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      Association between Dental Caries and Obesity in Children and Young People: A Narrative Review

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          To explore the association between obesity and dental caries in children and adolescents. Furthermore, to consider the possible reasons behind this relationship.


          A database search for papers published between January 2015 and May 2018, inclusive, addressing the association between obesity and dental caries was conducted. A review and critical appraisal of all included studies was performed.


          Twenty-six studies were included in this review from different populations worldwide. Eight studies assessed the primary dentition, nine studies were conducted on permanent dentition, and remaining nine studies on both dentitions. The results regarding the association between obesity and dental caries were conflicting and inconsistent. Nine studies concluded that there was no relationship between obesity and dental caries. A positive association was reported in five studies, while the inverse association was reported in eleven studies. Studies included in this review had significant variations in methodology and the investigated cofactors. Possible explanations of the controversial association between obesity and dental caries are discussed in this review.


          Both obesity and dental caries are multifactorial diseases, and their association is far more complex that can be explained by a single common risk factor, presenting evidence for the complexity of this association.

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          Waist circumference and not body mass index explains obesity-related health risk.

          The addition of waist circumference (WC) to body mass index (BMI; in kg/m(2)) predicts a greater variance in health risk than does BMI alone; however, whether the reverse is true is not known. We evaluated whether BMI adds to the predictive power of WC in assessing obesity-related comorbidity. Subjects were 14 924 adult participants in the third National Health and Nutrition Examination Survey, grouped into categories of BMI and WC in accordance with the National Institutes of Health cutoffs. Odds ratios for hypertension, dyslipidemia, and the metabolic syndrome were compared for overweight and class I obese BMI categories and the normal-weight category before and after adjustment for WC. BMI and WC were also included in the same regression model as continuous variables for prediction of the metabolic disorders. With few exceptions, overweight and obese subjects were more likely to have hypertension, dyslipidemia, and the metabolic syndrome than were normal-weight subjects. After adjustment for WC category (normal or high), the odds of comorbidity, although attenuated, remained higher in overweight and obese subjects than in normal-weight subjects. However, after adjustment for WC as a continuous variable, the likelihood of hypertension, dyslipidemia, and the metabolic syndrome was similar in all groups. When WC and BMI were used as continuous variables in the same regression model, WC alone was a significant predictor of comorbidity. WC, and not BMI, explains obesity-related health risk. Thus, for a given WC value, overweight and obese persons and normal-weight persons have comparable health risks. However, when WC is dichotomized as normal or high, BMI remains a significant predictor of health risk.
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            Obesity and dental caries in children: a systematic review and meta-analysis.

            Obesity and dental caries have become increasingly prevalent challenges to public health. Research results into the relationship between obesity and dental caries in children have been mixed and inconclusive. The aim of this review and meta-analysis was to provide evidence to quantify the relationship between obesity and dental caries in children using a systematic approach. A systematic search for papers between 1980 and 2010 addressing childhood obesity and dental caries was conducted and a random effects model meta-analysis applied. Fourteen papers met the selection criteria. Overall, a significant relationship between childhood obesity and dental caries (effect size = 0.104, P = 0.049) was found. When analysed by dentition type (primary versus permanent), there was a nonsignificant association of obesity and dental caries in permanent and primary dentitions, yet on accounting only for standardized definitions for assessment of child obesity using body mass index, a strong significant relationship was evident in children with permanent dentitions. Moderating for study country of origin (newly 'industrialized' versus industrialized) showed a significant relationship between obesity and dental caries in children from industrialized but not newly industrialized countries. Cofactors such as age and socioeconomic class were significant moderators. Future analysis should investigate these confounding variables, helping shape the future of obesity management programmes and oral health interventions, through determining common risk factors. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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              Dental caries and childhood obesity: roles of diet and socioeconomic status.

              Our objective was to determine (a) if caries and obesity were associated in a pediatric population and (b) if so, then to explore diet and socioeconomic status as additional risk factors. Subjects were recruited at birth and are members of the Iowa Fluoride Study. Data such as parental age, parental education levels and family incomes were obtained by questionnaire at recruitment. Children's primary dentition was examined and their weight and height measured at 4.5-6.9 years of age. Parental weight and height were measured when children were 7.6-10.9 years of age. Beverage and nutrient intake patterns were obtained from 3-day food and beverage diaries completed at 1, 2, 3, 4 and 5 years of age. Children with caries had lower family incomes, less educated parents, heavier mothers and higher soda-pop intakes at 2, 3 and for 1-5 years than children without caries (P < 0.05). 'Overweight' children had less educated fathers and heavier parents than 'normal' weight children (P < 0.05). Children 'at risk' of overweight had higher caries rates than 'normal' or 'overweight' children (P < 0.05). In stepwise logistic regression models to predict caries experience, soda-pop intakes were displaced by mother's education, leaving 'at risk' of overweight and mother's education in the final model. Caries and obesity coexist in children of low socioeconomic status. Public health measures to improve dietary education and access to appropriate foodstuffs could decrease the risk of both diseases.

                Author and article information

                Int J Dent
                Int J Dent
                International Journal of Dentistry
                2 May 2019
                : 2019
                1Department of Prosthodontics and Biomaterials, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
                2Division of Pediatric Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
                3Division of Pediatric Dentistry, Department of Dentistry, Ministry of Health, Riyadh, Saudi Arabia
                Author notes

                Guest Editor: Maha El Tantawi

                Copyright © 2019 Abdulmonem A. Alshihri et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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