Oral Health, Obesity Status and Nutritional Habits in Turkish Children and Adolescents: An Epidemiological Study

The effects of socioeconomic status, oral and dental health practices, and nutritional status on dental health in 12-year-old school children

Background

This study aims to examine the effects of socioeconomic status, oral, and dental health practices, dietary habits and anthropometric measurements on dental health in 12-year-old schoolchildren.

Methods

The sample of the study consisted of a total of 254 children (44.1% boys and 55.9% girls) in three schools which were identified as low, moderate and high socioeconomic status. The data were collected by face-to-face interviews via a questionnaire form. Dentist determined DMFT and dmft indices of the children. SPSS (Statistical Package for the Social Sciences) package program was used to analyze the data.

Results

It was found that 70.9% of the children have dental caries on their permanent teeth. The number of girls with caries in permanent teeth and boys with caries in milk teeth was higher (p < 0.05). The frequency of seeing a dentist and changing toothbrush vary according to the socioeconomic status (p < 0.05). Oral and dental health indicators were determined to be affected by the frequency and duration of tooth brushing (p < 0.05). It was found that dmft values of the children consuming molasses and table sugar are lower (p < 0.05). There is a negative correlation between oral and dental health indicators and anthropometric measurements.

Conclusion

Dietary habits, anthropometric measurements, oral and dental health practices, gender, and socioeconomic status were shown to be effective on caries. Caries risk assessment and determining leading risk factors enable effective prevention programs to be implemented at different levels.

Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey

BACKGROUND

Dental caries in preschool children is prevalent worldwide, but data regarding its magnitude and associated factors were not available for preschool children in Zhejiang Province, China. This study examines the dental caries situation and its associated factors in Zhejiang Province.

METHODS

A total of 1591 children aged 3-5 years and their parents or caregivers were enrolled in this study. The condition of their teeth was assessed by three dental technicians qualified to WHO 2013 criteria. A structured questionnaire was completed by the children's parents or caregivers. A logistic regression analysis was used to analyze the risk factors that may be associated with dental caries occurring among preschool children.

RESULTS

Caries prevalence (dmft> 0) of 3-5 year old children in Zhejiang Province was 70.4%. The mean decayed, missing and filled teeth (dmft) scores of the 3, 4 or 5 year old children surveyed were 2.96 ± 4.07, 4.42 ± 4.66, and 5.75 ± 5.19 respectively. The negative binomial regression model found that higher dental caries prevalence was found in children as age increased, with lower body mass index (BMI), with longer breastfeeding duration and with fewer hours of sleep.

CONCLUSIONS

The dental caries prevalence and dmft score of 3-5-year-old children in Zhejiang Province was high, and it was associated with age, BMI, breastfeeding duration and hours slept.

Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review

BACKGROUND

Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17 years) and young adults (18-34 years).

METHODS

A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies.

RESULTS

Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis.

CONCLUSION

There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507.

Association between dental hygiene, gingivitis and overweight or the risk of overweight in primary teeth of 4- and 5-year-old preschoolers in México

OBJECTIVE

To determine the association between dental hygiene, gingivitis and overweight or the risk of overweight according to body mass index (BMI).

METHODS

A cross-sectional study was performed with 1527 preschoolers. The children were divided into 4 groups: (i) absence of visible plaque and normal weight; (ii) absence of visible plaque and risk of overweight or overweight; (iii) presence of visible plaque and normal weight; and (iv) presence of visible plaque and risk of overweight or overweight. The clinical parameters evaluated were as follows: body mass index, degree of urban marginalization, dental caries, the simplified oral hygiene index and gingival status. Bivariate analysis and multivariate binary logistic regression models were used to identify associations between variables.

RESULTS

The highest mean of gingivitis (0.28) was observed in the groups with visible plaque with normal weight and with overweight and risk of overweight. The presence of visible plaque and risk of overweight or overweight were positively associated (P = .0001) with the mean of gingivitis (OR = 8.28, 95% CI = 3.30-19.8). The absence of visible plaque and risk of overweight or overweight (P = .0001) were also positively associated with the presence of gingivitis (OR = 2.44, 95% CI = 0.68-8.06). This is after both models were adjusted by gender and degree of marginalization.

