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Table 4 No Association between dental caries and BMI

From: Body mass index and dental caries in children and adolescents: a systematic review of literature published 2004 to 2011

Authors Country Design N Age Sampling Dental rating HDI* Dental measure Significant cariogenic risk factors Sample demographics
Cereceda et al. (2010) Chile CS 1190 ‘lower middle class’ sample 5-15 Stratified random sampling by gender and grade of eight primary schools from different districts of Santiago 3 at cavity level 44 COPD dmft No association between caries and BMI Caries prevalence: 79.5%.
 Caries prevalence by BMI:
 Underweight: 60%
 Normal weight: 80%
 Overweight: 78.1%
 Obese: 79.9%
BMI:
 Underweight: 1.2%
 Normal weight: 51.6%
 Overweight: 25%
 Obese: 22%
Cinar et al. (2011) Denmark CS 332 15 Eight Danish municipalities selected for the purpose of representing various geographical areas of the Denmark and various degrees of urbanisation 2- cavity level (for 76% of the sample)
3- cavity level (for the rest of the sample)
16 DMFT No direct association High loading on “health cluster” for BMI, DMFT, daily fruit consumption, and non smoking Caries prevalence = 62%
Mn DMFT: 2.03 (SD= 3.01)
BMI:
Mn BMI: 21.30 (SD= 3.62)
 Obese 16%
Cinar & Murtomaa (2011) Turkey CS 611
360 public school
254 private school
10-12 Two schools selected by cluster sampling from high- and low- socio-economic level suburbs 3 – cavity level 92 DMFS Attendance at public school associated with higher caries rates and lower rates of BMI DMFS, CPI and BMI shared the “health” cluster among both private and public school children Caries prevalence:
Public School: 91%
 Mn DMFS:4.44 (SD= 3.4)
Private School: 70%
 Mn DMFS: 2.64 (SD= 2.6)
BMI:
Public School
 Obese: 25%;
 Non-obese: 75%
Private School: 70%
 Obese: 40%;
 Non-obese: 60%
Cinar & Murtomaa (2008) Finland and Turkey CS 949
Finnish 338
Turkish 611
10 -12 Matched suburbs. Participating schools in Turkey selected through cluster sampling to represent socio-economic range of district. 1 Fin
3Turk – cavity level
22
92
DMFT No direct association found between BMI and DMFT Turkish children from public school had lower mean BMI but higher Mn DMFT than Turkish children in private school Turkish sample higher in BMI and dental caries than Finnish sample. FA found obesity and caries shared same cluster. Caries Prevalence:
 Finland: 33%
 Turkey: 84%
Mn DMFT:
 Finland: 0.71 (SD= 1.54)
 Turkey 2.93 (SD= 1.99)
BMI
 Finland: 20% obese
 Turkey: 28% obese
Turkish private vs public schools:
Caries prevalence:
 Public schools: 92%;
 Private: 73%
Obesity:
 Public schools: 39%
 Private: 22%
de Carvalho Sales-Peres et al. (2010) Brazil CS 207 12 From eight schools (public and private) in the Midwest region of São Paulo 3 – cavity level 84 DMFT index No association between caries and BMI Higher dental caries was associated with lower socioeconomic status Caries prevalence:
 Private school: 11.9%
 Public school: 60.8%
Mn Dmft:
 Private schools: 0.23
 Public schools: 2.16
BMI:
 Private schools:
 Low weight: 35.59%
 Normal weight: 55.93%
 Overweight: 8.47%
 Obese: 0%
Public schools:
 Low weight: 41.22%
 Normal weight: 52,03%
 Overweight: 4.73%
 Obese: 2.03%
