is unclear. In this study, we investigated the association between the consumption of sugary drinks and 1 year incidence rate of caries in permanent teeth among Taiwanese schoolchildren with mixed dentition.

METHODS

A longitudinal 1 year follow-up study was conducted among Taiwanese schoolchildren aged 8-9 years. A questionnaire collected information regarding the parents' oral health status and their children's demographic background, oral health-related behaviours and consumption habits of sugary drinks, including handmade drinks (specifically bubble tea and pearl milk tea) and carbonated drinks. Dental caries was recorded through standardized oral examinations. The number of dental services received was retrieved from the Taiwan National Health Insurance Research Database. Multivariate Cox proportional hazards models and zero-inflated negative binomial models were used to estimate the association between the consumption of sugary drinks and the incidence rate of caries in permanent teeth after 1 year.

RESULTS

The study involved 494 children. During the 1 year follow-up period, 117 children developed new dental caries in their permanent teeth, yielding a caries incidence rate of 0.183 per person-year. After adjustments for confounding factors, children who preferred having sugar-rich beverages were associated with having a 4.3 times higher (95% confidence interval [CI] = 1.2-15.7) risk of developing caries than did those who preferred nonsugary drinks (P < .05). Additionally, children who often consumed handmade drinks were associated with having a 1.7 times higher (95% CI = 1.1-2.9) risk of developing caries than those who seldom consumed (P < .05).

CONCLUSIONS

The findings suggest that the consumption of sugary drinks during the mixed dentition stage might be a major etiological factor for caries in permanent teeth. These findings could be valuable to paediatricians, dentists, nutritionists and policymakers.

Age at first childbirth in relation to oral health later in life

OBJECTIVE

This study aimed to examine the relationship between age at first childbirth and oral health. The mediation effect of body mass index (BMI) on this relationship was also determined.

METHODS

This study analyzed data of 2,506 parous postmenopausal women aged 50 or older from the Korea National Health and Nutrition Examination Survey 2013-2015. Chewing inconvenience was investigated by an oral interview. Periodontitis and dental caries were determined through dental examinations. Multivariable logistic regression analysis was performed to examine the relationship between age at first childbirth and oral health, and mediation analysis was performed to examine the contribution of BMI on the relationship between age at first childbirth and oral health.

RESULTS

Women who underwent their first delivery between the age of 26 and 46 years had significantly decreased odds of chewing inconvenience (odds ratio [OR] = 0.72, 95% confidence interval [95% CI] = 0.56-0.93, P = 0.010) compared with the odds of those women whose first delivery was between at the age of 15 and 22 years. We also found a significant linear relationships between age at first childbirth and odds of chewing inconvenience (OR = 0.83, 95% CI = 0.74-0.95, P = 0.017) and dental caries (OR = 0.84, 95% CI = 0.74-0.96, P = 0.025). BMI accounted for 12.9% of the relationship between age at first childbirth and dental caries. Age at first childbirth was only indirectly associated with periodontitis through BMI (OR = 0.98, 95% CI = 0.96-0.99, P = 0.003).

CONCLUSIONS

Women whose first delivery occurred at a young age had significantly increased odds of chewing inconvenience and dental caries. BMI mediated the relationships between age at first childbirth and periodontitis and dental caries.

Oral manifestations of magnesium and vitamin D inadequacy

Adequate nutrition is essential for maintaining good oral health. Minerals such as magnesium, calcium, and phosphorus found in the diet constitute the main structural components of the tooth. Their inadequacy leads to absorption impairment, increased bleeding tendency, bone resorption, looseness, and premature tooth loss. Inadequacy of those essential minerals is associated with delayed tooth eruption and with enamel or dentin hypoplasia. Taking calcium without magnesium results in soft dental enamel, which cannot resist the acids causing tooth decay. In addition to magnesium, calcium, and phosphorus, adequate vitamin D is needed to maintain optimal oral health. Vitamin D exerts anti-inflammatory effects and helps in calcium absorption and bone remodeling. Moreover, adequate vitamin D status could reduce formation of dental caries by delaying its onset and progression. Here we summarize the oral manifestations of vitamin D and magnesium inadequacy.

The Effect of Ca and Mg Concentrations and Quantity and Their Correlation with Caries Intensity in School-Age Children

Introduction

Saliva is a watery product formed by the salivary glands and secreted in the mouth. Besides the fundamental factors, saliva with its ingredient is one of the main etiologic factors of caries presence. In the development of dental caries, the relationship between demineralization and remineralization is influenced by the presence of saliva, which facilitates the transportation of ions, oral bacteria, and fermentable carbohydrates to the exposed surfaces of teeth. The main components of saliva electrolytes are sodium, calcium, copper, magnesium, bicarbonates, and organic phosphates. Increase in calcium level in the remineralization solution may enhance the deposition velocity of minerals in the caries lesion. Magnesium, except the similar role as calcium, takes an active part in cellular reparation process.

