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Lee G, Zhang Y, Yang Q, Angley M, Lu L, Kahe K. The Association between Lead Exposure and Dental Caries: A Systematic Review. Caries Res 2024; 58:141-152. [PMID: 38354711 DOI: 10.1159/000537826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/12/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Dental caries has declined over the years, but it remains a major public health issue. This review aimed to investigate the association between lead (Pb) and caries experience in either deciduous or permanent teeth. METHODS A comprehensive search of PubMed, Embase, and Google Scholar was conducted to identify relevant studies published up until December 2022. Included were human observational studies that investigated the association between Pb exposure and dental caries. The review adhered to the PRISMA guideline. RESULTS Sixteen studies were included in this review, with nine focusing on deciduous teeth, thirteen on permanent teeth, and six examining both types of teeth. Most of the studies (5 of 6) found a positive association between blood lead (PbB) levels and caries in deciduous teeth, while the findings for permanent teeth were less conclusive, with only 3 of 10 studies finding an association. One of the two studies assessing salivary lead levels found a weak association for permanent teeth. All four studies that measured Pb concentration from teeth found a positive association for both deciduous and permanent teeth. CONCLUSION Many published studies have indicated a positive association between Pb exposure and caries experience in deciduous dentition. Children with elevated PbB level should be considered having higher caries experience. Due to lack of consensus on measurement and examination technique, there remains insufficient evidence to make any definitive conclusions, especially in permanent dentition, and so more studies are warranted.
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Affiliation(s)
- Gajin Lee
- College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Yijia Zhang
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Qiannan Yang
- College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Meghan Angley
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Liping Lu
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ka Kahe
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Motevasselian F, Abdi K, Ghodarati H, Shamshiri AR, Lippert F, Hessari H. The role of lead and cadmium in deciduous teeth and saliva on dental caries in children residing in Tehran, Iran. J Trace Elem Med Biol 2023; 79:127209. [PMID: 37210890 DOI: 10.1016/j.jtemb.2023.127209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 09/26/2022] [Accepted: 05/17/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Lead (Pb) and Cadmium (Cd) are important environmental contaminants. There is no biological monitoring of exposure to these heavy metals and their potential effect on dental caries in children in Tehran, Iran, a polluted megacity. Therefore, the present study investigated the potential association between Pb and Cd levels in primary teeth and saliva and dental caries. METHODS In a cross-sectional design, 211 children aged 6-11 years referred to Tehran University of Medical Sciences, School of Dentistry and residing in Tehran were examined. Pb and Cd levels of exfoliated primary teeth and stimulated saliva were determined by atomic absorption spectrophotometry (AAS). Dental caries prevalence was evaluated according to WHO criteria. Socioeconomic status, oral hygiene behavior, snacking frequency and salivary pH data were acquired as confounding factors. Frequency and percentages were reported for categorical variables, mean and standard deviation (SD) for continuous variables, and geometric mean for skewed continuous variables. A simple linear regression and Pearson correlation tests were used for statistical analyses. P-values < 0.05 were considered as significant. RESULT The mean (95 % confidence interval) Pb and Cd levels in teeth were 213.26 ppb (164.29-274.84) and 23.75 ppb (20.86-27.05), respectively. The mean Pb and Cd levels in saliva were 11.83 ppb (10.71-13.06) and 3.18 ppb (2.69-3.75), respectively. Furthermore, Pb and Cd in primary teeth and saliva were not associated (p > 0.05) with socioeconomic status, oral hygiene behavior and snacking frequency CONCLUSION: This study showed no association between Pb and Cd concentrations in primary teeth and in saliva with dental caries prevalence.
