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Abouseta N, Gomaa N, Tassi A, Elzagallaai AA, Rieder MJ, Dixon SJ, Pani SC. Relationships among Cortisol, Perceived Stress, and Dental Caries Experience in Adolescents and Young Adults. Caries Res 2024; 58:421-430. [PMID: 38657570 DOI: 10.1159/000539041] [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: 11/24/2023] [Accepted: 04/20/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Stress can impact mental and physical health, especially during adolescence and young adulthood, but the extent of its contribution to dental caries is poorly understood. The present study assessed the association between perceived stress, cortisol levels (in hair and saliva), and overall caries experience of adolescents and young adults aged 15-25 years. METHODS Hair and saliva samples were obtained from 93 participants free of periodontal disease. Cortisol in hair and saliva was determined using a competitive enzyme-linked immunosorbent assay. Participants completed a perceived stress questionnaire and underwent full-mouth oral examination by a calibrated examiner. Dental caries experience was based on the decayed, missing, and filled teeth (DMFT) index. Sociodemographic variables were also recorded. RESULTS There were significantly higher hair cortisol levels and perceived stress scale (PSS) scores in individuals with dental caries experience (DMFT≥1) than in those without (DMFT = 0). However, there was no significant difference in salivary cortisol concentration. A binary logistic regression revealed that higher hair cortisol levels and greater scores on the perceived stress scale were associated with increased odds of having experienced dental caries. In contrast, no significant association was found between salivary cortisol concentration and dental caries. Using multivariable regression models, caries experience was found to be significantly associated with both hair cortisol levels and PSS scores. These associations remained statistically significant even after adjusting for sociodemographic variables. CONCLUSION Hair cortisol levels and perceived stress have a significant association with dental caries experience, whereas salivary cortisol concentrations do not.
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Affiliation(s)
- Naima Abouseta
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Noha Gomaa
- Oral Diagnostic Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Ali Tassi
- Graduate Orthodontics and Dentofacial Orthopaedics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Abdelbaset A Elzagallaai
- Drug Safety Lab, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Michael J Rieder
- Departments of Paediatrics, Physiology and Pharmacology, and Medicine, Schulich Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - S Jeffrey Dixon
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Sharat Chandra Pani
- Schulich Dentistry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
- Pediatric Dentistry, BC Children's Hospital, Vancouver, British Columbia, Canada
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Padmanabhan V, Islam MS, Habib M, Abdulaziz Z, Goud M, Chaitanya NCSK, Haridas S, Rahman MM. Association between Salivary Cortisol Levels, Dental Anxiety, and Dental Caries in Children: A Cross-Sectional Study. Dent J (Basel) 2023; 11:205. [PMID: 37754325 PMCID: PMC10528522 DOI: 10.3390/dj11090205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
AIM This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. MATERIALS AND METHODS A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4-12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson's correlation coefficient, were performed to determine significant differences and associations. RESULTS The study group showed significantly higher salivary cortisol levels compared to the control group (p < 0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p < 0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p = 0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p < 0.001). CONCLUSION The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. CLINICAL SIGNIFICANCE This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients.
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Affiliation(s)
- Vivek Padmanabhan
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates; (M.S.I.)
| | - Md Sofiqul Islam
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates; (M.S.I.)
| | - Muneera Habib
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates; (M.S.I.)
| | - Zainab Abdulaziz
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates; (M.S.I.)
| | - Manjunatha Goud
- RAK College of Medical Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates (S.H.)
| | - Nallan CSK Chaitanya
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates; (M.S.I.)
| | - Sheela Haridas
- RAK College of Medical Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates (S.H.)
| | - Muhammed Mustahsen Rahman
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Al Juwais, Al Qusaidat, Ras al Khaimah 11172, United Arab Emirates; (M.S.I.)
