Blood Lead Levels and Dental Caries in U.S. Children Who Do Not Drink Tap Water.
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ABSTRACT:
SUBMITTER: Sanders AE
PROVIDER: S-EPMC5783762 | biostudies-literature | 2018 Feb
REPOSITORIES: biostudies-literature
Publications
Blood Lead Levels and Dental Caries in U.S. Children Who Do Not Drink Tap Water.
Sanders Anne E AE Slade Gary D GD
American journal of preventive medicine 20171127 2
<h4>Introduction</h4>This study's purpose is to determine whether nonconsumption of tap water is associated with lower prevalence of elevated blood lead levels and higher prevalence of dental caries in children and adolescents.<h4>Methods</h4>Cross-sectional data from the National Health and Nutrition Examination Survey 2005-2014 recorded drinking water source (n=15,604) and blood lead levels (n=12,373) for participants aged 2-19 years, and dental caries experience for the 2011-2014 subset (n=5, ...[more]
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Project description:Fluoridation of America's drinking water was among the great public health achievements of the 20th century. Yet there is a paucity of studies from the past 3 decades investigating its dental health benefits in the U.S. POPULATION:This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention's Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race/ethnicity, rural-urban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with ?75% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with <75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.
| S-EPMC6169031 | biostudies-literature
Project description:Tap water provides a calorie-free, no-cost, environmentally friendly beverage option, yet only some youth drink it.To examine sociodemographic characteristics, weight status, and beverage intake of those aged 1-19 years who drink tap water.National Health and Nutrition Examination Survey data (2005-2010) were used to examine factors associated with tap water consumption. A comparison was made of beverage intake among tap water consumers and nonconsumers, by age, race/ethnicity, and income.Tap water consumption was more prevalent among school-aged children (OR=1.85, 95% CI=1.47, 2.33, for those aged 6-11 years; OR=1.85, 95% CI=1.32, 2.59, for those aged 12-19 years) as compared to those aged 1-2 years. Tap water intake was less prevalent among girls/women (OR=0.76, 95% CI=0.64, 0.89); Mexican Americans (OR=0.32, 95% CI=0.23, 0.45); non-Hispanic blacks (OR=0.48, 95% CI=0.34, 0.67); and others (OR=0.50, 95% CI=0.36, 0.68) as compared to whites; Spanish speakers (OR=0.72, 95% CI=0.55, 0.95); and among referents with a lower than Grade-9 education (OR=0.52, 95% CI=0.31, 0.88); Grade 9-11 education (OR=0.50, 95% CI=0.32, 0.77); and high school/General Educational Development test completion (OR=0.50, 95% CI=0.33, 0.76), as compared to college graduates. Tap water consumers drank more fluid (52.5 vs 48.0 ounces, p<0.01); more plain water (20.1 vs 15.2 ounces, p<0.01); and less juice (3.6 vs 5.2 ounces, p<0.01) than nonconsumers.One in six children/adolescents does not drink tap water, and this finding is more pronounced among minorities. Sociodemographic disparities in tap water consumption may contribute to disparities in health outcomes. Improvements in drinking water infrastructure and culturally relevant promotion may help to address these issues.
| S-EPMC4452285 | biostudies-literature
Project description:BackgroundDrinking water is recognized as a source of lead (Pb) exposure. However, questions remain about the impact of chronic exposure to lead-contaminated water on internal dose.ObjectiveOur goal was to estimate the relation between a cumulative water Pb exposure index (CWLEI) and blood Pb levels (BPb) in children 1-5 years of ages.MethodsBetween 10 September 2009 and 27 March 2010, individual characteristics and water consumption data were obtained from 298 children. Venous blood samples were collected (one per child) and a total of five 1-L samples of water per home were drawn from the kitchen tap. A second round of water collection was performed between 22 June 2011 and 6 September 2011 on a subsample of houses. Pb analyses used inductively coupled plasma mass spectroscopy. Multiple linear regressions were used to estimate the association between CWLEI and BPb.ResultsEach 1-unit increase in CWLEI multiplies the expected value of BPb by 1.10 (95% CI: 1.06, 1.15) after adjustment for confounders. Mean BPb was significantly higher in children in the upper third and fourth quartiles of CWLEI (0.7-1.9 and ≥ 1.9 μg/kg of body weight) compared with the first (< 0.2 μg/kg) after adjusting for confounders (19%; 95% CI: 0, 42% and 39%; 95% CI: 15, 67%, respectively). The trends analysis yielded a p-value < 0.0001 after adjusting for confounders suggesting a dose-response relationship between percentiles of CWLEI and BPb.ConclusionsIn children 1-5 years of age, BPb was significantly associated with water lead concentration with an increase starting at a cumulative lead exposure of ≥ 0.7 μg Pb/kg of body weight. In this age group, an increase of 1 μg/L in water lead would result in an increase of 35% of BPb after 150 days of exposure.
