The relationship between oral hygiene status and obesity among preschool children in Hong Kong

Association between overweight/obesity and dental outcomes in early childhood: Findings from an Australian cohort study

OBJECTIVES

Oral health is an important part of general health and well-being and shares risk factors, such as poor diet, with obesity. The published literature assessing the association between obesity and oral health in early childhood is sparse and inconsistent. The objective of this study was to investigate associations between overweight/obesity (measured by body mass index) and dental outcomes (caries, plaque index and gingival index) both cross-sectionally and longitudinally, taking account of potential confounding factors, based on data collected at age 2 and age 5 within the Australian Study of Mothers' and Infants' Life Events Affecting Oral Health (SMILE) birth cohort study.

METHODS

This study used data from 1174 SMILE participants. Associations between overweight/obesity and dental outcomes were assessed using generalized linear regression models for the modified Poisson family with log link to estimate prevalence ratios. Cross-sectional and longitudinal models were fitted, after minimal and full adjustment for potential confounders.

RESULTS

Approximately 12% of the participants were overweight/obese at 2 years and 9% at 5 years. Between 2 and 5 years, the prevalence of caries increased from approximately 4% to 24%, at least mild plaque accumulation increased from 37% to 90% and at least mild inflammation from 27% to 68%. There were no associations between overweight/obesity and the prevalence of dental caries; prevalence ratios (PR) [95% confidence interval (CI)] after adjustment for age and sex were 0.9 (0.3, 2.4) cross-sectionally at 2 years, 1.0 (0.6, 1.5) cross-sectionally at 5 years, and 1.0 (0.6, 1.5) for overweight/obesity at 2 years and caries at 5 years. Prevalence ratios were all around the value of 1 for the other dental outcomes and also after adjustment for additional confounders.

CONCLUSIONS

There were no associations between overweight/obesity and dental caries, plaque index or gingival index in this cohort of preschool children. However, associations may emerge as the children become older, and it will be possible to extend analyses to include data collected at age 7 in the near future.

Anthropometric and Sociodemographic Correlates of Dental Caries and Gingival Health in Children With Special Healthcare Needs at a Saudi Tertiary Care Hospital

AIMS

To evaluate the impact of anthropometric and sociodemographic factors on dental caries and gingival health among children with special healthcare needs (SHCN).

METHODS AND RESULTS

This cross-sectional study involved 108 children, aged 4-14 years, with congenital heart disease, childhood cancer, bleeding disorders, various syndromes, and multiple conditions. Caregivers completed a sociodemographic questionnaire, and children underwent dental examinations to assess caries, gingival health, and oral hygiene. Anthropometric measures-weight, height, and body mass index (BMI)-were obtained and categorized into percentiles (<10, 10-90, >90) using age- and gender-specific growth charts. Dental caries was highly prevalent (93.5%), with a mean dmft/DMFT value of 7.70 (SD ± 5.22). The mean gingival index was 0.43 (SD ± 0.52). Total dmft/DMFT values were significantly higher in children ≤6 years and those with fathers of lower educational levels. Poor oral hygiene was a strong predictor of adverse outcomes for both caries and gingival health. Higher gingival indices correlated with children in the >90th weight percentile.

CONCLUSION

The findings highlight the need for comprehensive oral health interventions that integrate meticulous oral hygiene, paternal education, and holistic growth monitoring beyond BMI. The results support implementing a 3-month recall program for professional dental care, combined with individualized oral hygiene instruction for caregivers. This approach is particularly crucial for the younger age group (≤6 years) where targeted early intervention could significantly reduce caries risk.

Association between Periodontal Disease and Obesity: Umbrella Review

Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.

Longitudinal association between obesity and periodontal diseases among secondary school students in Hong Kong: a prospective cohort study

Background

There is no consensus opinion regarding the association between obesity and periodontal diseases among children and adolescents in the literature.

Methods

A prospective observational cohort study was conducted in a Hong Kong cohort at age 12, 15 and 18. CPI and various obesity indices including BMI, WC, WHR, WHtR, and TRSKF were recorded during each wave of data collection. Information on socioeconomic status and oral health behaviors were collected through self-completed questionnaires.