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Affiliation(s)
- Fariba Motevasselian
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Khosro Abdi
- Department of Radiopharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Ghodarati
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Shamshiri
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Frank Lippert
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Hossein Hessari
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Boskabady M, Ghorani V, Beigoli S, Boskabady MH. The effects of environmental lead on teeth and bone status and the mechanisms of these effects, animal and human evidence, a review. TOXIN REV 2022. [DOI: 10.1080/15569543.2022.2026398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Marzie Boskabady
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahideh Ghorani
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sima Beigoli
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Adler CJ, Cao KAL, Hughes T, Kumar P, Austin C. How does the early life environment influence the oral microbiome and determine oral health outcomes in childhood? Bioessays 2021; 43:e2000314. [PMID: 34151446 PMCID: PMC9084494 DOI: 10.1002/bies.202000314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/11/2022]
Abstract
The first 1000 days of life, from conception to 2 years, are a critical window for the influence of environmental exposures on the assembly of the oral microbiome, which is the precursor to dental caries (decay), one of the most prevalent microbially induced disorders worldwide. While it is known that the human microbiome is susceptible to environmental exposures, there is limited understanding of the impact of prenatal and early childhood exposures on the oral microbiome trajectory and oral health. A barrier has been the lack of technology to directly measure the foetal "exposome", which includes nutritional and toxic exposures crossing the placenta. Another barrier has been the lack of statistical methods to account for the high dimensional data generated by-omic assays. Through identifying which early life exposures influence the oral microbiome and modify oral health, these findings can be translated into interventions to reduce dental decay prevalence.
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Affiliation(s)
- Christina Jane Adler
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kim-Anh Lê Cao
- Melbourne Integrative Genomics, School of Mathematics and Statistics, The University of Melbourne, Parkville, Victoria, Australia
| | - Toby Hughes
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Piyush Kumar
- Department of Environmental Medicine and Public Health, Mount Sinai School of Medicine, New York, New York, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Mount Sinai School of Medicine, New York, New York, USA
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Yepes JF, McCormick-Norris J, Vinson LA, Eckert GJ, Hu H, Wu Y, Jansen EC, Peterson KE, Téllez-Rojo MM, Mier EAM. Blood levels of lead and dental caries in permanent teeth. J Public Health Dent 2020; 80:297-303. [PMID: 32729942 PMCID: PMC9974220 DOI: 10.1111/jphd.12384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 04/10/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to determine whether there is an association between lead exposure within the ages of 1-4 years and dental caries in the permanent dentition between ages 9-17 among Mexican youth. METHODS Data were collected for the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort from a group of 490 children born and reared in Mexico City. Among ages 1-4 years, blood lead levels were measured in micrograms of lead per deciliter of blood (μg/dL) and the presence of caries in adolescence was determined using the International Caries and Detection and Assessment System (ICDAS). The relationship between blood levels of lead and decayed, missing, or filled surfaces (DMFS) was examined using negative binomial regression. Covariates were selected based on previous studies and included age, gender, socioeconomic status, oral hygiene, body mass index, and diet. The nonlinear relationship between lead and DMFS was examined using smoothing splines. RESULTS The mean overall blood lead level (BLL) was 4.83 μg/dL (S.D. of 2.2). The mean overall caries level (DMFS) was 4.1. No statistically significant association was found between early childhood blood lead levels and dental caries in adolescence. CONCLUSION This study shows a lack of association between exposure to lead between the ages of 1-4 years of age and dental caries in permanent dentition later in life. Other covariates, such as age and sugar consumption, appeared to play a more prominent role in caries development.
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Affiliation(s)
- Juan F. Yepes
- Department of Pediatric Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | | | - LaQuia A. Vinson
- Department of Pediatric Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | | | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, Canada
| | - Yue Wu
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Erica C. Jansen
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Martha M. Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health in Mexico, Cuernavaca, Mexico
| | - Esperanza Angeles Martinez Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
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Zhang S, Huo X, Li M, Hou R, Cong X, Xu X. Oral antimicrobial activity weakened in children with electronic waste lead exposure. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:14763-14770. [PMID: 32056098 DOI: 10.1007/s11356-020-08037-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 02/10/2020] [Indexed: 02/05/2023]
Abstract
Environmental lead (Pb) exposure can induce dysbacteriosis, impair oral health, and is associated with the development of dental caries. However, the mechanism is unclear. The aim of this study was to explore the effects of Pb toxicity on oral antimicrobial activity in children in an e-waste area. Results showed higher blood Pb levels in e-waste-exposed group children, accompanied by decreased saliva SAG (salivary agglutinin) concentrations, increased peripheral WBC (white blood cell) counts and monocyte counts, and elevated peripheral monocyte percentage. LnPb (natural logarithmic transformation of blood Pb level) was negatively correlated with saliva SAG concentration, while positively correlated with peripheral monocyte percentage. Saliva SAG concentration played a complete mediating role in the correlation of LnPb to peripheral monocyte percentage. To our knowledge, this is the first study on the relationship of environmental Pb exposure and oral antimicrobial activity in children, showing that environmental Pb exposure may weaken oral antimicrobial activity through reducing saliva SAG concentration, which may raise the risk of oral dysbacteriosis and ultimately pathogen infection.