D’mello et al. (2011) New Zealand CS 200 sample of convenience 3-8 High caries of high anxiety patient in the paediatric dentistry clinics at the University of Otago School of Dentistry 2 5 Dmft (number of deciduous decayed, missing and restored teeth) No association between BMI and caries Caries:
 Mn Dmft = 6.1 ( SD =3.7)
 Obese: 24% had dmft ≥8;
 Overweight: 37.5% had
 dmft≥8
 35.4% had dmft ≥8
BMI:
 Obese: 17% (8.5%)
 Overweight: 23% (11.5%)
 Mn BMI = 16.0% (2.0)
Dye et al. (2004) USA CS 4236 2-5 NHANES III (1988-1994) 2 4 Dfs
Dichotomous: dfs=/>0 Continuous 0, 1-2, 3-5, >6 surfaces untreated
No association between BMI and caries Higher Caries associated with: Low parental education achievement, Ethnicity (greater caries experience in Mexican-Americans than non-Hispanics) Poverty status (=/< 200% of the federal poverty level) Not receiving breastmilk Not eating breakfast daily Eating < 5 servings fruit & veg Not having dental visit within 12 months, Age Caries Prevalence :
 2 yrs: 7.7%
 3 yrs: 15.5%
 4 yrs: 29.6%
 5 yrs: 40.2%
BMI:
 Obese: 23%
 Overweight: 26.4%
 Normal & Underweight: 23.5%
Frisbee et al. (2010) USA CS 128 3-18 5 counties in West Virginia 5 4 Parent report – Now or ever had a cavity, filling, tooth pulled and overall dental health No association between BMI and caries Caries prevalence:
 Now or ever had a cavity:  61%
 Now or even had a  filling,: 56%
 Now or even had a tooth  pulled: 36%
Overall all dental health:
 Excellent to very good: 55%;
 Poor to good: 45%
BMI:
 Overweight or obese 56%
Granville-Garcia et al. (2008) Brazil CS 2651 1-5 84 private and public elementary schools in Recife (city) 3- cavity level 84 dmft No association between caries and BMI Significantly higher decayed in public school. Caries Prevalence 19%
 Public school: 26.4%
 Private school: 11.4%
dmft: ~ 1.12
BMI:
 Obese: Overall 9%
 Public school: 4.6%
 Private school: 13.6%
Jamelli et al. (2010) Brazil CS with nested case control 689 12 Public school in the municipality of Caruaru; low socio-economic 465 cases (DMFT >0); *182 controls (DMFT=0) *no details on matching criteria No details 84 DMFT No association between caries and BMICaries associated with having visited a clinician. Caries Prevalence: 71.8%
Mn DMFT = 2.9
BMI:
 Low weight: 5.5%
 Risk of overweight: 9.3%
 Overweigh/Obesity: 3.2%
Juarez-Lopez & Villa-Ramos (2010) Mexico CS 189 3-6 Convenience sample from Iztapalapa´s area of Mexico City. Information not provided 57 dmf-t; dmf-s No association between dental caries and weight category (normal, overweight and obese). Gender (female) Caries prevalence:
 Normal weight: 77%
 Overweight: 84%
 Obese: 79%
BMI:
 Normal weight:33%
 Overweight: 33%
 Obese: 33%
Jürgensen & Petersen (2009) Laos CS 621 12 Multistage random sampling to select 10 representative elementary schools 3 cavity level 138 Cavity level dmft/DMFT No association between dental caries and BMI Caries associated with semi-urbanisation, poor self-assessment of general health, often experiencing tooth ache in last 12 months, and several time being absent from school in last 12 months, higher economic status, gender (girls), impairment of quality of life (i.e., problems with eating, smiling and sleeping), dental visits in the last 12 months, acute dental visits, preference for intake of sweet drinks during school hours and low attitude level towards health Caries Prevalence: 56%
 DMFT = 1.8 (SE=.09)
 dmft = .4 (SE=.04)
BMI:
 Normal weight: 60%
 Overweight: 8%
 Underweight: 32%
