Common Determinants of Dental Caries and Obesity in Children: A Multi-Ethnic Nested Birth Cohort Study in the United Kingdom

Childhood dental caries and obesity: Opportunities for interdisciplinary approaches to prevention

Dental caries and obesity are prevalent and preventable chronic childhood diseases. Evidence shows a strong connection between these two diseases, with overlapping common risk factors, including diet as a key driver of risk. Dental professionals are well-positioned to perform nutritional counseling and obesity prevention in dental clinic settings, but training and clinical integration remain key challenges. This paper highlights the potential for leveraging the common risk factor approach (CRFA) framework and its principles to reduce the impact of childhood dental caries and obesity. Strategies and methods are provided to integrate meaningful didactic and clinical training experiences in dental academia, and the need to include effective and evidence-based nutritional counseling techniques in dental settings is also described. Additionally, the potential for integrating CRFA and engaging health care providers across the spectrum of care, including primary care settings, to reduce the prevalence of these diseases in pediatric populations is highlighted. Finally, the authors propose future directions for multidisciplinary research to advance the scientific knowledge in this area and to inform effective and comprehensive interventions for dental settings.

Household, dietary, and clinical characteristics of childhood caries and overweight progression-A prospective cohort study

BACKGROUND

Childhood caries and obesity are complex chronic diseases with negative health outcomes.

AIM

This study sought a risk profile for childhood caries and overweight.

DESIGN

Children were recruited into a longitudinal prospective cohort study. Caries and overweight characteristics were obtained at baseline, 6, 12, and 18 months. Sequential data modeling steps determined a disease risk profile.

RESULTS

At baseline, 50% of the children (n = 194, 3.0 to 6.9 years) had caries; 24% were overweight, of whom 50% had caries. Correlation analysis separated child characteristics from household circumstances. Principal component modeling separated child snacking from meal-eating patterns, and household smoking from parent education variables. Baseline caries and overweight were not associated, but they grouped together in the modeling of composite features. Forty-five percent of children showed caries progression, 29% overweight progression, and 10% progression of both diseases. The strongest predictors of progression were disease presence, household-based characteristics, and sugary drinks. Children with caries and overweight progression shared multiple child- and household-based features.

CONCLUSION

Individually, caries and overweight were not associated. Children with progression of both conditions shared a profile and multiple risk characteristics suggesting these findings could be useful in assessing the risk for the most extreme cases of caries and overweight.

Antibacterial Activities of Ag/Cellulose Nanocomposites Derived from Marine Environment Algae against Bacterial Tooth Decay

Dental caries is an infectious oral disease caused by the presence of different bacteria in biofilms. Multidrug resistance (MDR) is a major challenge of dental caries treatment. Swabs were taken from 65 patients with dental caries in Makkah, Saudi Arabia. Swabs were cultivated on mitis salivarius agar and de Man, Rogosa, and Sharpe (MRS) agar. VITEK 2 was used for the identification of isolated bacteria. Antibiotic susceptibility testing of the isolated bacteria was performed using commercial antibiotic disks. Ulva lactuca was used as a reducing agent and cellulose source to create nanocellulose and Ag/cellulose nanocomposites. Fourier-transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction spectroscopy (XRD) were used to characterize nanocellulose and Ag/cellulose nanocomposites. The results showed that most bacterial isolates were Streptococcus spp., followed by Staphylococcus spp. on mitis salivarius media. Lactobacillus spp. and Corynebacterium group f-1 were the bacterial isolates on de Man, Rogosa, and Sharpe (MRS) media. The antibiotic susceptibility test revealed resistance rates of 77%, 93%, 0, 83%, 79%, and 79% against penicillin G, Augmentin, metronidazole, ampicillin, ciprofloxacin, and cotrimoxazole, respectively. Ag/cellulose nanocomposites and Ag/cellulose nanocomposites with fluoride were the most effective antibacterial agents. The aim of this work was to assess the antibacterial activity of Ag/cellulose nanocomposites with and without fluoride against bacteria isolated from the oral cavities of patients with dental caries. This study demonstrated that Ag/cellulose nanocomposites have antibacterial properties against multidrug-resistant bacteria that cause dental caries.