| S-EPMC4786982 | biostudies-literature
Project description:BACKGROUND:The increase in nitric oxide (NO) levels in the oral cavity and saliva have been associated with various oral diseases; however, the gastro-salivary interaction of NO remains controversial. Thus, the aim of this study was to determine and compare salivary NO levels of dyspeptic and non-dyspeptic healthy children and to conduct an evaluation of its association with dental caries. METHODS:Seventy children with dyspepsia (dyspeptic group) and 30 children without any gastrointestinal complaints (control group) were included in the study. Two biopsies from the gastric tissues were collected from dyspeptic children for histopathologic examination. Oral examination involved the assessment of dental caries, gingival index, plaque index, buffering capacity, salivary flow rate and pH. Salivary Streptococcus mutans (S. mutans) and Lactobacilli sp. counts were performed by commercial kits. For the comparison of the normal distribution between dyspeptic and control groups, Student t-test and for the comparison of the non-normal distribution, Kruskal-Wallis and Mann-Whitney-U tests were used. Chi-square test was used for comparison of qualitative data and the Pearson correlation test was used to evaluate the association between certain variables. Significance was assessed at p?<?0.05 level. RESULTS:Helicobacter pylori (H.pylori) were found in gastric biopsies of 84.2% (59/70) of the dyspeptic children. While the mean salivary NO values did not differ significantly between gastric H.pylori positive, negative and control groups, the salivary NO level of the dyspeptic group (213.7?±?51.68??mol/dL) was found to be significantly higher than the control group (185.7?±?16.66??mol/dL). No significant relationship was found between the mean salivary NO values, DMFT/dmft numbers and other oral parameters. CONCLUSIONS:The association of dental caries and salivary NO levels could not be considered specific in the current study. Although there were no statistically significant differences between salivary NO levels of gastric H.pylori positive, gastric H.pylori negative and control groups, greater salivary NO levels among dyspeptic children compared with the control group demonstrated that the concentration of NO in the saliva could be used as a biological marker in dyspepsia, which could lead to the improvement of more specified, uncomplicated and susceptible methods for analysis.
| S-EPMC6329182 | biostudies-other
Project description:Background. Hematopoietic cell transplantation (HCT) is a potentially curative therapy for a wide range of pediatric malignant and nonmalignant diseases. However, complications, including blood stream infection (BSI) remain a major cause of morbidity and mortality. While certain bacteria that are abundant in the oral microbiome, such as S. mitis, can cause BSI, the role of the oral microbial community in the etiology of BSI is not well understood. The finding that the use of xylitol wipes, which specifically targets the cariogenic bacteria S. mutans is associated with reduced BSI in pediatric patients, lead us to investigate dental caries as a risk factor for BSI. Methods. A total of 41 pediatric patients admitted for allogenic or autologous HCT, age 8 months to 25 years, were enrolled. Subjects with high dental caries risk were identified as those who had dental restorations completed within 2 months of admission for transplant, or who had untreated decay. Fisher’s exact test was used to determine if there was a significant association between caries risk and BSI. Dental plaque and saliva were collected on a cotton swab from a subset of 4 high caries risk (HCR) and 4 low caries risk (LCR) children following pretransplant conditioning. 16SrRNA sequencing was used to compare the microbiome of HCR and LCR subjects and to identify microbes that were significantly different between the 2 groups. Results. There was a statistically significant association between caries risk and BSI (p<0.035) (Fisher’s exact test). Multivariate logistic regression analysis showed children in the high dental caries risk group were 21.39 times more likely to have BSI, with no significant effect of age or mucositis severity. HCR subjects showed significantly reduced microbial alpha diversity as compared to LCR subjects. LEfse metagenomic analyses, showed the oral microbiome in HCR children enriched in order Lactobacillales. This order includes Streptococcus and Lactobacillus, both which contain bacteria primarily associated with dental caries. Discussion. These findings support the possibility that the cariogenic microbiome can enhance the risk of BSI in pediatric populations. Future metagenomic analyses to measure microbial differences at, before, and after conditioning related to caries risk, may further unravel the complex relationship between the oral microbiome, and whether it affects health outcomes such as BSI.