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Affiliation(s)
- Shaocheng Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, 22 Xinling Rd, Shantou, 515041, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511486, Guangdong, China
| | - Minghui Li
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, 22 Xinling Rd, Shantou, 515041, Guangdong, China
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Ruikun Hou
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, 22 Xinling Rd, Shantou, 515041, Guangdong, China
| | - Xiaowei Cong
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, 22 Xinling Rd, Shantou, 515041, Guangdong, China
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, 22 Xinling Rd, Shantou, 515041, Guangdong, China.
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, Guangdong, China.
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Khalid M, Abdollahi M. Role of lead in dental diseases. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, TOXICOLOGY AND CARCINOGENESIS 2020; 38:329-361. [PMID: 33382012 DOI: 10.1080/26896583.2020.1834313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Lead (Pb) is ubiquitous in our environment and causes many pathophysiological health effects, including dental diseases. Dental Pb levels are considered good biological indicators of environmental and occupational Pb exposure. Pb in blood and saliva causes imbalances in the growth of oral microflora. The pH of saliva decreases, interferes with and interacts with bone-seeking elements, changes oral inflammatory parameters, generates reactive oxygen species, causes oxidative damage, and delays the mineralization process, leading to dental diseases. Pb's dental diseases include periodontitis, enamel lesions and defects, fluorosis, Burton's line, and tooth loss. Environmental and physiological factors, including age, gender, tooth type and position, pregnancy and lactation, eating and drinking habits, smoking habits, and exposures from Pb-contaminated residential and occupational areas, affect the distribution of Pb in blood, bone, and saliva, which contributes to dental diseases. However, living and working in Pb free areas can prevent environmental and occupational Pb exposure. Healthy lifestyles and eating habits, prohibiting smoking and alcohol drinking, further help prevent Pb exposure. Also, the fluoridation of water, salt, and milk provide nutritional supplements of trace elements, which can help prevent teeth from absorbing Pb from the environment, thereby reducing the risk of dental diseases.
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Affiliation(s)
- Madiha Khalid
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS) and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS) and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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8
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Primary teeth microhardness and lead (Pb) levels. Heliyon 2019; 5:e01551. [PMID: 31049448 PMCID: PMC6484203 DOI: 10.1016/j.heliyon.2019.e01551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives Lead (Pb) exposure is associated with dental caries. Whether Pb affects tooth microhardness, is unclear. Our objective was to assess whether Pb concentration is associated with microhardness. Methods Exfoliated primary teeth were collected from 46 volunteers. Teeth were sectioned, one half of each tooth was tested for enamel Knoop microhardness. The remaining half was digested and Pb measured using an inductively coupled plasma-mass spectrometer. Results The correlations between Pb levels and microhardness were very low, and were not statistically significant at p < 0.05. Conclusions Previous exposure to high levels of Pb was not associated with decreased tooth microhardness. Clinical significance This study assessed whether Pb in deciduous teeth is associated with tooth microhardness. As this was not the case, further studies are needed to identify the mechanisms behind the association between lead exposure and tooth decay.
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Sinitkul R, Wongrathanandha C, Sirirattanapruk S, Plitponkarnpim A, Maude RJ, Marczylo EL. Children's Environmental Health in Thailand: Past, Present, and Future. Ann Glob Health 2018; 84:306-329. [PMID: 30835380 PMCID: PMC6748291 DOI: 10.29024/aogh.2301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: There is increasing evidence of a link between environmental pollution and preventable diseases in developing countries, including Thailand. Economic development has generated several types of pollution that can affect population health. While these environmental health effects can be observed throughout life, pregnant women and children represent particularly vulnerable and sensitive groups. Methods: The published epidemiological literature investigating environmental chemical exposure in Thai children was reviewed, highlighting those that investigated associations between exposure and subsequent health outcomes. Results: The majority of the Thai epidemiological studies on environmental health in children were cross-sectional in design, with some demonstrating associations between exposure and outcome. The three main types of chemical exposure in Thai children were pesticides, heavy metals, and air pollution, which resulted from agricultural activities in countryside areas, industrial zones (both registered and unregistered establishments), mining, and traffic in inner cities. Major health outcomes included detrimental effects on cognitive function and cancer risk. Pesticide exposure was focused on, but not limited to, agricultural areas. The success of the Thai environmental policy to introduce lead–free petrol can be demonstrated by the decline of mean blood lead levels in children, particularly in urban areas. However, unregistered lead-related factories and smelters act as hidden sources. In addition, there is increasing concern, but little acknowledgement, about the effects of chronic arsenic exposure related to mining. Lastly, air pollution remains a problem in both dense city populations due to traffic and in rural areas due to contamination of indoor air and house dust with heavy metals, endotoxins and other allergens. Conclusions: The increasing number of published articles demonstrates an improved awareness of children’s environmental health in Thailand. Chemical hazards, including the improper use of pesticides, environmental contamination with heavy metals (lead and arsenic), and air pollution in inner cities and indoor air, continue to be growing issues.
