Khan Durdana, Hernandez-Castro Ixel, Larvie Doreen Y, Armah Seth M, Cardenas Andres, Malin Ashley J
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States.
Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, United States.
Front Oral Health. 2025 Jul 9;6:1617695. doi: 10.3389/froh.2025.1617695. eCollection 2025.
Historic research shows that a diet rich in calcium, phosphorus, fat-soluble vitamins, and vitamin C, and low in phytates may help to prevent and arrest dental caries; however, current research on this topic is scarce. We examined associations of dietary intake of these nutrients with dental caries prevalence in the United States among youth 1-19 years old.
The study included 2,676 young children (1-5 years), 3,214 older children (6-11 years) and 3,701 adolescents (12-19 years) from the National Health and Nutrition Examination Survey (NHANES 2011-2018). Daily nutrient intake was ascertained via two 24 h recalls. We assessed the number and presence (yes/no) of decayed and/or filled teeth (DFT) among young children and decayed, missing and/or filled teeth (DMFT) among older children and adolescents. Covariate-adjusted survey-weighted negative binomial regression was used to examine associations of nutrient quartiles with DFT or DMFT scores. We examined joint associations of nutrients with the probability of caries using the probit extension of Bayesian Kernel Machine Regression.
Mean (SD) DFT or DMFT scores were 0.82 (2.23) for young children, 2.08 (2.81) for older children and 2.51 (3.35) for adolescents. Higher phosphorus and vitamin A intake was associated with fewer DFT among young children [incident rate ratio (IRR) = 0.52, 95% CI: 0.29-0.94, = 0.03, and IRR = 0.60, 95% CI: 0.37-0.95, = 0.03, respectively]. Unexpectedly, higher intake of phytates was also associated with lower DFT scores among young children (IRR = 0.37, 95% CI: 0.21-0.65, = 0.001). Higher phosphorus and vitamin E intake was associated with fewer DMFT among older children (IRR = 0.58, 95% CI: 0.40-0.84, = 0.003 and IRR = 0.73, 95% CI: 0.54-0.97, = 0.03, respectively). For adolescents, higher phosphorus and vitamin K intake was associated with fewer DMFT (IRR = 0.72, 95% CI: 0.53-0.99, < 0.05; IRR = 0.82, 95% CI: 0.68-0.97, = 0.02, respectively). The joint effect of nutrients was also associated with lower odds of DMFT. Setting all nutrients at their 75th relative to 50th percentiles was associated with 0.87 [95% credible interval (CrI): 0.81, 0.94] and 0.92 (95% CrI: 0.85, 0.99) lower odds of DMFT in older children and adolescents, respectively. Phosphorus and vitamin K contributed most to these associations.
Fat-soluble vitamins and phosphorus may have systemic dental benefits that warrant further investigation.
历史研究表明，富含钙、磷、脂溶性维生素和维生素C且植酸盐含量低的饮食可能有助于预防和阻止龋齿；然而，目前关于该主题的研究很少。我们研究了美国1至19岁青少年这些营养素的膳食摄入量与龋齿患病率之间的关联。
该研究纳入了来自国家健康与营养检查调查（2011 - 2018年NHANES）的2676名幼儿（1至5岁）、3214名大龄儿童（6至11岁）和3701名青少年（12至19岁）。通过两次24小时膳食回顾确定每日营养素摄入量。我们评估了幼儿中龋齿和/或补牙的数量及存在情况（是/否）（DFT），以及大龄儿童和青少年中龋齿、缺失和/或补牙的情况（DMFT）。采用协变量调整的调查加权负二项回归来研究营养素四分位数与DFT或DMFT得分之间的关联。我们使用贝叶斯核机器回归的概率扩展来研究营养素与龋齿发生概率的联合关联。
幼儿的平均（标准差）DFT得分是0.82（2.23），大龄儿童是2.08（2.81），青少年是2.51（3.35）。幼儿中较高的磷和维生素A摄入量与较少的DFT相关[发病率比（IRR） = 0.52，95%置信区间（CI）：0.29 - 0.94，P = 0.03；以及IRR = 0.60，95% CI：0.37 - 0.95，P = 0.03]。出乎意料的是，较高的植酸盐摄入量在幼儿中也与较低的DFT得分相关（IRR = 0.37，95% CI：0.21 - 0.65，P = 0.001）。大龄儿童中较高的磷和维生素E摄入量与较少的DMFT相关（IRR分别为0.58，95% CI：0.40 - 0.84，P = 0.003和IRR = 0.73，95% CI：0.54 - 0.97，P = 0.03）。对于青少年，较高的磷和维生素K摄入量与较少的DMFT相关（IRR分别为0.72，95% CI：0.53 - 0.99，P < 0.05；IRR = 0.82，95% CI：0.68 - 0.97，P = 0.02）。营养素的联合效应也与较低的DMFT几率相关。将所有营养素设定在第75百分位数相对于第50百分位数时，大龄儿童和青少年中DMFT的几率分别降低0.87 [95%可信区间（CrI）：0.81，0.94]和0.92（95% CrI：0.85，0.99）。磷和维生素K对这些关联贡献最大。
脂溶性维生素和磷可能对牙齿有全身性益处，值得进一步研究。