2022-04-05 | GSE199991 | GEO
Project description:IntroductionThe Air Force uses dental caries risk assessments (CRA) to determine which active duty Air Force (ADAF) members are at high caries risk (HCR) and will benefit from additional preventive and restorative dental care. The purpose of this study is to describe the caries risk of ADAF from 2009 to 2017 and determine how demographic, military, and tobacco-use characteristics affect caries risk.Materials and methodsData from ~300,000 ADAF annual dental examinations from 2009 to 2017 were used. The outcome variable investigated was dental caries risk (high, moderate, or low). Independent variables analyzed were: age, sex, race, education, marital status, military rank, service years, flying status, and tobacco use. Descriptive and multivariable analyses were performed to explore associations between potential risk indicators and caries risk outcomes.ResultsFrom 2009 to 2013, there was a steady decline in ADAF that were diagnosed as low caries risk (LCR), from 80.3% to 67.7%. Since 2013, the prevalence of ADAF that are LCR has remained unchanged at about two-thirds of the force. The proportion of the ADAF that are moderate caries risk (MCR) increased from 15.7% in 2009 to 25.3% in 2013 and remained unchanged affecting about a quarter of the force since then. The proportion that was diagnosed as HCR increased from 3.9% in 2009 to 7.1% in 2013 and declined slightly in 2017 (6.0%). After controlling for other covariates, younger age (<20 years old: odds ratio [OR], 4.4; 95% confidence interval [CI], 3.3-5.8), less time in service (≤4 years: OR, 2.1; 95% CI, 1.7-2.6), junior rank (E-1-E-4: OR, 1.6; 95% CI, 1.3-1.8), less education (high-school graduate: OR, 2.3; 95% CI, 2.0-2.6), using tobacco (Smoker: OR, 1.6; 95% CI, 1.5-1.7), being a nonflyer (OR, 1.2; 95% CI, 1.1-1.3), being male (OR, 1.1; 95% CI, 1.1-1.2), or being black (OR, 1.2; 95% CI, 1.1-1.2) were each associated with being HCR. Among the cohort of Airmen who were LCR at baseline, the majority (75.9%) remained at low risk, but for nearly a quarter (24.1%), their risk of caries increased over 9 years. Among those who were originally MCR in 2009, 61.5% improved to LCR, whereas 4.6% progressed to HCR; among those identified as high risk for caries in 2009, a substantial majority (89.1%) improved over 9 years, but 10.9% remained unchanged.ConclusionsThe prevalence of HCR and MCR service members increased from 2009 to 2013 but has remained consistent since 2013. Overall caries risk in the Air Force is lower compared to previously published findings from 2001 to 2004. This suggests that CRA and prevention programs have been effective at helping to reduce caries prevalence among Airmen. Smoking prevalence among ADAF has also declined substantially over the past 16 years which may contribute to overall caries risk reductions. Using a CRA approach may be an effective tool for helping to identify and develop strategies to manage dental caries risk in patients.
| S-EPMC7974017 | biostudies-literature
Project description:BackgroundIt is difficult to discern the proportion of blood lead (PbB) attributable to ambient air lead (PbA), given the multitude of lead (Pb) sources and pathways of exposure. The PbB-PbA relationship has previously been evaluated across populations. This relationship was a central consideration in the 2008 review of the Pb national ambient air quality standards.ObjectivesThe objectives of this study were to evaluate the relationship between PbB and PbA concentrations among children nationwide for recent years and to compare the relationship with those obtained from other studies in the literature.MethodsWe merged participant-level data for PbB from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 9908 (1999-2008) with PbA data from the U.S. Environmental Protection Agency. We applied mixed-effects models, and we computed slope factor, d[PbB]/d[PbA] or the change in PbB per unit change in PbA, from the model results to assess the relationship between PbB and PbA.ResultsComparing the NHANES regression results with those from the literature shows that slope factor increased with decreasing PbA among children 0-11 years of age.ConclusionThese findings suggest that a larger relative public health benefit may be derived among children from decreases in PbA at low PbA exposures. Simultaneous declines in Pb from other sources, changes in PbA sampling uncertainties over time largely related to changes in the size distribution of Pb-bearing particulate matter, and limitations regarding sampling size and exposure error may contribute to the variability in slope factor observed across peer-reviewed studies.