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Affiliation(s)
- Ratchaneewan Sinitkul
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, TH
| | | | | | | | - Richard J Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, TH.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Harvard TH Chan School of Public Health, Harvard University, Boston, US
| | - Emma L Marczylo
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
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Kim YS, Ha M, Kwon HJ, Kim HY, Choi YH. Association between Low blood lead levels and increased risk of dental caries in children: a cross-sectional study. BMC Oral Health 2017; 17:42. [PMID: 28086936 PMCID: PMC5237218 DOI: 10.1186/s12903-017-0335-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study was to examine the association between low blood lead levels of <5 μg/dL and the development of dental caries among children. Methods The Children’s Health and Environment Research (CHEER) group recruited a cohort of 7,059 school-aged children from six Korean cities. The final study populations in the permanent and deciduous teeth groups were 1,564 and 1,241 children, respectively, after excluding 4 children with blood lead levels of >5 μg/dL. Compared with the children who did not have dental caries, the risk of having dental caries according to blood lead level was estimated by using the zero-inflated negative binomial model. Results The geometric mean (geometric standard deviation, maximum) blood lead level was 1.53 μg/dL (1.57, 4.89 μg/dL), and 74.4% of children had a level of <2 μg/dL. Blood lead level was significantly higher in the children with than in those without deciduous dental caries (1.59 vs. 1.51 μg/dL), similarly with permanent dental caries (1.65 vs. 1.51 μg/dL). After adjustment for covariates, deciduous teeth surfaces that were decayed and filled increased significantly with increasing blood lead levels in a dose-dependent manner (prevalence ratio, 1.14; 95% confidence interval: 1.02–1.27). However, the risk of having dental caries in permanent teeth was not linearly associated with the increase in blood lead level. Conclusions In the sum of decayed and filled surfaces, we found a significant increase in risk of dental caries of the deciduous teeth with an increase in blood lead levels (<5 μg/dL) but found no statistical significance in the association with decayed and filled surfaces of caries separately.
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Affiliation(s)
- Young-Suk Kim
- Department of Dental Hygiene, U1 University, Yeongdong, Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam, 31116, Republic of Korea.
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam, 31116, Republic of Korea
| | - Hae-Young Kim
- Department of Health Policy and Management, College of Health Science, and Department of Health Science, Graduate School, Korea University, Seoul, Korea
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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11
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Wiener RC, Long DL, Jurevic RJ. Blood levels of the heavy metal, lead, and caries in children aged 24-72 months: NHANES III. Caries Res 2014; 49:26-33. [PMID: 25358243 DOI: 10.1159/000365297] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 06/15/2014] [Indexed: 11/19/2022] Open
Abstract
Lead remains a significant pollutant. It has acute toxic and chronic effects on many tissues and accumulates in teeth and bones. The researchers for this study investigated the association of blood lead levels with the extent/severity of caries as measured by the number of decayed/filled teeth of children aged 24-72 months using data from NHANES III (the Third National Health and Nutrition Examination Survey), accounting for the excess zero caries in the analysis and using less than 2 µg/dl as the reference blood lead level (n = 3,127). Zero-inflated negative binomial regression models indicated unadjusted extent/severity mean ratios of 1.79, 1.88 and 1.94 for the number of decayed/filled teeth in children whose blood lead levels were 2-5, 5-10 and >10 µg/dl, respectively, compared with children having <2 µg/dl blood lead levels. The results did not attenuate when other variables were added to the model for the 5-10 and >10 µg/dl levels of exposure. The adjusted extent/severity mean ratios were 1.84, 2.14 and 1.91, respectively, for the categories. This study indicated a strong association of blood lead levels with increasing numbers of carious teeth in children aged 24-72 months. These findings support other studies in an innovative analysis handling cases of children with no caries. The findings may inform caries risk assessment.
