SOS Teeth: First Priority Teeth with Advanced Caries and Its Associations with Metabolic Syndrome among a National Representative Sample of Young and Middle-Aged Adults

Abstract

“SOS teeth” are defined as the first priority teeth for treatment, that have distinct cavitation reaching the pulp chamber or only root fragments are present. These are teeth with severe morbidity, that may require pulp capping, root canal treatment, or extraction, and therefore should be treated first. The study aims to explore whether or not a metabolic syndrome (MetS) is associated with SOS teeth. To that end, we performed across-sectional records-based study of a nationally representative sample of 132,529 military personnel aged 18–50 years, who attended the military dental clinics for one year. The mean number of SOS had no statistically significant association with: smoking (p = 0.858), alcohol consumption (p = 0.878), hypertension (p = 0.429), diabetes mellitus (p = 0.866), impaired glucose tolerance (p = 0.909), hyperlipidemia (p = 0.246), ischemic heart disease (p = 0.694), S/P myocardial infarction (p = 0.957), obstructive sleep apnea (p = 0.395), fatty liver (p = 0.074), S/P stroke (p = 0.589), and S/P transient ischemic attack (p = 0.095) and with parental history of: diabetes (p = 0.396)], cardiovascular disease (p = 0.360), stroke (p = 0.368), and sudden death (p = 0.063) as well as with any of the medical auxiliary examinations (p > 0.05). Cariogenic diet was positively associated with SOS teeth (p < 0.001). We conclude that SOS teeth had no statistically significant association with MetS components or with conditions that are consequences or associated with MetS. The only statistically significant parameter was a cariogenic diet, a well-known risk factor for caries and MetS.

Hypertension and Its Associations with Dental Status: Data from the Dental, Oral, Medical Epidemiological (DOME) Nationwide Records-Based Study

“…Moreover, while some studies support the association of hypertension with caries [ 14 , 15 ], other studies did not find a significant association between carious teeth and hypertension [ 16 , 17 ]. These conflicting results could be attributed to the limitations of the published studies, such as heterogeneity in the definitions of dental and systemic diseases and the presence of possible confounders that were not always considered.…”

“…The DOME is a cross-sectional records-based study that combines comprehensive socio-demographic, medical, and dental databases of a nationally representative sample of military personnel from the Israel Defense Forces (IDF) [ 24 ]. The methods of data collection of the DOME study were described in detail previously [ 17 , 24 , 25 , 26 ]. An unusual opportunity exists in Israel to study these associations using this comprehensive information collected in the military databases and captured in the DOME repository.…”

“…The military population in Israel is large and comprises a credible data source for epidemiological studies among young and middle-aged adults. This is partly since conscription exists in Israel for all Jewish, Druze, or Circassian citizens over the age of 18 [ 17 ]. Importantly, service in the IDF includes medically complex individuals, except for those who are unfit for service for health reasons (physical or mental), and even for those subjects, there is an option to apply for volunteering [ 27 , 28 ].…”

“…In our recent publications, we coined the term “SOS teeth” to represent teeth that need to be treated first due to advanced caries reaching the pulp or the presence of decayed root fragments [ 17 , 26 ]. Using the DOME database, we have previously shown that teeth with advanced caries termed “SOS teeth” had no statistically significant association with metabolic syndrome [ 17 ]. In this study, we focused on hypertension and further explored its association with dental treatment needs and actual dental treatments.…”

“…Nevertheless, we hypothesized that these associations and correlations may be explained by shared risk factors, and therefore will be lost after controlling for socio-demographics, common health-related habits, and other systemic morbidities. This hypothesis was based on our prior evidence when analyzing the associations between metabolic syndrome and periodontal disease, as well as SOS teeth [ 17 , 31 ].…”