Pathways in the association between added sugar consumption, obesity in mother‐child dyads, and chronic oral disease burden in early childhood

Abstract

In this study, we modeled the pathways in the association of socioeconomic status, frequency of added sugar consumption, and obesity in mother-child dyads with chronic oral disease burden in early childhood using structural equation modeling.A population-based study was conducted on preschoolers from public daycare centers in São Luís, Brazil (n = 674) and their mothers. Chronic oral disease burden in early childhood was a latent variable, representing the shared variance of the following indicators: visible plaque index, gingivitis, and dental caries. A higher consumption frequency of added sugars by children [standardized regression coefficient (SC) = 0.219] explained the chronic oral disease burden. A higher consumption frequency of added sugars by mothers was associated with greater consumption of sugar by children (SC = 0.236), and indirectly with a greater chronic oral disease burden (SC = 0.052). Maternal obesity was associated with obesity in the offspring (SC = 0.130). The chronic oral disease burden is already present in early childhood and can be explained by the higher consumption of added sugars by the mother-child dyad. Approaches to preventing chronic oral diseases should focus on common risk factors, start early in life, and promote family involvement in this process.

Chronic oral diseases burden: The confluence of caries and periodontitis throughout life

“…The progression of caries lesions is higher during the first and second decades of life (Kassebaum et al, 2015) when the periodontal tissues experience early signs of breakdown (López et al, 2009). These findings corroborate previous results showing caries correlated with inflammatory periodontal indicators in children and the young (Araújo et al, 2022; Carmo et al, 2018), preceding periodontal destruction (Leite et al, 2017). Our observations in Brazilian and Chilean adolescents showed a higher correlation between caries, pulpal involvement, and PPD ≥4 mm (Carmo et al, 2018; Nascimento et al, 2018), suggesting the combined onset and progression of caries and periodontitis early in life.…”

“…This construct encompasses a multidimensional variable based on pocket depth ≥4 mm, bleeding on probing (BoP), DMFT index, and untreated caries (Carmo et al, 2018). A similar construct, comprising the indicators of biofilm, caries, and gingivitis, was also observed among 3-5-year-old Brazilian children, indicating that oral conditions cluster early in life (Araújo et al, 2022). Finally, among young adults, Leite et al (2017) identified the number of decayed teeth as a predictor of periodontitis (Leite et al, 2017); that was also the case for Chilean and Finnish adults (Mattila et al, 2010;Strauss et al, 2019).…”

“…Dental caries and periodontitis are among the most prevalent non‐communicable diseases worldwide (GBD, 2018), and their prevalence has remained stable over the past 30 years (Peres et al, 2019). Both diseases present pathophysiological continuums, that is, chain events from reversible to destructive across the life (Jepsen et al, 2017; Araújo et al, 2022; Featherstone, 2004), ultimately culminating in tooth loss (Kassebaum et al, 2014a). Caries and periodontitis have their aetiology linked to oral biofilm dysbiosis (Nyvad & Takahashi, 2020) and also to several common causes such as socio‐economic disadvantage, unhealthy diet, smoking, alcoholism, and obesity (Chapple et al, 2017; Costa et al, 2022).…”

Sugar intake above international recommendations and oral disease burden: A population‐based study

“…The Chronic Oral Disease Burden comprised a good construct, with indicators of caries and periodontal disease significantly correlated with each other. These data are consistent with our previous findings in children and adolescents, which supported the association between a high frequency of sugar consumption and a heavy burden of oral disease (Araújo et al, 2022; Carmo et al, 2018). In this study, we expanded the knowledge on this topic by using a six times larger sample to test the intake limits of added sugars according to international guidelines for future NCD prevention.…”

“…The common risk factors shared by caries and periodontitis prompted us to propose the Chronic Oral Disease Burden , an epidemiologic manifestation analyzed as a latent variable composed of indicators of both diseases (Araújo et al, 2022; Carmo et al, 2018). Using such an approach, we could identify that a high sugar consumption frequency was associated with oral disease burden even from early childhood (Araújo et al, 2022; Carmo et al, 2018). Despite the role of sugar, the effect of the consumption limits recommended by the WHO and the AHA was not assessed in caries and periodontal diseases.…”