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Affiliation(s)
- R Constance Wiener
- Department of Dental Practice and Rural Health, School of Public Health, West Virginia University, Morgantown, W.Va., USA
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Youravong N, Teanpaisan R, Chongsuvivatwong V. Salivary lead in relation to caries, salivary factors and cariogenic bacteria in children. Int Dent J 2013; 63:123-9. [PMID: 23691956 DOI: 10.1111/idj.12020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Saliva has been suggested as a useful biomarker of environmental contamination, including exposure to lead. AIMS The study examined the associations between salivary lead level and the following factors: blood lead level, the number of decayed and filled surfaces (dfs) on deciduous and permanent teeth (DMFS), salivary flow rate, pH, buffer capacity, lactobacilli and mutans streptococci counts. MATERIALS AND METHODS One hundred and twenty saliva samples of children living in a shipyard area (known to be an area contaminated with lead) were analysed for lead. Clinical oral examination was conducted to define carious lesions in accordance with the criteria of the World Health Organisation. RESULTS The analysis revealed detectable levels of lead in a range of 0.16-28.52 μg/dl with a mean concentration of 2.26 ± 3.67 μg/dl. No significant differences in salivary lead concentrations were found in relation to gender and age. The salivary lead level significantly correlated with the blood lead level (Rs = 0.18, P = 0.05). There was no association between the salivary lead levels and dfs or DMFS. The results indicated that children with high salivary lead levels did not differ in flow rate, pH, buffer capacity of saliva from those with low lead levels. However, the number of mutans streptococci were reduced in the high salivary lead groups, while the lactobacilli count was not associated with the salivary lead levels. CONCLUSIONS The current finding suggests that saliva may not have potential to be an appropriate alternative for biological monitoring of lead exposure.
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Affiliation(s)
- Nattaporn Youravong
- Department of Preventive Dentistry, Prince of Songkla University, Songkhla, Thailand.
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Youravong N, Teanpaisan R. The periodontal health of lead-exposed children living in a shipyard industrial area. Toxicol Ind Health 2013; 31:459-66. [PMID: 23406954 DOI: 10.1177/0748233712472529] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In a cross-sectional design, 292 schoolchildren living around a shipyard area, known to be contaminated with lead from shipyard industry, were examined to verify the association between lead exposure and periodontal health. The probing pocket depth (PD), bleeding on probing, plaque and calculus, and the presence of Aggregatibacter actinomycetemcomitans (Aa) in subgingival crevices were recorded. Gingival inflammation was the most common (98%) among children in the area. No significant difference in gingival inflammation was observed between high blood lead (PbB) and low PbB children. The prevalence rate of probing PD of ≥5 mm was 14%. The high PbB group showed more deep pockets at tooth 16 (upper right first permanent molar) and tooth 46 (lower right first permanent molar) than the low PbB group. The odds ratios (ORs) for having probing PD ≥5 mm after adjusting for other factors were 3.63 (95% confidence interval (CI), 1.24-10.61; p = 0.02) for tooth 16 and 3.93 (95% CI, 1.18-13.00; p = 0.02) for tooth 46. The presence of Aa was observed in 17% of the children and it significantly increased in high PbB compared with low PbB children at tooth 46 (OR = 5.53, 95% CI: 1.68-18.15; p = 0.005). This study may suggest no association between lead exposure and gingival inflammation, yet there was the involvement of deeper periodontal tissue in lead-exposed children.
