Study Finds Adiposity Unrelated to Caries Rates in Children

In a recent study of 5,694 participants in the United States’ National Health and Nutrition Examination Survey from 2011 through 2018, researchers from Brazil and the United Kingdom investigated the relationship between caries in permanent teeth and adiposity in kids ages 8 through 19. Adiposity refers to body fat. Excess adiposity translates as obesity, and in this study, it was defined as a sex- and age-specific value at or above the 75th percentile according to the US reference standards for body fat percentage or fat mass index.¹

Body mass index, a traditional way of determining nutritional status among kids in studies of obesity and caries, was assessed via whole body dual-energy X-ray absorptiometry imaging. Decayed teeth and decayed, missing, and filled teeth indexes; prevalence of untreated dentin caries; and lifetime caries prevalence served as the caries measurements.¹

Caries is a disease stemming from many factors. The researchers, however, found no association between measures of adiposity and caries in the study group, despite their shared risk factors.

COMORBIDITIES

Because caries and obesity share risk factors, they can be regarded as comorbidities, and many believe they should be treated jointly. For instance, a position statement from the British Society of Paediatric Dentistry (BSPD) declares that dental caries and obesity must be tackled together.²

A recent analysis from Public Health England indicates that children, whether underweight, overweight, or very overweight, are more likely to experience caries compared to kids at a healthy weight. Many of these kids come from disadvantaged communities and also have nutritional deficits. In addition, new studies show that sugar consumption is up among children and adolescents — as high as three times the recommended levels.²

In response to such findings, the BSPD is advocating for clearer food labeling as well as lower sugar content in food and drinks likely to be consumed by children. It is also pushing for coordinated multiagency approaches to both obesity and caries management.

NOT CLEAR CUT

Not all research, however, focuses on socioeconomic factors and diet as the only factors linking obesity and dental caries. Indeed, a Korean literature review of 29 studies on the relationship between obesity and dental caries in children and adolescents found inconsistencies in the significance of the relationship.³

When investigating the obesity-caries link, the Korean researchers conclude that all risk factors must be reviewed for an accurate analysis. Instead of just assessing diet and sugar consumption, salivary flow rate, chronic disease, smoking, brushing technique, oral care, and drug therapy should all be seen as factors that might have significant bearing on the relationship between obesity and caries.

While the evidence does not show a cause-and-effect relationship between obesity and caries, it is clear that addressing common risk factors, such as poor nutrition and sugar intake, can positively effect both. And because caries is a multifactorial disease, oral health maintenance is especially important. With children, this starts at home, with a good, consistent oral hygiene regimen.

REFERENCES

1. Piovesan ET, Leal SC, Bernabe E. Adiposity is not associated with caries among youth in the United States. J Am Dent Assoc. 2023;154:991–999.
2. Dental caries and obesity must be tackled together. Br Dent J. 2020;229:768.
3. Hwang SJ, Kim H, Seo MS. Relationship between obesity and dental caries in some university students: a pilot study. Journal of Dental Hygiene Science. 2021;21:127–132.