Association between dental caries activity, quality of life and obesity in Brazilian adolescents

Class 3 Obesity and Oral Health in Adults: A Scoping Review of the Challenges for Oral Healthcare Services

Background: Obesity is one of the most neglected public health problems affecting both developed and developing countries. The most clinically severe obesity (Class 3 obesity) has both clinical and service delivery implications on dental services. However, associations between Class 3 obesity and oral health are minimally explored in the literature and thus poorly understood. Aims: This scoping review aimed to explore the existing evidence on Class 3 obesity and oral health. Methods: A literature search was performed via Medline, Scopus, Google scholar and Embase research databases. Results: A total of 375 papers were sourced from the database search. Twenty seven full-text papers were included in the final literature review. Results revealed findings from both quantitative and qualitative studies. Papers included results pertaining to associations with dental disease, oral health and associated behaviours, oral health-related quality of life and the barriers experienced by adults with Class 3 obesity in accessing dental services. Conclusions: While mixed findings were identified, this scoping review reports associations between Class 3 obesity and poor oral health across various domains including clinical parameters and oral health related quality of life. The literature has also highlighted important barriers to dental care in those with the most severe Class 3 obesity. Based upon our findings, we have summarised current oral health management implications and directions for future research.

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.

Poor dental service utilization in those with clinically severe obesity: A neglected issue with solutions needed

Data linking body mass index (BMI) and dental service utilization with oral and general health, quality of life, wellbeing, and mental health are lacking. Adult patients with clinically severe obesity attending a hospital-based obesity service in Greater Western Sydney were invited to participate in a cross-sectional survey that collected data on dental utilization and visiting patterns, dental anxiety, and oral health-related quality of life (OHRQoL). General health data were obtained from participants' medical records. Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire, and 74 (91.3%) answered additional screening questions related to their general wellbeing and mental health. Of the participants, 50 (61.7%) reported that their last dental visit was more than 1 year ago, 43 (53.1%) visited only as needed and 22 (27.2%) participants reported favourable dental visiting patterns. Twenty-four (29.6%) participants reported high levels of dental anxiety, and low levels of OHRQoL compared with national data. Screening questions suggested low general wellbeing and poor mental health in this patient cohort. Within this group, BMI was not significantly correlated with any of the variables of dental service utilization, dental anxiety, OHRQoL, wellbeing, or mental health (p > .05). There was a negative correlation between dental anxiety and dental utilization (p < .05). Patients with clinically severe obesity reported poor dental utilization, low OHRQoL, and high levels of dental anxiety. This study highlighted the frequency of medical complications, lack of wellbeing, and poor mental health, which were evident in this cohort and may complicate dental management.

Impact of dental caries and nutritional status on oral health related quality of life in young Indian adolescents

Background

A combination of poor oral health status and malnourishment ultimately affect the quality of life of the person. Hence, these tools may help in identifying individuals at risk of poor quality of life and malnutrition caused by oral problems especially in adolescents.

Objective

To test the association between dental caries, nutritional status and Oral Health Related Quality of Life (OHRQoL) in 12-15 year-old school going adolescents.

Study design

A cross sectional study was conducted on 12-15-year-old school going adolescents. A total of 1214 adolescents participated in the study. Data on quality of life was collected using OHIP-14 and clinical examination was done to assess the DMFT status and Body Mass Index (BMI) as measure of nutritional status of the subjects.

Results

DMFT was found to be positively correlated with total OHIP score, however BMI was negatively correlated with OHIP. Controlling for BMI, partial correlation analysis revealed that there is a weak association between OHIP and DMFT scores which was found to be statistically significant.

Conclusion

Both caries experience and nutrition status had significant impact on Quality of Life. All the three parameters were found to be correlated to each other.

Impact of dental caries severity and activity on oral health-related quality of life among children aged 8-11 years

Caries disease can lead to strong impact in terms of pain and suffering, to functional impairment, and to negative effects on quality of life. Studies have demonstrated that the impact on quality of life increases with dental caries severity, and few studies have assessed the relationship between caries activity and children's oral health-related quality of life (OHRQoL). This cross-sectional study aimed to assess the impact of dental caries severity and activity on the OHRQoL of schoolchildren. The study was conducted with a sample of children aged 8 to 11 years from Pelotas, southern Brazil. Children answered the Child Perceptions Questionnaire 8-10, and socioeconomic data were collected. Children's dental caries (Kappa value of 0.95), PUFA, traumatic dental injuries, and malocclusion were examined. The Mann-Whitney, Kruskal-Wallis, and Poisson regression tests were performed. A total of 119 children were included. Children with initial (mean ratio (MR) of 1.92; 95% confidence interval (95% CI) of 1.05-3.48), moderate (MR: 2.66; 95%CI: 1.44-4.90), and severe carious lesions (MR: 2.65; 95%CI: 1.46-4.79) had a greater impact on OHRQoL compared with those without carious lesions (p =0 .047). Children with active carious lesions exhibited a greater impact on OHRQoL (MR:1.53 and 95%CI: 1.11-2.11) when compared to those without active lesions (p = 0.019). The findings demonstrate an association between dental caries severity and activity and the OHRQoL of school-aged children.

