The Relationship between Obesity and Childhood Dental Caries in the United States

Abstract

Background: Childhood obesity and dental caries are prevalent chronic, multifactorial conditions with adverse health consequences and considerable healthcare costs. The aims of this study were: (1) to evaluate the relationship between obesity and dental caries among young children using multiple definitions for both conditions, and (2) to evaluate the role of family socioeconomic status (SES) and the child’s intake of added sugars in explaining this association. Methods: Data from 2775 2–5-year-olds children from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 were analysed. Three different international standards were used to define obesity, namely the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the International Obesity Task Force (IOTF). Dental caries was measured during clinical examinations and summarised as counts (dt and dft scores) and prevalence (untreated caries [dt > 0] and caries experience [dft > 0]). The association of obesity with dental caries was assessed in regression models controlling for demographic factors, family SES and child’s intake of added sugars. Results: In crude models, obesity was associated with greater dt scores when using the IOTF standards (RR: 2.43, 95% CI: 1.11, 5.29) but not when using the WHO and CDC standards; obesity was associated with greater dft scores when using the WHO (1.57, 95%CI: 1.11–2.22), CDC (1.70, 95%CI: 1.17–2.46) and IOTF standards (2.43, 95%CI: 1.73–3.42); obesity was associated with lifetime caries prevalence when using the WHO (1.55, 95%CI: 1.05–2.29), CDC (1.73, 95%CI: 1.14–2.62) and IOTF standards (2.45, 95%CI: 1.61–3.71), but not with untreated caries prevalence. These associations were fully attenuated after controlling for demographic factors, family SES and child’s intake of added sugars. Conclusions: The relationship between obesity and dental caries in primary teeth varied based on the definition of obesity and dental caries used. Associations were observed when obesity was defined using the IOTF standards and dental caries was defined using lifetime indicators. Associations were fully attenuated after adjusting for well-known determinants of both conditions.

Association between dental caries and obesity among Libyan schoolchildren during the armed conflict in Benghazi

“…However, after controlling for common risk factors, this association became non-statistically significant when obesity was measured using BMI and changed in direction when BAZ was used as an obesity measure. Similar findings have been reported in a recent US study which concluded that the caries-obesity relationship is influenced by how they are measured and attenuated by common risk factors [ 14 ]. In addition, a negative association between dental caries and BAZ has been observed in studies conducted in Bangladesh [ 28 ] and Saudi Arabia [ 29 ].…”

“…Nevertheless, the current study supports the notion that obesity and caries risk are not directly related; instead, common risk factors drive the development of both conditions. Furthermore, these factors are influenced by wider social determinants [ 14 , 34 ].…”

“…The relationship between caries and obesity has received much attention in recent years. However, the evidence from several systematic is equivocal [ 7 – 13 ], which is partly attributed to inconsistencies in assessment and measurements of both conditions [ 10 , 14 ]. More importantly, the previous reviews highlighted the need to adjust the caries-obesity relationship for the social environment and sugar intake, which are well-known common risk factors for both caries and obesity [ 15 , 16 ].…”

Cross-Cultural Validity of a Dietary Questionnaire for Studying Dental Caries in Japanese Children

“…Other medical and health professionals could easily apply the scale to identify gradual changes in a person’s diet between specific time points in order to enlighten them on common risk factors for dental caries development. The scale could be used as a tool to improve the understanding of the relationship of the diet to oral-health and other conditions, such as obesity and overweight status [ 27 , 28 , 29 ].…”

Characterization of the oral and gut microbiome in children with obesity aged 3 to 5 years

“…Interestingly, Streptococcus mutans and Lactobacillus spp., the two primary caries-associated pathogens belonging to the phylum Firmicutes, are more abundant in the gut microbiota of children with obesity, suggesting that oral Firmicutes may reflect the gut condition of preschool-aged children with obesity ( Reis et al., 2022 ). However, other studies have suggested that the relationship between dental caries in primary teeth and obesity can vary based on the definitions of obesity and dental caries ( Piovesan et al., 2022 ).…”