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Tsai WT, Lawrence HP. Association between psychosocial determinants of adverse childhood experiences and severe early childhood caries among First Nations children. Int J Paediatr Dent 2022; 32:352-366. [PMID: 34358378 DOI: 10.1111/ipd.12891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 07/04/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
AIM To determine whether psychosocial determinants of adverse childhood experiences (ACE), from pregnancy to 2 years old, are associated with severe early childhood caries (S-ECC) in Indigenous children. DESIGN Secondary data analyses from an ECC prevention trial among 344 First Nations mother-child dyads living on- and off-reserve in Ontario and Manitoba, Canada. Stratified (on-/off-reserve) logistic regression, controlling for mother's age and income source, assessed three categories of psychosocial ACE determinants: alcohol/drug misuse, household financial hardship (overcrowding and food insecurity) and emotional/social well-being (Perceived Stress Scale (PSS-14), sense of personal control (SOC), social support, subjective social status). RESULTS Household overcrowding [adjusted odds ratio (AOR) = 1.89 (95% CI: 1.06-3.38)], food insecurity [AOR = 2.86 (1.53-5.34)] and mothers' high perceived stress [AOR = 2.48 (1.40-4.37)] were associated with S-ECC (dmft > 9) for those on-reserve. Maternal SOC had a protective effect for off-reserve children [AOR = 0.17 (0.03-0.95)]. CONCLUSIONS Increased efforts to reduce psychosocial ACE determinants are paramount to decreasing Indigenous children's vulnerability to S-ECC.
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Affiliation(s)
- Wan Ting Tsai
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Kennedy B, Peura S, Hammar U, Vicenzi S, Hedman A, Almqvist C, Andolf E, Pershagen G, Dicksved J, Bertilsson S, Fall T. Oral Microbiota Development in Early Childhood. Sci Rep 2019; 9:19025. [PMID: 31836727 PMCID: PMC6911045 DOI: 10.1038/s41598-019-54702-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/14/2019] [Indexed: 12/25/2022] Open
Abstract
Early life determinants of the oral microbiota have not been thoroughly elucidated. We studied the association of birth and early childhood characteristics with oral microbiota composition using 16 S ribosomal RNA (rRNA) gene sequencing in a population-based Swedish cohort of 59 children sampled at 6, 12 and 24 months of age. Repeated-measurement regression models adjusted for potential confounders confirmed and expanded previous knowledge about the profound shift of oral microbiota composition in early life. These alterations included increased alpha diversity, decreased beta diversity and alteration of bacterial composition with changes in relative abundance of 14 of the 20 most common operational taxonomic units (OTUs). We also found that birth characteristics, breastfeeding and antibiotic use were associated with overall phyla distribution and/or with the relative abundance of specific OTUs. Further, we detected a novel link between morning salivary cortisol level, a physiological marker of neuroendocrine activity and stress, and overall phyla distribution as well as with decreased abundance of the most common OTU mapped to the Streptococcaceae family. In conclusion, a major part of the maturation of the oral microbiome occurs during the first two years of life, and this development may be influenced by early life circumstances.
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Affiliation(s)
- Beatrice Kennedy
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Sari Peura
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Forest Mycology and Plant Pathology, Science for Life Laboratory, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ulf Hammar
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Silvia Vicenzi
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,School of Medicine, University of Tasmania, Hobart, Australia
| | - Anna Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Unit of Pediatric Allergy and Pulmonology at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ellika Andolf
- Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Johan Dicksved
- Department of Animal Nutrition and Management, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Stefan Bertilsson
- Department of Ecology and Genetics, Limnology, Uppsala University, Uppsala, Sweden.,Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Cornejo Ulloa P, van der Veen MH, Krom BP. Review: modulation of the oral microbiome by the host to promote ecological balance. Odontology 2019; 107:437-448. [PMID: 30719639 PMCID: PMC6732124 DOI: 10.1007/s10266-019-00413-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/23/2019] [Indexed: 01/05/2023]
Abstract
The indivisible relationship between the human host and its oral microbiome has been shaped throughout the millennia, by facing various changes that have forced the adaptation of oral microorganisms to new environmental conditions. In this constant crosstalk between the human host and its microbiome, a bidirectional relationship has been established. The microorganisms provide the host with functions it cannot perform on its own and at the same time the host provides its microbes with a suitable environment for their growth and development. These host factors can positively affect the microbiome, promoting diversity and balance between different species, resulting in a state of symbiosis and absence of pathology. In contrast, other host factors can negatively influence the composition of the oral microbiome and drive the interaction towards a dysbiotic state, where the balance tilts towards a harmful relationship between the host and its microbiome. The aim of this review is to describe the role host factors play in cultivating and maintaining a healthy oral ecology and discuss mechanisms that can prevent its drift towards dysbiosis.