Systemic conditions and oral health-related quality of life of pregnant women of normal weight and who are overweight

OBJECTIVE

This study evaluated systemic and periodontal conditions and their association with quality of life in women in the third trimester of pregnancy, assisted by the Brazilian public health-care system, with excessive and normal weight.

METHODS

Fifty pregnant women were allocated into two groups according to their pre-pregnancy body mass index (BMI): excessive (GE; n = 25; BMI ≥ 25.00 kg/m2 ); and normal (GN; n = 25; 18.00 ≤ BMI ≤ 24.99 kg/m2 ). Thereafter, variables such as socio-economic level, anthropometric parameters (body mass index and gestational weight gain), systemic conditions, periodontal status, and oral health-related quality of life using the short version of the Oral Health Impact Profile (OHIP-14), were evaluated.

RESULTS

There was no significant difference between groups in schooling level, monthly household income and gestational weight gain (P > 0.05). The GE group showed a higher frequency of arterial hypertension (P = 0.018), sought dental services less frequently (P = 0.035), had a higher prevalence of periodontitis (P = 0.011), and had a higher OHIP-14 overall score (P = 0.004) characterised by physical and psychological impact. In the final binary logistic regression models, high maternal BMI was associated with arterial hypertension and periodontitis during pregnancy, while periodontitis was strongly associated with moderate and high impact on quality of life.

CONCLUSION

Pregnant women in the third trimester with excessive weight, assisted by the Brazilian public health-care system, presented with a higher prevalence of arterial hypertension, worse periodontal conditions and consequent high impact on quality of life.

Correlation Between Body Mass Index and Dental Caries Among Three- to 12-Year-Old Schoolchildren in India: A Cross-Sectional Study

Introduction: Diet is a deeply ingrained element of a person’s life. Children’s dietary habits are a significant contributor to obesity and dental caries. Dental caries during childhood continues to be a significant public health concern, while childhood obesity is increasingly being cited as a major public health problem. This study aimed to assess the correlation between body mass index (BMI) and dental caries in children aged three to 12 years who attended both government and private schools in Chennai, Tamil Nadu, India.

Materials and methods: We conducted a cross-sectional review of 2200 children aged three to 12 years with clinically recorded dental caries. The World Health Organization diagnostic criteria for BMI percentile was used to evaluate and record dental caries clinically. The Mann-Whitney and the Kruskal-Wallis tests were used for univariate comparisons.

Results: Mean values between the overweight category and underweight category revealed no significant differences.

Conclusion: We found no association between BMI-for-age and dental caries in children in both primary and mixed dentition. This relationship should be investigated further by longitudinal studies.

[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.

Oral clinical status and oral health-related quality of life: is socioeconomic position a mediator or a moderator?

AIM

To evaluate whether socioeconomic position exerts a mediating and/or moderating effect on the association between oral clinical measures and oral health-related quality of life (OHRQoL) in adolescents.

MATERIALS AND METHODS

The study analysed data on 5,445 adolescents aged 15-19 years from the Brazilian Oral Health Survey (SBBrasil Project). The numbers of decayed and missing teeth, number of sextants with gingivitis and malocclusion were assessed through oral clinical examinations. Participant's age, sex, OHRQoL and socioeconomic position were also collected. Monthly family income was used to indicate the participant's socioeconomic position, and OHRQoL was assessed using the Oral Impacts on Daily Performance. Moderation was tested using Poisson regression models. Structural equation modelling and Sobel's test assessed the mediation effects.

RESULTS

Oral clinical measures, OHRQoL and socioeconomic position were significantly correlated (P < 0.001). The moderator effect of socioeconomic position on the association between all oral clinical measures and OHRQoL was observed. The impact of all oral clinical conditions on adolescents' OHRQoL was lower in the low-family-income groups compared with those with a better income. Socioeconomic position partially mediated the relationship between the four oral clinical measures and OHRQoL. Sobel's test confirmed these findings (P < 0.001).

CONCLUSIONS

The findings suggest the importance of socioeconomic position as a moderator and mediator factor between oral clinical measures and OHRQoL. Disadvantaged adolescents are likely to experience poor OHRQoL due to oral conditions. The reduction of the impact of oral conditions on quality of life in adolescents may be enhanced by addressing social inequalities related to oral health.