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Affiliation(s)
- Nattaporn Youravong
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand Common Oral Diseases and Epidemiology Research Center, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Rawee Teanpaisan
- Common Oral Diseases and Epidemiology Research Center, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand Department of Stomatology, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
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14
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Youravong N, Carlen A, Teanpaisan R, Dahlén G. Metal-ion susceptibility of oral bacterial species. Lett Appl Microbiol 2011; 53:324-8. [PMID: 21711369 DOI: 10.1111/j.1472-765x.2011.03110.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS This study aimed to evaluate the effect of lead (Pb) on growth of bacterial species related to dental diseases in vitro. METHODS AND RESULTS The effects of lead acetate on representative species of the oral flora were examined at 0.1-10 mmol l(-1) and compared with the effect of silver nitrate and ferrous sulfate. The minimal inhibitory concentration of lead acetate was between 0.15 and 5 mmol l(-1) for the bacterial strains tested. The minimal bactericidal concentration of lead acetate for most oral species was detected in the range of 5-10 mmol l(-1). Silver nitrate at a concentration of 1.25 mmol l(-1) was sufficient to exhibit antibacterial activity against almost all bacteria tested. Ferrous sulfate had the lowest effect. CONCLUSIONS The study indicated a general antimicrobial effect of lead on oral bacterial species in the range of 0.15-10 mmol l(-1). The toxicity of silver nitrate was the highest, whereas that of ferrous sulfate was the lowest. Gram-positive species had a tendency to be less susceptible for metals than Gram-negatives. SIGNIFICANCE AND IMPACT OF THE STUDY The study shows that it is possible that microbiological changes may occur in the dental plaque in children because of toxic exposure of environmental lead.
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Affiliation(s)
- N Youravong
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand.
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15
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Bellinger DC. The protean toxicities of lead: new chapters in a familiar story. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:2593-628. [PMID: 21845148 PMCID: PMC3155319 DOI: 10.3390/ijerph8072593] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/17/2011] [Accepted: 06/20/2011] [Indexed: 12/11/2022]
Abstract
Many times in the history of lead toxicology the view that "the problem" has been solved and is no longer a major health concern has prevailed, only to have further research demonstrate the prematurity of this judgment. In the last decade, an extraordinary amount of new research on lead has illustrated, all too clearly, that "the problem" has not disappeared, and that, in fact, it has dimensions never before considered. Recent risk assessments have concluded that research has yet to identify a threshold level below which lead can be considered "safe." Although children's intelligence has traditionally been considered to be the most sensitive endpoint, and used as the basis for risk assessment and standard setting, increased lead exposure has been associated with a wide variety of other morbidities both in children and adults, in some cases at biomarker levels comparable to those associated with IQ deficits in children. In adults, these endpoints include all-cause mortality and dysfunctions in the renal, cardiovascular, reproductive, central nervous systems. In children, IQ deficits are observed at blood lead levels well below 10 μg/dL, and the dose-effect relationship appears to be supra-linear. Other health endpoints associated with greater early-life lead exposure in children include ADHD, conduct disorder, aggression and delinquency, impaired dental health, and delayed sexual maturation. Studies employing neuroimaging modalities such as volumetric, diffusion tensor, and functional MRI are providing insights into the neural bases of the cognitive impairments associated with greater lead exposure.
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Affiliation(s)
- David C Bellinger
- Children's Hospital Boston, Farley Basement Box 127, 300 Longwood Avenue, Boston, MA 02115, USA.
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16
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Chongsuvivatwong V, Kaeosanit S, Untimanon O. Twenty-six tons of lead oxide used per year in wooden boat building and repairing in southern Thailand. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2011; 33:301-307. [PMID: 20886362 DOI: 10.1007/s10653-010-9342-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2009] [Accepted: 09/09/2010] [Indexed: 05/29/2023]
Abstract
In southern Thailand, the wooden boat building and repair industry uses powdered lead oxide (Pb(3)O(4,) or red lead) in the caulking process. This had been shown to be a significant source of contamination in the workplace and the communities. This cross-sectional study was conducted to estimate the amount of lead oxide used in the region and to document the management of hazardous waste product in this industry. All boatyards in southern Thailand registered to the Ministry of Industry were visited with walk-through observation. After consent, questionnaire-based interviews were conducted among workers and boatyard owners who rented out the space for building and repairing the boats. Of the 63 active boatyards identified, approximately 26 tons of lead oxide was used to repair approximately 8,000 boats each year. Due to the casual employment system in this industry, no facility for the protection of workers and the environment from lead contamination exists. The findings indicate the need for further studies on the extent of contamination in the broader area. Intervention programmes are also urgently needed to reduce the release of this hazardous waste into the community.