CONCLUSIONS

The professionals should develop interdisciplinary approaches to (i) propose appropriate interventions to improve oral health in overweight preschoolers; and (ii) propose interventions to decrease the overweight with the possibility of also reducing its association with gingivitis.

A Meta-Analysis and an Evaluation of Trends in Obesity Prevalence among Children and Adolescents in Turkey: 1990 through 2015

OBJECTIVE

Obesity in childhood and adolescence is one of the most serious public health problems due to a remarkable increase in prevalence in recent years and its close relationship with non-communicable diseases, such as diabetes and hypertension, resulting in increased adult morbidity and mortality. This study aims to quantify the secular trend in different regions of Turkey from 1990 to 2015 by performing a meta-analysis of childhood and adolescent obesity prevalence studies conducted.

METHODS

Uludag University Library Database was searched for relevant articles published prior to March 2017. The heterogeneity of the studies in the meta-analysis was tested by the I2 statistic and Cochran's Q test. The obesity trend analyses were examined by chi-square trend analysis with respect to five year periods. The statistical significance level was taken as α=0.05.

RESULTS

A total of 76 papers were initially identified addressing childhood and adolescent obesity in Turkey. Fifty-eight papers were selected for analysis. The prevalence of obesity increased from 0.6% to 7.3% with an 11.6-fold increase between the periods 1990-1995 to 2011-2015. The prevalence of obesity increased in both genders. However, boys were more likely to be obese than girls.

CONCLUSION

Studies on obesity prevalence in the 5-19 age group in Turkey have gained importance, especially in the 2000s. While a remarkable number of prevalence studies, mostly regional, have been conducted between 2005-2011, a gradual decline was observed thereafter. Further national and population-based surveys on prevalence of obesity in children and adolescents are definitely needed in Turkey.

Added Sugar Consumption and Chronic Oral Disease Burden among Adolescents in Brazil

Chronic oral diseases are rarely studied together, especially with an emphasis on their common risk factors. This study examined the association of added sugar consumption on "chronic oral disease burden" among adolescents, with consideration of obesity and systemic inflammation pathways through structural equation modeling. A cross-sectional study was conducted of a complex random sample of adolescent students enrolled at public schools in São Luís, Brazil ( n = 405). The outcome was chronic oral disease burden, a latent variable based on the presence of probing depth ≥4 mm, bleeding on probing, caries, and clinical consequences of untreated caries. The following hypotheses were tested: 1) caries and periodontal diseases among adolescents are correlated with each other; 2) added sugar consumption and obesity are associated with chronic oral disease burden; and 3) chronic oral disease burden is linked to systemic inflammation. Models were adjusted for socioeconomic status, added sugar consumption, oral hygiene behaviors, obesity, and serum levels of interleukin 6 (IL-6). All estimators of the latent variable chronic oral disease burden involved factor loadings ≥0.5 and P values <0.001, indicating good fit. Added sugar consumption (standardized coefficient [SC] = 0.212, P = 0.005), high IL-6 levels (SC = 0.130, P = 0.036), and low socioeconomic status (SC = -0.279, P = 0.001) were associated with increased chronic oral disease burden values. Obesity was associated with high IL-6 levels (SC = 0.232, P = 0.001). Visible plaque index was correlated with chronic oral disease burden (SC = 0.381, P < 0.001). Our finding that caries and periodontal diseases are associated with each other and with added sugar consumption, obesity, and systemic inflammation reinforces the guidance of the World Health Organization that any approach intended to prevent noncommunicable diseases should be directed toward common risk factors.

Common risk indicators for oral diseases and obesity in 12-year-olds: a South Pacific cross sectional study

BACKGROUND

Despite the increasing need to prevent obesity and oral diseases in adolescents worldwide, few studies have investigated the link existing between these conditions and their common risk factors. This study aims to evaluate the oral health and weight status of New Caledonian Children (aged 6,9,12 years) and to identify, amongst 12-year-olds, risk indicators that may characterize the groups of children affected by oral diseases, obesity or both diseases.