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Affiliation(s)
- Pilar Cornejo Ulloa
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Bastiaan P Krom
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Abstract
BACKGROUND This scoping review addressed the question 'what do we know about stress-related changes in saliva and dental caries in general population?' METHODS The review was conducted using electronic searches via Embase, MEDLINE, PsycINFO, CINAHL and WoS. All published human studies with both observational and experimental designs were included. Two reviewers independently reviewed eligible articles and extracted the data. The studies' quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool. RESULTS Our search identified 232 reports, of which six were included in this review. All six studies were conducted in children and used salivary cortisol as stress marker. The studies varied by design, types of stressors, children's caries experience, methods of saliva collection. Four studies reported a positive association between saliva cortisol levels and caries (p < 0.05) while the other two reported no association (p > 0.05). The quality of the included studies was weak to moderate. CONCLUSIONS There is lack of evidence about an association between stress-related changes in saliva and caries. Well-designed longitudinal studies with rigorous measurement technics for stress, saliva and dental caries are necessary. This will help to generate new insights into the multifactorial etiology of caries and provide evidence for a rational method for its control.
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Bright MA, Alford SM, Hinojosa MS, Knapp C, Fernandez-Baca DE. Adverse childhood experiences and dental health in children and adolescents. Community Dent Oral Epidemiol 2014; 43:193-9. [DOI: 10.1111/cdoe.12137] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 10/14/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Melissa A. Bright
- Institute for Child Health Policy; University of Florida; Gainesville FL USA
| | - Shannon M. Alford
- Institute for Child Health Policy; University of Florida; Gainesville FL USA
| | | | - Caprice Knapp
- Department of Health Policy and Administration; The Pennsylvania State University; State College PA USA
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Küchler EC, Deeley K, Ho B, Linkowski S, Meyer C, Noel J, Kouzbari MZ, Bezamat M, Granjeiro JM, Antunes LS, Antunes LA, de Abreu FV, Costa MC, Tannure PN, Seymen F, Koruyucu M, Patir A, Mereb JC, Poletta FA, Castilla EE, Orioli IM, Marazita ML, Vieira AR. Genetic mapping of high caries experience on human chromosome 13. BMC MEDICAL GENETICS 2013; 14:116. [PMID: 24192446 PMCID: PMC3907033 DOI: 10.1186/1471-2350-14-116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 10/31/2013] [Indexed: 02/04/2023]
Abstract
Background Our previous genome-wide linkage scan mapped five loci for caries experience. The purpose of this study was to fine map one of these loci, the locus 13q31.1, in order to identify genetic contributors to caries. Methods Seventy-two pedigrees from the Philippines were studied. Caries experience was recorded and DNA was extracted from blood samples obtained from all subjects. Sixty-one single nucleotide polymorphisms (SNPs) in 13q31.1 were genotyped. Association between caries experience and alleles was tested. We also studied 1,481 DNA samples obtained from saliva of subjects from the USA, 918 children from Brazil, and 275 children from Turkey, in order to follow up the results found in the Filipino families. We used the AliBaba2.1 software to determine if the nucleotide changes of the associated SNPs changed the prediction of the presence of transcription-binding site sequences and we also analyzed the gene expression of the genes selected based on binding predictions. Mutation analysis was also performed in 33 Filipino individuals of a segment of 13q31.1 that is highly conserved in mammals. Results Statistically significant association with high caries experience was found for 11 markers in 13q31.1 in the Filipino families. Haplotype analysis also confirmed these results. In the populations used for follow-up purposes, associations were found between high caries experience and a subset of these markers. Regarding the prediction of the transcription-binding site, the base change of the SNP rs17074565 was found to change the predicted-binding of genes that could be involved in the pathogenesis of caries. When the sequence has the allele C of rs17074565, the potential transcription factors binding the sequence are GR and GATA1. When the subject carries the G allele of rs17074565, the potential transcription factor predicted to bind to the sequence is GATA3. The expression of GR in whole saliva was higher in individuals with low caries experience when compared to individuals with high caries experience (p = 0.046). No mutations were found in the highly conserved sequence. Conclusions Genetic factors contributing to caries experience may exist in 13q31.1. The rs17074565 is located in an intergenic region and is predicted to disrupt the binding sites of two different transcription factors that might be involved with caries experience. GR expression in saliva may be a biomarker for caries risk and should be further explored.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alexandre R Vieira
- Department of Oral Biology, University of Pittsburgh, 614 Salk Hall, Pittsburgh, PA, USA.
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