Kopycka-Kedzierawski et al. (2008) a USA CS 10180 2-18 NHANES III (1988-1994) Nationally representative sample 2 4 DMFS and dfs dichotomised as either having caries experience or not Dfs and DFS in children aged 2-11 years were estimated Age 2-5 years: No association between dental caries and BMI Caries risk associated with: poverty and Mexican–American Ethnicity, cotinine levels Caries prevalence (%):
2-5yrs old; Primary Caries
 Overall:23.8 (1.4)
 Overweight= 23 (3.6)
 At risk = 26.4 (3)
 Normal weight= 23.5-(1.4)
6-11yrs old; Primary Caries
 Overall: 49.5 (1.6)
 Overweight= 40.6 (4.7)
 At risk = 45.5 (4.6)
 Normal weight= 51.4 (1.6)
6-11yrs old; Permanent Caries
 Overall: 25.9 (1.7)
 Overweight= 17.6 (2.9)
 At risk = 29.9 (4.0)
 Normal weight= 26.5 (1.7)
12-18yrs; Permanent Caries
 Overall: 66.3 (1.0)
 Overweight= 57.7 (4.6)
 At risk =67.8 (4.7)
 Normal weight= 67.2 (2.2)
b USA CS 7568 2-18 NHANES 1999-2002 Nationally representative sample 2 4 DMFS and dfs dichotomised as either having caries experience or not
Dfs and DFS in children aged 2-11 years were estimated
No association between dental caries and BMI at any age group Age 2-5 years: Caries risk associated with: Mexican–American ethnicity, poverty, time since the last dental visit and blood lead levels above median associated with increased risk 6–11 years of age: Caries risk associated with: Mexican–American ethnicity, time since the last dental visit, poverty and serum cotinine levels 12–18 years of age: Caries risk associated with: Mexican– American ethnicity, time since the last dental visit, poverty and serum cotinine levels Caries prevalence (%):
2-5yrs old: Primary Caries
 Overall: 28.2 (1.8)
 Overweight= 35.7 (5.8)
 At risk = 24.3 (5.4)
 Normal weight= 27.7 (1.8)
6-11yrs old; Primary Caries
 Overall: 49 (2.5)
 Overweight= 52.3 (3)
 At risk = 42.5 (4.1)
 Normal weight= 49.7 (2.9) 6-11yrs old; Permanent Caries
 Overall: 20.3 (1.4)
 Overweight= 23 (2.4)
 At risk = 23.1 (3.2)
 Normal weight= 19.1 (1.7)
12-18yrs; Permanent Caries
 Overall: 56.8 (1.1)
 Overweight= 56.6 (2.7)
 At risk =58.2 (2.9)
 Normal weight= 56.6 (1.2)
Macek & Mitola (2006) USA CS 7617 2-17 NHANES 1999-2002 Nationally representative sample 2 4 Prevalence DMFT /dmft>0 Severity geometric mean for DMFT and dmft No association between dental caries prevalence and weight categories Dental caries severity (geometric Mn DMFT) in permanent dentition associated with BMI: overweight children had lower geometric mean DMFT Caries prevalence (%):
2-5 yrs (primary dentition)
 Overall: 27.5 (1.7)
 Underweight: 18 (5.2)
 Overweight: 36.1 (6.4)
 At risk of overweight:  26.9 (5.0)
 Normal: 28.1 (.8)
6-17 yrs (permanentdentition)
 Overall: 37.8(1.2)
 Underweight: 31.7(6.3)
 Overweight: 38.8(1.7)
 At risk of overweight:  38.1 (2.3)  Normal: 37.8(1.4)
BMI:
 Underweight: 4%
 At risk o/weight: 15%
 Overweight: 15%
 Normal weight: 63%
Moreira et al. (2006) Brazil CS 3330 (1665 obese; 1665 normal-weight) 12-15 Random sampling from public and private schools in plba 3 cavity level 84 DMFT No association between dental caries and BMI Higher rates of dental caries associated in Public versus Private school, age ( 12 vs 15 yrs old) Caries Prevalence in:
Obese children: 30%
 Private Schools: 9.0%
 Public Schools: 50.9%
Normal weight: 31%
 Private Schools: 9.6%
 Public Schools: 52.4%
Mn DMFT in :
Obese children in  Private schools: 1.90