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17
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Analytical Approaches for Sampling and Sample Preparation for Heavy Metals Analysis in Biological Materials. ENVIRONMENTAL HEAVY METAL POLLUTION AND EFFECTS ON CHILD MENTAL DEVELOPMENT 2011. [DOI: 10.1007/978-94-007-0253-0_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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18
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Arora M, Weuve J, Schwartz J, Wright RO. Association of environmental cadmium exposure with pediatric dental caries. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:821-5. [PMID: 18560540 PMCID: PMC2430240 DOI: 10.1289/ehp.10947] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Accepted: 02/04/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Although animal experiments have shown that cadmium exposure results in severe dental caries, limited epidemiologic data are available on this issue. OBJECTIVES We aimed to examine the relationship between environmental cadmium exposure and dental caries in children 6-12 years of age. METHODS We analyzed cross-sectional data, including urine cadmium concentrations and counts of decayed or filled tooth surfaces, from the Third National Health and Nutrition Examination Survey. We used logistic and zero-inflated negative binomial (ZINB) regression to estimate the association between urine cadmium concentrations and caries experience, adjusting these analyses for potential confounders including environmental tobacco smoke (ETS). RESULTS Urine cadmium concentrations ranged from 0.01 to 3.38 ng/mL. Approximately 56% of children had experienced caries in their deciduous teeth, and almost 30% had been affected by caries in their permanent dentition. An interquartile range (IQR) increase in creatinine-corrected cadmium concentrations (0.21 microg/g creatinine) corresponded to a 16% increase in the odds of having experienced caries in deciduous teeth [prevalence odds ratio (OR)=1.16; 95% confidence interval (CI), 0.96-1.40]. This association was statistically significant in children with low ETS exposure (prevalence OR=1.30; 95% CI, 1.01-1.67). The results from the ZINB regression indicated that, among children with any caries history in their deciduous teeth, an IQR increase in cadmium was associated with 17% increase in the number of decayed or filled surfaces. We observed no association between cadmium and caries experience in permanent teeth. CONCLUSIONS Environmental cadmium exposure may be associated with increased risk of dental caries in deciduous teeth of children.
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Affiliation(s)
- Manish Arora
- Environmental and Occupational Medicine and Epidemiology, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA.
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19
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Youravong N, Teanpaisan R, Norén JG, Robertson A, Dietz W, Odelius H, Dahlén G. Chemical composition of enamel and dentine in primary teeth in children from Thailand exposed to lead. THE SCIENCE OF THE TOTAL ENVIRONMENT 2008; 389:253-8. [PMID: 17910978 DOI: 10.1016/j.scitotenv.2007.08.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Revised: 08/30/2007] [Accepted: 08/31/2007] [Indexed: 05/17/2023]
Abstract
Enamel and dentine in teeth of children with high blood levels of lead were analyzed by means of secondary ion mass spectrometry (SIMS) and X-ray micro-analyses (XRMA) and compare with teeth from children with low blood levels of lead. The SIMS analysis revealed detectable levels of Pb in dentine close to the pulp. The XRMA analyses could not detect any lead. There were no differences found in lead level in enamel of high lead level exposed teeth from low level exposed. The results confirm that children with high blood levels of lead have an uptake of lead in dentine close to the pulp.
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Affiliation(s)
- Nattaporn Youravong
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
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20
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Youravong N, Teanpaisan R, Chongsuvivatwong V, Geater AF, Dahlén G. Microbiology in toothbrush samples from children exposed to lead in southern Thailand. Acta Odontol Scand 2007; 65:22-8. [PMID: 17354091 DOI: 10.1080/00016350600863782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the prevalence and level of selected oral bacterial species in association with dental caries in low versus high blood lead (PbB) children. MATERIAL AND METHODS With an observational cross-sectional design, a sample of 292 children aged 6-11 years from two primary schools around a shipyard, known to be an area contaminated with lead, were examined. The number of decayed and filled surfaces on deciduous teeth (dfs) and the number of decayed, missing, and filled surfaces on permanent teeth (DMFS) were recorded. Microbiological plaque samples were taken from each child with a toothbrush. Enumeration of 17 bacterial species was carried out using the checkerboard DNA-DNA hybridization technique. RESULTS Overall means (SD) of dfs and DMFS were 13.2 (9.5) and 1.3 (2.3), respectively. Prevalence of excessive count (>or=10(6) cells/sample) was 100% for 4 known cariogenic bacteria and over 95% in another 2 species. With Bonferroni correction for type I error adjustment, there was no significant association between the count of each bacterial species and PbB and caries experience. The checkerboard method is sensitive in bacteria detection, but may not be suitable for differentiating caries risk in the endemic population.
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Affiliation(s)
- Nattaporn Youravong
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Hatyai, Thailand
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