A Cross-sectional Study of the Prevalence of Dental Caries among 12- to 15-year-old Overweight Schoolchildren

INTRODUCTION

Overweight and obesity are growing health-related problems worldwide, and it is currently the most prevalent nutritional disorder among children and adolescents. The objective of this study was to assess the association between overweight and dental caries among 12- to 15-year-old schoolchildren in Mangaluru district, Karnataka, India.

MATERIALS AND METHODS

Data were obtained from 2000 school-going children aged 12 to 15 years. The children were categorized as overweight and normal-weight group by assessing the body mass index (BMI). Body mass index was categorized using the classification system given by the International Obesity Task Force (IOTF) and obtained in units of kg/m². The dental caries was assessed by detection and was performed according to decayed, missing, and filled teeth (DMFT) index.

RESULTS

Of the 2000 children examined, the mean BMI recorded was 26.87 ± 2.26 for the overweight children and 20.82 ± 1.48 for the normal-weight children. Even though the DMFT (3.90 ± 2.95) in the overweight children was slightly higher than the control group (3.36 ± 2.73), it was not statistically significant.

CONCLUSION

Within the confines of the present study, it can be concluded that there is no significant association between overweight and dental caries among the schoolchildren of Mangaluru district in Karnataka. Longitudinal studies are necessary to substantiate the possible relationships between dental caries and overweight in children. Knowledge of these relationships could lead to preventive health measures designed to reduce the prevalence of both obesity and dental caries.

Oral Health, Obesity Status and Nutritional Habits in Turkish Children and Adolescents: An Epidemiological Study

BACKGROUND

Studies evaluating the relationship between oral health status and obesity have provided conflicting data. Therefore, there is a great need to investigate and clarify the possible connection in a comprehensive sample.

AIMS

To assess the relationship of obesity and oral health status among children and adolescents aged 6 to 17 years-old.

STUDY DESIGN

Cross-sectional study.

METHODS

Data were obtained from 4,534 children and adolescents (2,018 boys and 2,516 girls). Questionnaires were sent home prior to examination; afterwards, anthropometric and dental data were collected from participants. Community Periodontal Index (CPI) and number of decayed, missing, and filled teeth in the permanent dentition (DMFT), and deciduous dentition (dmft) index were used to measure oral health status. Height, body weight, body mass index (BMI), waist circumference (WC), and body fat percentage were analyzed.

RESULTS

For DMFT scores, healthy (score=0) girls and boys had significantly higher BMI and WC values than unhealthy (score>1) girls and boys (p<0.05). Healthy girls had higher fat percentage values than unhealthy girls (p<0.05). In terms of CPI scores, healthy boys had lower BMI and WC values than unhealthy boys (p<0.05). According to multiple binary logistic regression results for model 1, BMI predicted DMFT scores in both genders but CPI scores only in boys. No beverage consumption predicted DMFT scores in boys, while milk consumption predicted DMFT scores in girls. No meal skipping predicted CPI scores in boys. For model 2, WC predicted DMFT scores in both genders and CPI scores only in boys. Milk consumption predicted DMFT scores only in girls. No meal skipping predicted CPI scores for both gender (p<0.05). According to DMFT, there were significant differences between the frequencies of the BMI groups (normal weight, overweight and obese) at the age of 7 (girls only), 9, 10, and 16 (boys only) years and overall (only girls) (p<0.05). According to CPI, significant differences between the frequencies of the BMI groups at the age of 16 (boys only) and 17 (girls only) were seen (p<0.05).

CONCLUSION

Periodontal and dental status appears to correlate with nutritional habits and obesity. Obesity and dental/periodontal diseases are multifactorial diseases that follow similar risk patterns and develop from an interaction between chronic conditions originating early in life. It is important for all health professionals to educate patients at risk about the progression of periodontal and dental diseases and the importance of proper oral hygiene.

Relationship between Body Mass Index and Tooth Decay in a Population of 3-6-Year-Old Children in Iran

The aim of the present study was to evaluate the relationship between BMI and tooth decay in a population of Iranian children. In this cross-sectional descriptive/analytical study, 1482 children were selected from kindergartens and preschool centers in Kerman, Iran. The children underwent examination of deciduous teeth (using the dmft index) after determination of height and weight for calculation of BMI. The relationship between BMI (after adjustment for age) and dmft was determined using Poisson's regression model. The mean of dmft in children with normal BMI was 1.5-fold that in subjects with extra body weight. Age had a significant effect on dmft. In addition, dmft was higher in boys compared to girls. The results of the present study showed that caries rate in the deciduous teeth of 3-6-year-old children decreases with an increase in body weight.