 Public schools: 4.27
Normal-weight children in  Private schools: 1.91
 Public schools: 4.25
Pinto et al. (2007) USA CS 135 sample of convenience: 81% African American M= 8.7( SD = 2.37) Initial visit at (urban) Pennsylvania Dental School 2 4 DS/ds No association between ds/Ds and BMI or between ds/Ds and gender or ethnicity Age significantly associated with Ds/ds Mn Ds score 2.06 (CI 1.4-2.7)
BMI:
 Mn BMI 18.36 (3.5)
 At risk overweight: 12%  Overweight: 15%
Sadeghi et al. (2011) Iran CS 747 12-15 Twelve state and private secondary schools 3- cavity level 88 DMFT No association between DMFT and BMI Males had higher DMFT than females Caries prevalence: 83.9%
Mn DMFT=2.83 (2.2)
 Underweight: 2.91 (2.2)
 Normal weight: 2.92 (2.3)
 At risk for overweight:  2.54 (1.8)
 Overweight: 2.34 (1.9)
BMI:
 Underweight: 7.5%
 Normal weight: 72.8%
 At risk for overweight: 13.8%
 Overweight: 5.9%
Scheutz et al. (2007) Tanzania L 1997, 1999 and 2003 218 ~6-14 Two primary schools (‘Affluent’ and ‘Poor’) in Dar es Salaam 3 cavity level 152 DMFS No association between DMFS and low BMI Caries:
DMFS at baseline:
 Cohort 1= 0.33;
 Cohort 2= 0.37;
 Cohort 3= 0.32
Sheller et al. (2009) USA Retrospective case study 293 children with severe early childhood caries 2-5 Thirty different state, low income population 1 4 dmft Number teeth with Pulp involvement No association between dmft and BMI Other factors associated with higher dmft/pulp involvement were Age (older) and ethnicity (Asian and ‘not reported’) Caries Prevalence: 100%
Mn dmft: =11.8
 Underweight: 11.6 (1.5)
 Normal weight: 11.9 (.5)
 At risk for overweight:  11.1 (1.4)
 Overweight: 12.2 (1.4)
Mn pulp involved teeth  = 4.1
 Underweight: 4.5 (1.5)
 Normal weight: 4.0 (.5)
 At risk for overweight:  4.0 (1.5)
 Overweight: 3.9 (1.0)
BMI:
 Underweight: 12%
 Normal weight: 69%
 At risk for overweight: 9%
 Overweight: 11%
Tramini et al. (2009)1 France CS 835 12 Randomly selected from Montpellier schools 3 caries in to dentine 20 DMFT No association between DMFT and BMI Dental caries associated with higher sugar consumption, soft drink consumption and gender Caries prevalence: 51.7%
 Underweight= 40%
 Normal weight = 51.7%
 Overweight= 50.5%
 Obese= 62.5%
Mn DMFT: 1.47
 Underweight= 0.73
 Normal weight = 1.47
 Overweight= 1.58
 Obese= 1.66
Mn BMI = 18.9
Tripathi et al. (2010) India CS 2688 6-17 Selected from a private and two governments schools in Bareilly 3 cavity level 134 DMFT No association between DMFT caries and weight category. Caries prevalence = 19.1%
 Private schools= 27.6%
 Government schools = 9.6%
BMI: Obese: 4.7%
 Private schools:
 Obese 7.5%;
 Non-obese 92.6%
Government schools:
 Obese 1.57%;
 Non-obese 98.4%
Van Gemert-Schriks et al. (2011) Suriname CS 380 6 Seventeen schools from 2 different regions of the Rainforst, selected from the databases of the Medical Mission 3 104 Total caries experience (dmfs) Total-ds Dichotomised dentogenic infections >0/=0 No association between dmfs and BMI Higher rates of caries associated with reduced height suggesting caries is impacting on normal growth and development. Caries:
 M total-ds: 14.0 (+/- 10.1)
  1. 1Authors found a negative association using a logistic and Poisson regression models but report no association after undertaking a zero-inflated and zero-inflated negative binomial regression models.
  2. HDI* = Human Development Index.