METHODS

This survey evaluated in 2011-2012 the oral health and stature-weight status and related risk indicators in a national representative sample of 6, 9 and 12 years-old children in New Caledonia. Dental status, chewing efficiency, height, weight and waist circumference were clinically recorded at school. The body mass index (BMI) and the waist to height ratio (WtHR) were calculated. For BMI the WHO Cut-offs were used. Twelve years-old participants responded to a questionnaire concerning socio-demographic and behavioural variables. For statistical analysis, the Clinical Oral and Global Health Index (COGHI) was developed and used. Twelve years-old children were categorised into four groups; Oral Diseases (ODG), Obesity (OG), Obesity and Oral Diseases (ODOG) and a Healthy Group (HG). A multivariate analysis was conducted using mixed-effects multinomial logistic regression models.

RESULTS

Prevalence of overweight and obesity was greatly increasing from 6 years (respectively 10.8% [8.8;13.3] and 7.8% [6.0;9.9]) to 12 years (respectively 22.2% [19.9;24.7] and 20.5% [18.2;22.9]) and one third of the 12-yr-olds had an excess of abdominal adiposity. At age 12, 36.6% of the children were healthy (HG), 27.3% had oral diseases (ODG), 19.7% were obese (OG) and 16.5% had both conditions (ODOG). Geographical location, ethnicity, tooth-brushing frequency and masticatory disability were significant risk factors for the OG, ODOG and ODG groups. Ethnicity and masticatory impairment were common risk indicators for the association of oral diseases and obesity.

CONCLUSIONS

In NC health promotion programs should be specifically addressed towards Native populations who are particularly exposed to oral diseases and obesity, integrating a multiple risk factors approach, in order to prevent the onset of chronic diseases in adulthood. The impact of masticatory ability on children's weight status is a major issue for future research.

Factors affecting oral health determinants in female university students: a cross-sectional survey in Saudi Arabia

Objective This study aims at investigating factors affecting oral health patterns, attitudes and health risk behaviors among female university students. Methods An online questionnaire was distributed to female university students in Al Madinah in the western region of Saudi Arabia. Students were requested to answer questions on demographic data, oral hygiene practices, dental attendance, smoking history, practice of sports and body weight and height. Results Two hundred and fourteen students participated with age range of 18-31 years (mean = 21.64 ± 1.72 years). Oral hygiene habits were reported by a percentage of 97.2%, 34.6%, 30.8% and 19.2% who used a tooth brush, dental floss, mouthwash, and a miswak (a teeth cleaning twig made from the Salvadora persica tree), respectively. The only factor that was significantly associated with a good oral hygiene level was a university major of non-healthcare specialties (p = 0.009). Conclusion It is concluded that female university students use various oral hygiene methods, however, dental attendance is poor and a number of health risk factors are noticed like smoking, lack of practicing sport and unhealthy body mass index (BMI).

Childhood overweight-obesity and periodontal diseases: is there a real correlation?

OBJECTIVE

The association between obesity and periodontitis has been extensively investigated in adults but not in young people. The aim of this study was to examine the association between overweight-obesity and periodontal disease in pediatric subjects.

METHODS

Controlled cross-sectional study involving 100 school children of both gender (50 M and 50 F) between 7 and 12 years of age (mean age 9,19±1,57). Two groups were formed based on Body Mass Index value: test group with BMI ≥ 25 Kg/m² and control group with BMI ≤ 24 Kg/m². Diet intake and oral hygiene habits were recorded by a specific questionnaire and the periodontal clinical parameters were evaluated.

RESULTS

The periodontal examination in the control group revealed a full-mouth plaque score (FMPS) value equal to 21.86% against 50.08% in the group of patients overweight/obese; the full-mouth bleeding score (FMBS) in the control group amounted to 12.7% against 26.24% of test group. No patient in either group included in the study presented a probing pocket depth (PPD) ≥3, so a significant difference regarding this value was not found. Regarding the frequency and quantity of food consumption, the number of obese patients who did not follow a balanced diet largely exceeded the number of normal-weight patients (70 versus 20%).

CONCLUSIONS

These results focus the attention on the negative impact of obesity on gingival health in young subjects, probably due to a combination of metabolic and inflammatory profiles and the result of a careless attitude towards prevention diseases of the oral cavity.