| S-EPMC4080523 | biostudies-literature
Project description:Aim:Dental enamel, the most rigid biological tissue of the tooth known to mankind, is the most integral and fundamental part of the tooth. Enamel matrixes compile 5% of Enamelin peptides and at the time of tooth development, they are considered to effect the formation and elongation of enamel crystallites. ENAM plays critical role in enamel formation. Any changes in ENAM may affect the thickness of enamel and may lead to dental caries. The present study is aimed to evaluate the association of ENAM gene polymorphisms and susceptibility of dental caries development risk. Material and methods:The present study was carried out on 168 South Indian children, children's with dental caries were included in study. Written consent was taken from their parents/guardians. Additionally 193 healthy individuals were enrolled as controls. Sampling was done after dental examination of the individuals. Three ENAM gene single nucleotide polymorphisms (SNPs) were rs7671281, rs3796704 and rs12640848 was genotyped to check their role in susceptibility of dental caries development risk. Results:Out of three SNPs rs7671281 showed statistically significant risk association with dental caries susceptibility in this ethnic population at heterozygous allele CT (OR: 1.939, p?=?.01865) and with minor allele T (OR: 1.451, p?=?.001292). SNP rs3796704 showed significant protective association with dental caries in Indian population at heterozygous allele GA (OR: 0.409, p?=?.0192) and with minor allele A (OR: 0.645, p?=?.00875). SNP rs12640848 showed significant protective association with dental caries in Indian population at heterozygous allele AG (OR: 3.041, p?=?.00642) and with minor allele G (OR: 1.478, p?=?.02184). Preliminary insilico analysis also showed that rs7671281 (Ile648Thr) amino acid change will cause the structural and functional changes in ENAM protein. Conclusions:In the present study significant association was observed between ENAM gene SNP rs7671281 and dental caries susceptibility in South Indian children. These results suggested that ENAM gene variants may contribute to dental caries in children.
| S-EPMC6486511 | biostudies-literature
Project description:Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels (<30 ng/mL) and the prevalence of caries in the permanent teeth and mixed dentition of 7-year-old children. A sample of 335 children from the population-based birth cohort Generation XXI (Porto, Portugal) was included. Data on children's demographic and social conditions, health status, dental health behaviours, dental examination including erupted permanent first molars, and blood samples available for vitamin D analysis were collected. Dental outcomes included the presence of caries, including non-cavitated lesions (d1-6mft/D1-6MFT > 0), and advanced caries (d3-6mft/D3-6MF > 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children's vitamin D levels <30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at ?7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.
| S-EPMC7825719 | biostudies-literature
Project description:Background:Lead can cause significant biological and neurologic damage, even at small concentrations, and young children are at higher risk. Informal recycling of lead batteries and lead-based workshops/industries have increased the burden of lead toxicity in developing countries, including India. Many informal recycling lead battery workshops have been established by the local people of Patna, Bihar as self-employment opportunities. However, most of the residents are not aware of the risk factors associated with lead poisoning. Objectives:The present pilot study aimed to assess blood lead levels (BLLs) and hemoglobin levels among children aged between 3 to 12 years in the settlement of Karmalichak near Patna, India. Materials and Methods:Children residing near the informal lead battery manufacturing unit were selected for BLL assessment. A total of 41 children were enrolled in the questionnairebased survey. Results:All the children in the present study had detectable lead concentrations in their blood. Only 9% of the studied children had a BLL ?5 ?g/dl, while 91% children had a BLL above >5 ?g/dl. Conclusions:The present study carried out in children of Karmalichak region of Patna, India was an attempt to better understand the problem of lead toxicity, describe the epidemiology of its adverse effects, identify sources and routes of exposure, illustrate the clinical effects and develop strategies of prevention so that remedial measures may be taken by government agencies and regulatory bodies. In view of the high lead levels in children in the study area, attempts are being made to develop strategies for future prevention by relocating the informal battery recycling workshops from the area. Moreover, parents have been advised to increase nutritional supplementation of children by providing calcium-, iron- and zinc-rich foods, including milk and vegetables. Participant Consent:Obtained. Ethical Approval:The study was approved by the ethical committee of Era's Lucknow Medical College & Hospital, Era University, Lucknow (India). Competing Interests:The authors declare no competing financial interests.
| S-EPMC7058140 | biostudies-literature