Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences.
Department of Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences.
Environ Health Prev Med. 2024;29:42. doi: 10.1265/ehpm.24-00093.
Poor oral hygiene, generally manifesting as dental caries, gingivitis, or periodontitis, is a common chronic condition among both children and adults worldwide and has been reportedly associated with hypertension and arterial stiffness mainly in adult patients. However, these associations have not been well-studied in children and adults in the general population. Therefore, we conducted this cross-sectional study to clarify the associations between oral hygiene indices and high blood pressure (BP)/hypertension and arterial stiffness as assessed by the cardio-ankle vascular index (CAVI) in children along with their mothers. The association between maternal oral hygiene and high BP in children was also examined based on the hypothesis that maternal awareness of oral hygiene is related to their children's oral hygiene.
This study was conducted as an Adjunct Study of the Aichi Regional Sub-Cohort of the Japan Environment and Children's Study. Participating children (n = 220, 85-104 months old) and their mothers (n = 217, 29-52 years old) underwent dental/intra-oral examination and BP and CAVI assessment. High BP in children and hypertension in mothers were diagnosed according to corresponding American guidelines. Logistic regression analysis or analysis of covariance was used to examine the associations of poor oral hygiene indices with BP and CAVI.
Maternal dental caries ≥1 was associated with their hypertension (adjusted odds ratio [aOR]: 2.72, 95% confidence interval (CI): 1.12-6.61). Maternal dental plaque ≥1/3 was associated with maternal hypertension and children's high BP (aOR, 95% CI: 4.71, 1.33-16.73 and 5.67, 1.22-25.04, respectively). Maximum pocket depth ≥4 mm was associated with children's high BP (aOR: 6.85, 95% CI: 1.24-38.01). No associations were observed between oral hygiene indices and CAVI in children; however, there was a significant association between dental plaque and CAVI in mothers (F = 5.62, p < 0.01).
The small sample size, especially the case number, made it necessary to refrain from drawing unambiguous conclusion. The hypothesis that warrants further investigation based on the present study results is that poor oral hygiene is associated with high BP in children and hypertension and arterial stiffness in mothers, and maternal oral hygiene is associated with high BP in children.
在全球范围内，儿童和成人普遍存在口腔卫生不良的情况，主要表现为龋齿、牙龈炎或牙周炎，这是一种常见的慢性疾病。据报道，这种情况与高血压和动脉僵硬有关，主要发生在成年患者中。然而，在一般人群中的儿童和成人中，这些关联尚未得到很好的研究。因此，我们进行了这项横断面研究，以阐明口腔卫生指标与高血压（BP）/高血压和动脉僵硬之间的关系，这些指标通过心血管脚踝血管指数（CAVI）在儿童及其母亲中进行评估。还根据母亲对口腔卫生的认识与其子女口腔卫生有关的假设，检查了母亲口腔卫生与儿童高血压之间的关系。
本研究作为日本环境与儿童研究爱知县分队列的辅助研究进行。参与的儿童（n=220，85-104 个月大）及其母亲（n=217，29-52 岁）接受了牙科/口腔内检查以及 BP 和 CAVI 评估。根据相应的美国指南，诊断儿童高血压和母亲高血压。使用逻辑回归分析或协方差分析检查口腔卫生不良指数与 BP 和 CAVI 的关系。
母亲的龋齿≥1 与母亲的高血压相关（调整后的优势比[aOR]：2.72，95%置信区间[CI]：1.12-6.61）。母亲的牙菌斑≥1/3 与母亲的高血压和儿童的高血压相关（aOR，95%CI：4.71，1.33-16.73 和 5.67，1.22-25.04）。最大牙周袋深度≥4mm 与儿童的高血压相关（aOR：6.85，95%CI：1.24-38.01）。口腔卫生指数与儿童的 CAVI 之间没有观察到关联；然而，母亲的牙菌斑与 CAVI 之间存在显著关联（F=5.62，p<0.01）。
样本量小，特别是病例数，使得我们不得不避免得出明确的结论。基于本研究结果，需要进一步研究的假设是，口腔卫生不良与儿童的高血压以及母亲的高血压和动脉僵硬有关，母亲的口腔卫生与儿童的高血压有关。
