肥胖儿童和青少年的磨蚀性牙齿磨损和龋齿患病情况。

Erosive tooth wear and caries experience in children and adolescents with obesity.

机构信息

Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.

出版信息

J Dent. 2019 Apr;83:77-86. doi: 10.1016/j.jdent.2019.02.005. Epub 2019 Feb 27.

DOI:10.1016/j.jdent.2019.02.005

PMID:30825568

Abstract

CLINICAL SIGNIFICANCE

A large consumption of fermentable carbohydrates, for instance the high intake of sweetened beverages, is an important risk factor for overweight and obesity. As lemonades and fruit juices present high sugar content and quite low pH-values, overweight and obese children might also have an increased risk for dental caries and erosive tooth wear.

OBJECTIVES

The aim was to analyze the prevalence and severity of erosive tooth wear and caries experience in children and adolescents with overweight, obesity and extreme obesity compared to children with normal weight and to determine a possible association between erosive tooth wear and caries experience.

METHODS

223 children (4-17 years, n = 1476 primary and n = 4110 permanent teeth) were examined using standardized dental indices (BEWE, ICDAS, DMFT). Demographic and socio-economic data, eating habits, oral hygiene, fluoride supply and details of medical history were obtained from a questionnaire. Weight classification was based on age- and gender-specific relative body mass indices (BMI). Statistical analyses were done by Chi-tests, Kruskal-Wallis tests, logistic and linear regressions. To determine a possible association between erosive tooth wear and caries experience Chi-tests (prevalence to prevalence) and Spearman correlations (severity to severity) were performed (p < 0.05).

RESULTS

Erosive tooth wear and caries experience in primary and permanent teeth were significantly increased in children with obesity and extreme obesity compared to normal weight children (p < 0.05). Higher BMI, age, gender, and the consumption of erosive snacks/beverages were identified as statistically significant risk factors for erosive tooth wear. Higher BMI, age, socio-economic factors, poor toothbrushing habits, and consumption of cariogenic beverages were identified as significant caries risk factors. Erosive tooth wear and caries showed a weak correlation in children with (extreme) obesity (Φ = 0.110 to 0.248).

CONCLUSIONS

Higher BMI of children and adolescents is significantly associated with a higher risk for erosive tooth wear and caries.

摘要

临床意义

大量摄入可发酵碳水化合物，例如大量摄入含糖饮料，是超重和肥胖的一个重要危险因素。由于柠檬水和果汁含糖量高，pH 值相当低，超重和肥胖的儿童也可能面临更高的龋齿和酸蚀性牙齿磨损风险。

目的

本研究旨在分析超重、肥胖和极度肥胖儿童与体重正常儿童相比，发生酸蚀性牙齿磨损和龋齿的流行率和严重程度，并确定酸蚀性牙齿磨损与龋齿之间的可能关联。

方法

共检查了 223 名儿童（4-17 岁，n=1476 颗乳牙和 n=4110 颗恒牙），采用标准化牙科指数（BEWE、ICDAS、DMFT）进行检查。通过问卷获得人口统计学和社会经济数据、饮食习惯、口腔卫生、氟化物供应以及详细的病史信息。体重分类基于年龄和性别特异性相对体重指数（BMI）。采用卡方检验、克鲁斯卡尔-沃利斯检验、逻辑回归和线性回归进行统计分析。为了确定酸蚀性牙齿磨损与龋齿之间的可能关联，进行了卡方检验（流行率与流行率）和斯皮尔曼相关性分析（严重程度与严重程度）（p<0.05）。

结果

与体重正常的儿童相比，肥胖和极度肥胖儿童的乳牙和恒牙的酸蚀性牙齿磨损和龋齿患病率明显更高（p<0.05）。较高的 BMI、年龄、性别以及摄入侵蚀性零食/饮料被确定为酸蚀性牙齿磨损的统计学显著危险因素。较高的 BMI、年龄、社会经济因素、不良的刷牙习惯以及摄入致龋饮料被确定为龋齿的显著危险因素。在肥胖（极度肥胖）儿童中，酸蚀性牙齿磨损和龋齿之间存在弱相关性（Φ=0.110 至 0.248）。