Adiposity is not associated with caries among youth in the United States.
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Accepted version
Embargoed until: 2024-10-24
Embargoed until: 2024-10-24
Volume
154
Pagination
991 - 999.e2
DOI
10.1016/j.adaj.2023.07.013
Journal
J Am Dent Assoc
Issue
Metadata
Show full item recordAbstract
BACKGROUND: Body mass index has been traditionally used to determine the nutritional status of children in studies on obesity and caries. Imaging methods provide a superior assessment of body fat. This study investigated the relationship between measures of adiposity and caries in permanent teeth in children and adolescents. METHODS: The analysis included 5,694 participants in the National Health and Nutrition Examination Survey from 2011 through 2018, aged 8 through 19 years. The body fat percentage (BF%) and fat mass index (FMI) were determined from whole-body dual-energy x-ray absorptiometry scans. Excess adiposity was defined as a sex- and age-specific value at or above the 75th percentile according to the US reference standards for BF% or FMI. Caries was measured with the decayed teeth and decayed, missing, and filled teeth indexes; prevalence of untreated dentin caries; and lifetime caries prevalence. The associations between adiposity and caries were tested in confounding variables-adjusted regression models. RESULTS: The FMI score was associated with the decayed, missing, and filled teeth score (rate ratio, 1.03; 95% CI, 1.01 to 1.05) and lifetime caries prevalence (odds ratio, 1.06; 95% CI, 1.03 to 1.08), but the associations attenuated after adjustment for confounding variables. Neither the BF% score nor the presence of excess adiposity, defined according to the BF% or FMI reference standards, were associated with caries. CONCLUSION: The authors found no association between measures of adiposity and caries among US children and adolescents. PRACTICAL IMPLICATIONS: Caries is a multifactorial disease, and any observed association between obesity and caries is most likely due to the shared determinants and risk factors of both conditions.