Materials and Methods

In this study were included students of age 12-13. Students were divided into three groups; the first group included caries-free children, the second group with DMF = 1–6, and the third group with DMF > 6. Fully stimulated and nonstimulated saliva was collected in sterile graded patches in the morning hours, due to the circadian rhythm in 5-minute length. Chemical analyzes have been conducted at the Faculty of Chemistry, Ss. Cyril and Methodius University in Skopje. Statistical processing has been performed at the Medical Faculty, at the Institute of Medical Statistics in Skopje.

Results

Depending on the DMF, before and after stimulation, regarding Ca level, no significant differences were found. However, the Ca level prior to stimulation is significantly higher in the second group compared to the third one. Also, the amount of Ca after stimulation in the first group was significantly higher. No significant differences in Mg level and amount were found prior to and after stimulation, while the amount of Mg after stimulation had a significant difference between groups.

Conclusion

Saliva mineral analysis has shown significant differences in quantitative and qualitative components between examining groups. The decrease of calcium molality in saliva might play a significant role in caries occurrence; thus, we may suppose that saliva calcium level significantly influences hard dental tissues defense mechanism. Magnesium levels after stimulation showed a significant difference between groups I and III and no significant differences between groups I and II. Magnesium level and amount correlate with calcium level, favoring elemental caries resistance.

Dietary Food-Additive Phosphate and Human Health Outcomes

Dietary intake of phosphorus is required for human health, and dietary reference intakes for phosphorus have been established. Food-grade phosphates are used as additives to provide a wide range of technical functions in food production. Phosphates are often the most efficient ingredients to provide the required functionality in many applications, and in some cases, there are not effective and approved alternatives. However, many investigators have expressed concern about the quantities of phosphorus and food-additive phosphate present in the diets of many populations. This paper presents the outcome of an extensive review of 110 primary research articles focused on identifying evidence that substantiates or refutes associations of total dietary phosphorus and food-additive phosphate intake with health and disease in humans. The lack of conclusive evidence prevented the drawing of firm conclusions about the safety and possible risks of food-additive phosphate in the general population, which is consonant with the overall assessments of authoritative institutions who have concluded that available data are insufficient to make the required determinations. Despite the inadequacy of the evidence currently available, many of the authors of the publications reviewed for this paper expressed concerns about the quantities of phosphorus and food-additive phosphate in the diets of the populations and subpopulations they studied. At the same time, most of these authors offered only qualified conclusions and expressed themselves tentatively. In addition, authors of primary research publications, authors of review articles, and authoritative institutions have called for the conduct of further research.

Association of Processed Meat Intake with Hypertension Risk in Hemodialysis Patients: A Cross-Sectional Study

In this cross-sectional study, we hypothesized that hemodialysis patients consuming greater processed meat is associated with hypertension risk, which can be partly explained by the high sodium content in processed meat. From September 2013 to May 2014, one hundred and four patients requiring chronic hemodialysis treatment were recruited from hemodialysis centers. Data on systolic blood pressure and diastolic blood pressure before receiving dialysis, and 3-day dietary records of the recruited patients were collected. HD patients with systolic and diastolic blood pressures greater than140 mmHg and higher than 90 mmHg, respectively, were considered hypertension risk. Protein foods were divided into 4 categories: red meat, white meat, soybeans, and processed meat (e.g., sausage and ham). In a model adjusted for energy intake and hypertension history, additional servings of processed meats was positively associated to systolic blood pressure >140 mmHg (odds ratio [95% confidence interval]: 2.1 [1.0–4.3]), and diastolic blood pressure > 90 mmHg (odds ratio: 2.5 [1.2–5.5]). After adjustment for dietary sodium contents or body mass index (BMI), most associations were substantially attenuated and were no longer significant. In systolic blood pressure greater than140 mmHg, one serving per day of red meats (β = -1.22, P < .05) and white meats (β = -0. 75, P = .05) was associated with a reduced risk compared with one serving per day of processed meats. Similarly, compared with one serving per day of processed meat, a reduced risk of diastolic blood pressure higher than 90 mmHg was associated with one serving per day of red meat (β = -1. 59, P < .05), white meat (β = -0. 62, P < .05). Thus, in these hemodialysis patients, intake of processed meat is significantly positively associated with higher blood pressure risk, and both sodium contents in processed meat and BMI significantly contributes to this association.