The Association between Caries and Childhood Lead Exposure

Campbell, James R.; Moss, Mark E.; Raubertas, Richard F.

doi:10.2307/3434965

Cited by 13 publications

(21 citation statements)

References 20 publications

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“…In summary, our findings are consistent with those of several other recent studies (e.g., Campbell et al 2000;Moss et al 1999) in suggesting a weak association between children's lead exposure and caries in primary teeth. The association was region specific, however, suggesting that its magnitude depends on the local distributions of other, more important caries risk factors such as fluoride exposure, diet, and other aspects of social environment.…”

Section: Discussionsupporting

confidence: 83%

“…Second, in the urban subgroup, the blood lead level was associated with number of carious surfaces in primary but not in permanent teeth. This is consistent with the findings of Campbell et al (2000). Furthermore, the association was evident for several tooth surfaces: occlusal, lingual, and buccal tooth surfaces.…”

Section: Discussionsupporting

confidence: 81%

“…Furthermore, the association was evident for several tooth surfaces: occlusal, lingual, and buccal tooth surfaces. As noted by Campbell et al (2000), if the causal mechanism of lead's cariogenicity were a leadrelated decrease in salivary flow, as suggested by experimental studies in the rat (Watson et al 1997), buccal surfaces should be more affected than lingual surfaces. Thus, our data are not consistent with this hypothesized mechanism.…”

Section: Discussionmentioning

confidence: 99%

“…We evaluated a site × lnBPb term to determine whether the association differed significantly between the urban and rural subgroups. In multiple regression analyses, we adjusted for factors that previous studies (Campbell et al 2000;Moss et al 1999) had suggested are plausible confounders of an association between lead and caries, as well as for factors that tend to predict caries occurrence: age, sex (0 = female, 1 = male), family income (six categories, $10,000 increments beginning with ≤ $10,000), maternal education (less than high school, high school or high school graduate equivalence degree, greater than high school), maternal smoking (0 = no, 1 = yes), frequency of tooth brushing (less than once a day, once a day, more than once a day), use of medium/hard bristles (0 = no, 1 = yes), and gum chewing (never, occasionally, daily). In regressions performed on the urban subgroup, we also adjusted for selfidentified ethnicity (white, black, other/ mixed).…”

Section: Methodsmentioning

confidence: 99%

“…Among children (5-17 years old), an increase of 5 µg/dL in blood lead level was associated with nearly a doubling of the risk of dental caries, and the population-attributable risk associated with blood lead levels in the middle tertile of the distribution was nearly 10%. In a study of 248 school-age children, having a blood lead level greater than 10 µg/dL, measured between 18 and 37 months of age, was modestly associated with an increased risk of caries, but overall the data failed to support any of the hypotheses regarding possible mechanisms of lead cariogenicity (Campbell et al 2000). In the analyses reported by both Campbell et al (2000) and Moss et al (1999), adjustments were made for a variety of potentially confounding factors, including socioeconomic status, ethnicity, and geographic region.…”

mentioning

confidence: 97%

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Blood lead level and dental caries in school-age children.

Gemmel

Tavares

Alperin

et al. 2002

Environ Health Perspect

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The association between blood lead level and dental caries was evaluated in cross-sectional analyses of baseline data for 543 children 6-10 years old screened for enrollment in the Children's Amalgam Trial, a study designed to assess potential health effects of mercury in silver fillings. Approximately half of the children were recruited from an urban setting (Boston/Cambridge, MA, USA) and approximately half from a rural setting (Farmington, ME, USA). Mean blood lead level was significantly greater among the urban subgroup, as was the mean number of carious tooth surfaces. Blood lead level was positively associated with number of caries among urban children, even with adjustment for demographic and maternal factors and child dental practices. This association was stronger in primary than in permanent dentition and stronger for occlusal, lingual, and buccal tooth surfaces than for mesial or distal surfaces. In general, blood lead was not associated with caries in the rural subgroup. The difference between the strength of the associations in the urban and rural settings might reflect the presence of residual confounding in the former setting, the presence of greater variability in the latter setting in terms of important caries risk factors (e.g., fluoride exposure), or greater exposure misclassification in the rural setting. These findings add to the evidence supporting a weak association between children's lead exposure and caries prevalence. A biologic mechanism for lead cariogenicity has not been identified, however. Our data are also consistent with residual confounding by factors associated with both elevated lead exposure and dental caries.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 97%

See 3 more Smart Citations

Blood lead level and dental caries in school-age children.

Gemmel

Tavares

Alperin

et al. 2002

Environ Health Perspect

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Exposure to Metal Ions and Susceptibility to Dental Caries

Bowen

2001

Journal of Dental Education

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Results from several epidemiologic studies have shown that there are large differences in the prevalence of dental caries from one region to another within the United States as well as in other countries. It has been postulated that the observed differences may be attributed in part at least to exposure to trace elements such as selenium, vanadium, molybdenum, strontium, and lead. Although data from epidemiologic studies usually support this hypothesis, direct evidence is sparse with the possible exception of exposure to lead. Data from several epidemiologic studies and animal-based research support the concept that lead is a caries-promoting element. Lead mimics calcium in several respects and may affect development of teeth and salivary glands, clearly enhancing susceptibility to dental caries. Elevated blood levels are found most commonly in persons residing in inner cities, particularly among the poor. Many states require blood lead level to be monitored in young children. Where feasible, these records should form part of health history and be available to the treating dental practitioner to ensure that extra preventive procedures may be implemented. . The complete version of this paper can be viewed at http://www.nidcr.nih.gov/ news/consensus.asp.

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