Systemic and Oral Health Parameters in Eutrophic and Overweight/Obese Adolescents: A Cross-Sectional Study

To date, studies focusing on oral health in obese adolescents have provided controversial data. The aim of this cross-sectional study was to investigate systemic and oral health parameters in eutrophic and overweight/obese adolescents. In total, 100 adolescents, mean aged 13.33 ± 2.04 years, were divided into two groups: 59 overweight/obese adolescents in the study group (SG) and 41 eutrophic-weight adolescents in the control group (CG). Chi-squared and Fisher exact tests were performed to compare dichotomous and categorical variables between the two groups. The subjects in the SG (mean aged 13.21 ± 2.21) reported a body mass index (BMI) of 29.05 ± 4.09 kg/m², corresponding to over 95° percentile for both genders, and the subjects in the CG (mean aged 13.49 ± 1.77) reported a BMI of 18.26 ± 4.81 kg/m², corresponding to 25° percentile for both genders. In the SG, the serum level of 25-hydroxy-vitamin D was significantly lower (p-value < 0.001), whereas fasting blood glucose (p = 0.006), waist circumference, and hip circumference were significantly higher (p-value < 0.001). Plaque Index (PI), Plaque Control Record (PCR), Oral Hygiene Index (OHI), Gingival Index (GI), and Gingival bleeding index (GBI) depicted a significantly worse level of oral health in the SG. Moreover, the number of subjects with caries was significantly higher in the SG. Nutritional and physical activity status according to the Mediterranean Diet Quality Index for children and teenagers (KIDMED test) and the International Physical Activity Questionnaire (IPAQ-Adolescent) were reported to be significanlty better in the CG. In light of our results, obesity and poor oral health coexist in a cohort of adolescents. A screening of oral health status should be considered in obese subjects to focus resources on therapeutic interventions aiming at improving oral health.

Association between obesity and dental caries among adolescents in UAE: a pilot cross sectional study

Background

Obesity and dental caries among adolescents is a growing worldwide public health issue. They share some common and modifiable influences. The objective of this study was to evaluate the association between obesity and dental caries among adolescents in the United Arab Emirates (UAE).

Methods

This pilot cross-sectional study enrolled 161 adolescents 13-19 years old from private and public schools in the UAE. Participants were classified as normal weight, underweight, overweight or obese. Dental caries was diagnosed according to the criteria recommended by the World Health Organization (WHO). Independent t-tests were used to compare average number of decayed, missing and filled surfaces (DMFS) by age, sex, school type, mothers' employment, BMI categories, waist circumference, oral health habits and plaque index. Additionally, a multiple linear regression model was applied to analyze the association between BMI, waist circumference and dental caries, adjusted for confounding factors considered in this study.

Results

The average age of the participants was 16.2 ± 1.4 years old. The prevalence of overweight/obesity was 42% (N = 68) measured by BMI. In addition, 82% (N = 132) had average waist circumference and 18% (N = 29) with above average waist circumference. Overall, the average DMFS score was 4.35 ± 4.5, with significantly lower dental caries rates among girls ([3.3 (SD:4.0)] than boys (6.7 (SD:5.3), (p < 0.05). The linear regression model revealed that, being a male, attending a public school and having average waist circumference were all positively and significantly associated with dental caries (p < 0.05).

Conclusion

Obesity measured by waist circumference was significantly associated with dental caries among adolescents in the UAE. Further research is required to investigate the complex association between obesity and dental caries and how dietary habits, oral hygiene habits, and parental socioeconomic status mediate the association between obesity and dental caries.

Antibacterial Activity of Ulva/Nanocellulose and Ulva/Ag/Cellulose Nanocomposites and Both Blended with Fluoride against Bacteria Causing Dental Decay

One of the most prevalent chronic infectious disorders is tooth decay. Acids produced when plaque bacteria break down sugar in the mouth cause tooth decay. Streptococcus mutans and Lactobacillus acidophilus are the most prominent species related to dental caries. Innovative biocidal agents that integrate with a biomaterial to prevent bacterial colonization have shown remarkable promise as a result of the rapid advancement of nanoscience and nanotechnology. In this study, Ulva lactuca was used as a cellulose source and reducing agent to synthesize nanocellulose and Ulva/Ag/cellulose/nanocomposites. The characterizations of nanocellulose and Ulva/Ag/cellulose/nanocomposites were tested for FT-IR, TEM, SEM, EDS, XRD, and zeta potential. Ulva/Ag/cellulose/nanocomposites and Ulva/nanocellulose, both blended with fluoride, were tested as an antibacterial against S. mutans ATCC 25175 and L. acidophilus CH-2. The results of the SEM proved that nanocellulose is filament-shaped, and FT-IR proved that the functional groups of Ulva/nanocellulose and Ulva/Ag/cellulose/nanocomposites and cellulose are relatively similar but present some small diffusion in peaks. The TEM image demonstrated that the more piratical size distribution of Ulva/Ag/cellulose/nanocomposites ranged from 15 to 20 nm, and Ulva/nanocellulose ranged from 10 to 15 nm. Ulva/Ag/cellulose/nanocomposites have higher negativity than Ulva/nanocellulose. Ulva/Ag/cellulose/nanocomposites and Ulva/nanocellulose possess antibacterial activity against S. mutans ATCC 25175 and L. acidophilus CH-2, but Ulva/Ag/cellulose/nanocomposites are more effective, followed by that blended with fluoride. It is possible to use Ulva/Ag/cellulose/nanocomposites as an antimicrobial agent when added to toothpaste. It is promising to discover an economic and safe nanocomposite product from a natural source with an antimicrobial agent that might be used against tooth bacteria.

