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Byrd M, Davis E, Blostein F, Bhaumik D, Shaffer JR, McNeil DW, Marazita ML, Foxman B. Risk of Postpartum Dental Caries: Survival Analysis of Black/African American and White Women in Appalachia. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:108-119. [PMID: 38404680 PMCID: PMC10890941 DOI: 10.1089/whr.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/27/2024]
Abstract
Background Pregnancy is associated with increased risk of caries, but the extent this increase extends into the postpartum period is poorly understood. Study Objective Describe the epidemiology of dental decay in the postpartum period among Black/African American and White American women and explore associations with potentially modifiable risk factors. Materials and Methods We analyzed data from 1,131 Black/African American and White women participating in Center for Oral Health Research in Appalachia cohorts. Women were enrolled during the first two trimesters of pregnancy. Calibrated dental professionals completed dental examinations at the prenatal enrollment visit, and 2-month, 1-year, 2-year, and 3-year postpartum visits. Results Between the prenatal visit and 2-month visit, the incidence of decayed, missing, and filled teeth (DMFT) increase was 6.92/100 person-months, compared to 3.6/100 person-months between the 2-month and 1-year visit. In a multivariate Cox proportional hazard regression predicting incidence of caries up to 3-years postpartum, being younger, having less than college education, a household income <$50,000, smoking cigarettes, a DMFT >0, a very poor or poor Oral hygiene Rating Index, lower salivary pH at enrollment, or frequently drinking 100% juice increased the hazard of new dental caries. Adjusting for race/ethnic group did not affect the direction or magnitude of observed associations. Conclusions The strong associations of prior DMFT and Oral Rating Index with occurrence of new dental caries postpartum suggests that targeting young women for interventions to improve oral health may be more valuable for reducing caries incidence during pregnancy and in the postpartum period than targeting women only during pregnancy.
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Affiliation(s)
- Morgan Byrd
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Elyse Davis
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Freida Blostein
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Deesha Bhaumik
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - John R. Shaffer
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pennsylvania, Pennsylvania, USA
| | - Daniel W. McNeil
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Mary L. Marazita
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pennsylvania, Pennsylvania, USA
- Clinical Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Betsy Foxman
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Wen J, Tao Y, Pang L, Cao Y, Lin H, Zhou Y. Parental Feeding Styles and Risk of a New Carious Lesion in Preschool Children: A Longitudinal Study. Nutrients 2023; 15:4387. [PMID: 37892461 PMCID: PMC10609665 DOI: 10.3390/nu15204387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Parents may influence children's intake of sweets and sugar-sweetened beverages through their feeding styles. This study prospectively assessed the association between parental feeding styles and caries risk in preschool children. In November and December 2021, we recruited 1181 preschool children aged 3-4 years in Guangzhou, China, and then conducted a follow-up visit after 15 months. The children were examined for dental caries, and their parents answered the Chinese version of the Parental Feeding Style Questionnaire. Data were analyzed using logistic regression analysis. At baseline, 'control over eating' was found to be negatively associated with early childhood caries (OR = 0.60, 95%CI = 0.44, 0.83). After 15 months, no significant association between baseline parental feeding styles and the risk of a new carious lesion was found. When considering changes in parental feeding styles between the baseline and the follow-up visit, we found children with increasing scores on 'instrumental feeding' during the 15 months had a higher risk of a new carious lesion (OR = 1.91, 95%CI = 1.18, 3.12). However, children with always-intermediate scores (OR = 0.51, 95%CI = 0.30, 0.86), always-high scores (OR = 0.42, 95%CI = 0.23, 0.77), or increasing scores (OR = 0.50, 95%CI = 0.31, 0.83) on 'control over eating' had a lower risk of a new carious lesion. Our study highlighted the influence of parental feeding styles on caries risk in preschool children.
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Affiliation(s)
- Jie Wen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (J.W.); (Y.T.); (L.P.); (Y.C.); (H.L.)
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Ye Tao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (J.W.); (Y.T.); (L.P.); (Y.C.); (H.L.)
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Liangyue Pang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (J.W.); (Y.T.); (L.P.); (Y.C.); (H.L.)
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Yina Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (J.W.); (Y.T.); (L.P.); (Y.C.); (H.L.)
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Huancai Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (J.W.); (Y.T.); (L.P.); (Y.C.); (H.L.)
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Yan Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (J.W.); (Y.T.); (L.P.); (Y.C.); (H.L.)
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
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Foxman B, Davis E, Neiswanger K, McNeil D, Shaffer J, Marazita ML. Maternal factors and risk of early childhood caries: A prospective cohort study. Community Dent Oral Epidemiol 2023; 51:953-965. [PMID: 36168961 PMCID: PMC10043047 DOI: 10.1111/cdoe.12794] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the associations between time-varying factors (mother's oral health, oral hygiene, smoking habits, diet, food insecurity and stress) socioeconomic factors (mother's employment, marital status, household income, insurance status, household size) and medical history on children's risk of developing a carious lesion in the first 3 years of life. METHODS Longitudinal data from the Center for Oral Health Research in Appalachia Cohort Two (COHRA2) were analysed. Pregnant women ≥18 years in the USA were recruited during pregnancy; all consenting women delivering at term and their babies had regular dental assessments and complete in-person surveys and telephone interviews regarding sociodemographic factors, medical and dental history, and oral health behaviours. RESULTS In a logistic regression model adjusting for covariates, children whose mother had two or more prior pregnancies, smoked cigarettes post-partum, or had a recent unfilled carious lesion were at least twice as likely to experience a dental lesion by the three-year visit. The magnitude of these associations varied by maternal education and state of residence. CONCLUSIONS Untreated maternal decay but not maternal oral hygiene or diet were associated with cumulative risk of childhood caries by age three but were modified by maternal education and state of residence. Addressing structural and behavioural issues that reduce use of restorative dental care are needed to prevent the adverse impacts associated with early childhood caries.
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Affiliation(s)
- Betsy Foxman
- Center of Molecular and Clinical Epidemiology of Infectious Diseases, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Elyse Davis
- Center of Molecular and Clinical Epidemiology of Infectious Diseases, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Katherine Neiswanger
- Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel McNeil
- Departments of Psychology and Dental Practice & Rural Health, and Center for Oral Health Research in Appalachia, West Virginia University, Morgantown, West Virginia, USA
| | - John Shaffer
- Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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