Results

Two hundred and eighty-two (male: 122 and female: 160) participants completed all three rounds of data collection. Prevalence of overweight/obesity was 27.0, 19.1, and 14.2% at 12, 15, and 18 years, respectively. 19.9% participants had healthy periodontal conditions at age 12. While the percentage dropped to 10.3% at 15 years and 5.7% at 18 years. The proportion of 15-year-old adolescents who brushed teeth more than twice a day was significantly higher among participants belonging to the lower BMI, WC, WHR, and WHtR category (P < 0.05). The fully adjusted model revealed that participants with lower BMI at age 15 had higher probability of having more than 50% index teeth free from periodontal diseases at age 18 (OR: 2.78; 95% CI: 1.16, 6.64; P = 0.022).

Conclusions

Although higher BMI at 15 years was associated with more extensive periodontal inflammation at age 18, this was believed to be an indirect association confounded by the poor oral health care among overweight/obese individuals. Oral health promotions should be directed to improve periodontal conditions of overweight/obese secondary school students.

Association between dental hygiene, gingivitis and overweight or the risk of overweight in primary teeth of 4- and 5-year-old preschoolers in México

OBJECTIVE

To determine the association between dental hygiene, gingivitis and overweight or the risk of overweight according to body mass index (BMI).

METHODS

A cross-sectional study was performed with 1527 preschoolers. The children were divided into 4 groups: (i) absence of visible plaque and normal weight; (ii) absence of visible plaque and risk of overweight or overweight; (iii) presence of visible plaque and normal weight; and (iv) presence of visible plaque and risk of overweight or overweight. The clinical parameters evaluated were as follows: body mass index, degree of urban marginalization, dental caries, the simplified oral hygiene index and gingival status. Bivariate analysis and multivariate binary logistic regression models were used to identify associations between variables.

RESULTS

The highest mean of gingivitis (0.28) was observed in the groups with visible plaque with normal weight and with overweight and risk of overweight. The presence of visible plaque and risk of overweight or overweight were positively associated (P = .0001) with the mean of gingivitis (OR = 8.28, 95% CI = 3.30-19.8). The absence of visible plaque and risk of overweight or overweight (P = .0001) were also positively associated with the presence of gingivitis (OR = 2.44, 95% CI = 0.68-8.06). This is after both models were adjusted by gender and degree of marginalization.

CONCLUSIONS

The professionals should develop interdisciplinary approaches to (i) propose appropriate interventions to improve oral health in overweight preschoolers; and (ii) propose interventions to decrease the overweight with the possibility of also reducing its association with gingivitis.

Anthropometric measurements and periodontal diseases in children and adolescents: a systematic review and meta-analysis

The aim of this systematic review was to identify and summarize evidence of the association between anthropometric measurements and periodontal status in children and adolescents. We searched PubMed, Institute for Scientific Information Web of Knowledge, Cochrane Library, and 7 additional databases, following the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, up to December 2014. Observational studies reporting data on the association between anthropometric measurements and periodontal diseases in 2-18-y-old participants were included. An initial search identified 4191 papers; 278 potentially effective studies (k = 0.82) and 16 effective studies (k = 0.83) were included after screening. The mean quality of evidence among the studies was 20.3, according to the Strengthening the Reporting of Observational studies in Epidemiology checklist (k = 0.79). Meta-analyses showed that obesity (measured by body mass index) was significantly associated with visible plaque index (OR: 4.75; 95% CI: 2.42, 9.34), bleeding on probing (OR: 5.41; 95% CI: 2.75, 10.63), subgingival calculus (OR: 3.07; 95% CI: 1.10, 8.62), probing depth (OR: 14.15; 95% CI: 5.10, 39.25) and flow rate of salivary secretion (standardized mean difference: -0.89; 95% CI: -1.18, -0.61). However, various results were reported in the effective studies that were not included in meta-analyses. In conclusion, obesity is associated with some signs of periodontal disease in children and adolescents. Further studies with a comprehensive prospective cohort design and more potential variables are recommended.