Is chronotype profile a risk indicator for caries in children and adolescents in sub-urban Nigeria?

The Relationship between Sleep, Chronotype, and Dental Caries-A Narrative Review

This article provides an overview of how sleep and circadian rhythm disturbances mutually influence the occurrence of dental caries and how it is possible to reduce the risk of circadian rhythm disturbances, sleep, and associated adverse effects. Dental caries is a global problem worldwide that contributes to sociological limitations. Numerous factors influence the occurrence of dental caries, from socioeconomic factors to cariogenic bacteria, dietary habits, and oral hygiene. However, sleep disorders and circadian rhythm disturbances represent a new approach in the fight against the increasing prevalence of dental caries worldwide. Bacteria in the oral cavity and the oral microbiome are mainly responsible for the development of caries, and saliva plays an important role in their regulation. The circadian rhythm regulates numerous physiological functions, including sleep and saliva production. Disturbances in sleep and circadian rhythms affect saliva production, which impacts the development of dental caries, as saliva is necessary for regulating and maintaining oral health, especially for controlling oral infections. A person's preference for a particular time of day depends on the circadian rhythm called chronotype. Individuals with an evening chronotype have a less healthy lifestyle that can lead to a higher caries risk than individuals with a morning chronotype. Because circadian rhythms are critical to maintaining sleep homeostasis and oral health, sleep disturbances can disrupt circadian rhythms and lead to a vicious cycle.

Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review and meta-analysis

BACKGROUND

Dental caries (DC) is highly prevalent condition affecting mostly young children. There has been no systematic review done on the prevalence of DC amongst 12-year -olds in Africa. Although some African countries have reported a decrease in DC prevalence, others have shown an increase and it is essential to measure current trends in order to identify strategies and programmes that could assist in reducing DC in Africa. The aim of this systematic review was to determine the prevalence of DC (condition) amongst the permanent dentition of 12-year-old children (population) in Africa (context).

METHODS

A systematic review and meta-analysis was performed. Peer reviewed cross-sectional articles from January 2000 until December 2021 was searched and this included the following databases: Pubmed (Medline); SCOPUS; CINAHL (via EBSCOhost); Academic Search Complete (via EBSCOhost); Dentistry and Oral Sciences Sources (via EBSCOhost); and Science Direct. The search was last updated on the 10th January 2022. Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Prevalence figures were stratified by Urban/Rural status, country and time using a random-effects model. All studies performed on children 12-year-olds on the African continent were included. The prevalence of DC and the DMFT scores were the primary and secondary outcome measures, respectively. Only articles consisting of 12-year-old children who reside in Africa were included in this study. The systematic review was registered with Prospero CRD42021293666.

RESULTS

18,080 participants were included in this review. A total of thirty studies were included in the review. The pooled effect size of dental caries severity was 1.09 (CI 0.91-1.27) and the overall prevalence was 36% (CI 29.4-41.7%). Eritrea (78%) had the highest prevalence of DC while Zambia had the lowest (11%); Eritrea also had the highest DMFT score (2.5) with Sudan having the lowest score (0.49). Urban cities had the highest DMFT score (1.32, CI 0.97-1.68), compared to rural cities (1.13, CI 0.86-1.4) and there was an increasing trend in DC prevalence over time from 28% (CI 23-34%) in 2000 to 2005 to 57% (CI 43-72%) in studies conducted after 2015. The risk of bias was very low where majority of the studies scored more than 50% in the JBI critical appraisal tool.

CONCLUSIONS

There was a wide discrepancy in the DC prevalence and scores across the different countries, settings (rural versus urban) and there was an increase in the prevalence over time. This review was self-funded.

The associations of chronotype and social jetlag with prosocial behavior problems among Chinese adolescents

Potential relevance between the circadian rhythm and behavioral health has got raising attention in recent years. This study aimed to examine chronotype, social jetlag and their associations with prosocial behavior problems among Chinese adolescents. A total of 4,666 middle school students aged 12-18 years were enrolled in study. Sleep characteristics were collected by the modified Chinese version of Adolescent Sleep Hygiene Scale (M-ASHS); MSFsc and mid-sleep point were calculated to determine chronotypes and social jetlag. Prosocial behavior problems were assessed by the Strength and Difficult Questionnaire (SDQ). Multivariate logistic regression was applied to analyze the relationships between chronotype and social jetlag with prosocial behavior problems. Evening chronotype was associated with higher risk of prosocial behavior problems, whether among male (OR = 1.82, 95%CI:1.27-2.61, P = .001) or female adolescents (OR = 1.83, 95%CI:1.15-2.91, P = .011). Female adolescents with social jetlag of 1-2 hours had 1.60 times the risk of prosocial behavior problems than their peers whose social jetlag was <1 h (P = .028); social jetlag ≥ 2 h was positively associated with prosocial behavior problems in both male and female adolescents (OR = 1.79 and 2.45, respectively, both P < .05). Further, the combination of intermediate chronotype and social jetlag ≥ 2 h was correlated with prosocial behavior problems only in female adolescents (OR = 3.24, 95%CI = 1.40-9.21, P = .004). Evening chronotype and higher social jetlag were risk factors for prosocial behavior problems in adolescents, especially for the female. For the promotion of prosocial behavior in adolescents, the importance of circadian rhythm should be addressed.