Factors associated with a cariogenic diet among adolescents: a structural equation modeling approach

OBJECTIVE

To investigate the factors directly and indirectly associated with a cariogenic diet among southern Brazilian adolescents.

MATERIALS AND METHODS

This cross-sectional study included 15-19-year-old students attending high schools in Santa Maria, southern Brazil. The participants completed a questionnaire on sociodemographic and behavioral variables. The Oral Health Impact Profile-14 was applied to collect data on oral health-related quality of life (OHRQoL). Clinical examination was used to assess the dental caries status (decayed, missing, and filled teeth index). A cariogenic diet was considered a latent variable measured by the self-perception of a healthy diet and the frequency of consumption of sugary foods and drinks. Structural equation modeling was used to analyze the direct and indirect pathways to a cariogenic diet.

RESULTS

A total of 1197 adolescents were included. Low toothbrushing frequency (standardized coefficient (SC), 0.10; p < 0.05), cigarette smoking (SC, 0.15; p < 0.01), and alcoholic beverages (SC, 0.14; p < 0.01) were directly linked to a cariogenic diet, which, in turn, was directly linked to untreated dental caries (SC, 0.18; p < 0.01) and poor OHRQoL (SC, 0.16; p < 0.01). In addition, household income (via toothbrushing frequency) and age (via alcoholic beverages) were indirectly linked to a cariogenic diet.

CONCLUSION

A cariogenic diet was consistently associated with a range of unhealthy behaviors during adolescence as well as poor household income.

CLINICAL RELEVANCE

Health promotion strategies to restrict sugar consumption and encourage healthier lifestyles should be aware of the synergism observed among unhealthy behaviors during adolescence.

Risk factors associated with new caries lesions in permanent first molars in children: a 5-year historical cohort follow-up study

OBJECTIVE

The objective of this study is to analyze the factors associated with the occurrence of caries in the permanent teeth (PT) and in the permanent first molar (PFM) 5 years after their eruption.

MATERIAL AND METHODS

Children born in 2005 and enrolled in a community dental program were included. The inclusion criteria were: age 10 years in 2015; the availability of clinical dental history (CDH) data from before eruption of the PT and a follow-up period of 5 years after eruption of the PT. A total of 206 children were enrolled. Risk factors evaluated were: caries experience in the mother, educational level of the mother, frequent drug use, systemic diseases, eating habits, brushing frequency, presence of molar incisor hypomineralization (MIH) in PT, and caries in deciduous teeth (DT). Associations between explanatory factors and the DMF-T (decayed, missing, filled teeth in PT) and DMFT-M (DMF in PFM) indexes, independently considering cavitated or cavitated and non-cavitated caries as outcomes, were evaluated by poisson regression with robust variance analysis.

RESULTS

In the multivariate analysis, a cariogenic diet, especially soft drinks, was associated to high DMF-T and DMFT-M scores when both cavitated and non-cavitated caries were considered. A brushing frequency < 1 a day was significantly associated to high DMF-T scores. The presence of df-t (decayed and filled temporary teeth) score > 0 and MIH conditioned high DMF-T or DMFT-M values, considering cavitated or cavitated and non-cavitated caries.

CONCLUSIONS

The intake of sweets and soft drinks, brushing frequency, caries in DT, and MIH in PT were the best predictors of caries in PT.

CLINICAL RELEVANCE

Control of risk factors in early childhood is important for preventing caries in PT.