Effects of Parental Migration on Dental Caries of Six- to Eight-Year-Old Children Using Structural Equation Modeling

This cross-sectional study aimed to document the relationship between dental caries, oral health behaviors, and the duration of parental migration in rural Yunnan, China, from September to December 2020. Seven rural primary schools with high parental migration were studied. The oral health status of 500 six- to eight-year-old students was assessed using clinical examination and caregivers' interviews. A total of 51.8% of the children had at least one parent absent for at least 6 months (left-behind children). Among those children with parental migration <6 months, 40.0% consumed sugar twice or more daily and 82.8% of those with parental migration from 6 to 12 months brushed once a day or less. The percentage of daily sugar consumption twice or more and brushing once or less among those without parental migration were 36.0% and 68.6%. Prevalence of caries in permanent teeth (DMFT) in children without parental migration and those whose parental migration <6 months, 6 to <12 months, and ≤12 months were 30.9%, 20.0%, 28.7% and 19.8%, respectively. Out of several other causal pathways between parental migration and dental caries, our structural equation model delineated that sugar consumption is the important mediator variable. Special education programs may be needed to educate caregivers on sugar consumption for the left-behind children in rural areas.

The Influence of Parenting Styles on Eating Behavior and Caries in Their Children: A Cross-Sectional Study

The type of parenting style influences the way children cope with problems and can create states of anxiety that can even alter their eating habits, which can cause problems in their oral health. The present study aimed to find out which parenting style is more favorable for the oral health of their children. In this cross-sectional study, 186 children (aged 8-15 years) were examined to assess the mean Decayed/Missing/Filled teeth (DMFT + dmft) index, and they were asked to complete the State-Trait Anxiety Inventory, the Parenting Style Scale, and questions about their oral hygiene habits. On the other hand, their parents answered the Parental Feeding Style Questionnaire and the Children's Eating Behavior Questionnaire. Results showed that a worse oral health status was associated with a higher state of anxiety, more overeating, more emotional eating, and higher psychological control. A higher rate of missing teeth was associated with increased undereating and overeating. Emotional eating was positively related to psychological control. State of anxiety, overeating, and parental psychological control predicted 24.6% of DMFT + dmft. In addition, emotional eating had a moderating effect in DMFT + dfmt only in those with low levels of affection and communication. In conclusion, high psychological control and low levels of parental affection and communication will increase the state of anxiety in children, influencing their caries rate.

Socio-Economic Determinants of Dental Service Expenditure: Findings from a French National Survey

(1) Background: This study investigated how individual enabling resources influence (i) their probability of using dental services and (ii) consumers’ expenditure on dental treatment. (2) Methods: Data were derived from a self-administered national health survey questionnaire and from expenditure data from national health insurance. Multiple linear regression methods were used to analyze entry into the dental health system (yes/no) and, independently, the individual expenditure of dental care users. (3) Results: People with the highest incomes were more likely to use dental service (aOR = 1.59; 95% CI = 1.28, 1.97), as were those with complementary health insurance and the lowest deprivation scores. For people using dental services, good dental health status was associated with less expenditure (−70.81 EUR; 95% CI = −116.53, −25.08). For dental service users, the highest deprivation score was associated with EUR +43.61 dental expenditure (95% CI = −0.15; 87.39). (4) Conclusion: Socioeconomic determinants that were especially important for entry into the dental health service system were relatively insignificant for ongoing service utilization. These results are consistent with our hypothesis of a dental care utilization process in two steps. Public policies in countries with private fees for dentistry should improve the clarity of dental fees and insurance payments.