Tobacco use and caries increment in young adults: a prospective observational study

Potential interaction of sugar intake and tobacco exposure on dental caries in adults-A cross-sectional study from the National Health and Nutrition Examination Survey

Background/purpose

We suspected that there might be an interaction between sugar intake and tobacco exposure on the risk of dental caries. The study aimed to investigate the associations of sugar intake or tobacco exposure with the risk of dental caries.

Materials and methods

This cross-sectional study obtained data of 18804 participants from National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Weighted univariable and multivariable logistic regression models were applied to explore the associations of total sugar intake or tobacco exposure with the risk of dental caries. The relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI) evaluated the interaction between total sugar intake and tobacco exposure on the risk of dental caries. The effect size of odds ratio (OR), and 95% confidence interval (CI) was inputted.

Results

The OR of dental caries in adults with cotinine >10 ng/mL was 1.59 (95%CI: 1.38-1.82). The increased risk of dental caries was found in people with total sugar >19.5%E compared to those with total sugar ≤19.5%E (OR = 1.55, 95%CI: 1.34-1.78). Compared to people with cotinine ≤10 ng/mL and total sugar ≤19.5%E, adults with cotinine >10 ng/mL and total sugar >19.5%E were correlated with elevated risk of dental caries (OR = 2.76, 95%CI: 2.29-3.33). The interaction indicators RERI was 0.980 (95%CI: 0.413-1.547), API was 0.355 (95%CI: 0.192-0.517), and SI was 2.250 (95%CI: 1.344-3.767).

Conclusion

There might be interaction between sugar intake and tobacco exposure on the occurrence of dental caries in adults.

Clinical characteristics and caries risk assessment of tobacco heating systems smokers, cigarette smokers and non-smokers: a cross-sectional study

OBJECTIVES

The study compared clinical characteristics and caries risk assessments between tobacco heating system (THS) smokers, cigarette smokers and non-smokers.

MATERIALS AND METHODS

General data, data regarding fluoridation, smoking and dietary habits was obtained through a questionnaire. Caries experience was assessed by the DMFT index; the amount of biofilm by the Full mouth plaque score index; the amount of salivation by the quantum of stimulated salivation test; salivary pH with pH indicator strips and salivary number of S.mutans and Lactobacilli by cultivation on agar plates. The Cariogram method was used to assess caries risk.

RESULTS

No differences between the groups was detected regarding education level, average daily number of meals, fluoridation programs, systemic diseases, and caries experience. The groups significantly differed in the amount of salivary S.mutans and Lactobacilli (p < 0.001), accumulated biofilm (p = 0.034), salivation quantum (p < 0.001), and saliva pH (p = 0.009). Exposure to tobacco smoke and heated tobacco aerosol increased the accumulation of biofilm and decreased salivary pH. Smoking increased S. mutans, while THS consumption decreased salivation and Lactobacilli the most. The Cariogram analysis found no differences in chances of avoiding new caries lesions between the groups, but a significant difference in developing caries lesions due to dietary habits was detected (p < 0.001) with non-smokers having higher risk than smokers, but not than THS consumers.

CONCLUSIONS

THS and cigarette smoking were related to clinical characteristics that affect caries activity even though the caries risk assessment revealed no significant difference in the chances of avoiding new caries lesions between the groups.

CLINICAL RELEVANCE

THS and cigarette smokers could have higher caries activity than non-smokers. The clinical study protocol has been registered on ClinicalTrials.gov under the ID number: NCT06314100.

Risk of Postpartum Dental Caries: Survival Analysis of Black/African American and White Women in Appalachia

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.

High sugar intake from sugar-sweetened beverages is associated with prevalence of untreated decay in US adults: NHANES 2013-2016

OBJECTIVES

To assess the association between sugar from sugar-sweetened beverages (SSBs) and untreated decay in permanent teeth and calculate the cost burden of sugar from SSBs on untreated decay in US adults.

METHODS

Cross-sectional data from the 2013-2014 and 2015-2016 cycles of the National Health and Nutrition Examination Survey (NHANES) were analysed in 2020 (n = 9001 adults aged ≥20). Multivariable analyses assessed sugar intake from SSB consumption with the presence of untreated decay in permanent teeth and number of untreated decayed teeth. Population attributable risk was used to estimate the cost burden arising from SSBs on untreated decay in US adults.

RESULTS

One fourth (25.1%) of US adults had untreated dental decay, and higher prevalence was observed among those with low income, low education and race/ethnicity of non-Hispanic Black. Overall, 53% of adults reported no intake of SSBs. For the remaining 47%, the median 24-h intake was 46.8 g of sugar from SSBs. The adjusted prevalence ratio (PR) for untreated decay was 1.3 (95% confidence interval [CI] 1.1-1.5) for consumption of 46.8 g or more of sugar from SSBs compared to those reporting no sugar from SSBs. Number of untreated decayed teeth increased with sugar intake from SSBs from lowest to highest tertile: 0.1, (p = .35); 0.4, (p = .006); and 0.6, (p < .001). The cost burden of untreated decay attributable to SSBs in US adults is estimated conservatively at $1.6 billion USD.

CONCLUSIONS

Community level interventions directed at sugar from SSBs are justified to address disparities in the burden of untreated dental decay.

Factors Influencing the Survival Rate of Teeth and Implants in Patients after Tumor Therapy to the Head and Neck Region-Part 1: Tooth Survival

We aimed to evaluate possible factors influencing the long-term survival of teeth after tumor therapy (TT) to the head and neck region with and without radiation. Between January 2019 and January 2020, patients who underwent TT for head and neck cancer and received dental treatment before and after TT at the Department of Prosthetic Dentistry of the Martin Luther University Halle-Wittenberg were enrolled in the study. Clinical examination with assessment of dental status and stimulated salivary flow rate (SFR) was performed and information about disease progression and therapy was retrieved from medical records. Of 118 patients (male: 70.3%; mean age: 63.2 ± 12.4 years), 95 received radiotherapy (RT), and 47 were administered radio-chemotherapy (RCT). The teeth of irradiated patients exhibited a lower 5-year survival probability (74.2%) than those of non-irradiated patients (89.4%). The risk of loss (RL) after RT increased with nicotine use, presence of intraoral defects, reduced SFR, RCT and regarding mandibular teeth, and decreased with crowning following TT. Lower SFR increased the RL even without RT. Consideration of patient’s treatment history, individual risk profile, and clinical findings during the prosthetic planning phase could enable earlier, more targeted dental treatment after TT (e.g., timely crowning).

Dental caries among Finnish teenagers participating in physical activity and diet intervention: association with anthropometrics and behavioural factors

Background

An association between childhood anthropometric measurements and dental caries is conflicting. The prevalence and severity of dental caries and its association with anthropometric and behavioural factors, were investigated among Finnish teenagers.

Methods

The study sample comprised 202 15–17-year-old participants in the Physical Activity and Nutrition in Children (PANIC) Study. Dental caries findings were recorded using International Caries Detection and Assessment System (ICDAS) criteria, including activity estimation; numbers of decayed teeth (DT) and decayed, missing and filled teeth (DMFT) were recorded. Body weight, height and waist circumference were measured and respective body mass index (BMI) was calculated. Body fat percentage was assessed by dual-energy X-ray absorptiometry. Health-related behaviours and consumption of food and drinks were assessed using questionnaires, and intake of nutrients using a 4-day food record.

Results

Mean DMFT for all the participants was 2.4 (SD = 2.9), DT 0.6 (SD = 1.3), and 36% had DMFT = 0. No difference between genders was observed. In bivariate analyses, use of sugar-sweetened beverages (SSB) three times or less per week and not having used snuff associated significantly, whereas higher carbohydrate intake (E%), toothbrushing less often than twice a day and higher caries experience at baseline almost significantly with DT > 0. In adjusted regression analyses, frequent use of SSB and higher carbohydrate intake increased the odds for DT > 0. Additionally, higher carbohydrate intake (E%) and infrequent tooth brushing significantly associated with a higher number of DT.

Conclusion

Caries prevalence is still low and similar in Finnish teenage girls and boys. Behavioural factors are, but anthropometric factors are not associated with dental caries.

Caries prevalence among 18 years old, an epidemiological survey in Israel

BACKGROUND

There is a lack of evidence on caries prevalence among 18 years old Israeli young adults with only a scarce evidence regarding this index age group. In the last few years dental care policy in Israel underwent substantial changes and a major reform in dental services was led by the Israeli Ministry of Health, including coverage of dental care for children by the state. In addition, a cessation of community water fluoridation was in a debate. The objective of the current study was to describe prevalence of caries among 18 years old Israeli young adults and to evaluate possible associations with personal and demographic variables.

METHODS

The study was a cross sectional clustered survey. Participants were recruited to the study at their first day of military service. Participants completed a questionnaire for personal and demographic data, including: age, country of birth, education, and current smoking status. Then participants underwent clinical evaluation included DMFT and caries free rates. No radiographic evaluation was included in the current study. Univariate and multivariate statistical analysis were performed.

RESULTS

A total of 702 participants were included in the study, 58.4% were males. Their mean age was 19.03 ± 0.65 years, 91.3% of the participants were born in Israel. Mean DMFT was 1.95 ± 2.67, and 46.7% (n = 328) were caries free. Higher DMFT score was significantly associated with participant's parents' education, country of birth, and smoking status. Lower caries free rates were significantly associated with participant's parents' education, and smoking status. After linear regression for total DMFT, all variables were significant predictors to higher DMFT, except father's education, while logistic regression for caries free, only mother's education was found to be a significant predictor.

CONCLUSIONS

The current study presents encouraging low DMFT levels. Participants in this study were not included in the dental care services reform, and did enjoy the benefits of water fluoridation, enabling the results to play an important baseline data for future reference. Additionally, results should be considered when planning intervention programs for at risk groups.

TRIAL REGISTRATION

This study was registered in ClinicalTrials.gov (Identifier No. NCT02958891 , November 8th, 2016) and was approved by the IDF Institutional Review Board (#1524-2015).