Associations of Serum Vitamin D With Dental Caries and Periodontitis: The HUNT Study.

OBJECTIVE: To study the relationships of serum 25-hydroxyvitamin D [25(OH)D] with dental caries and periodontitis in a general Norwegian adult population. METHODS: We analysed a subsample of 1605 participants from the Trøndelag Health Study (HUNT) in Norway that had serum 25(OH)D levels measured in HUNT3 (2006-08) and oral health assessed in the HUNT4 Oral Health Study (2017-19). Negative binomial and Poisson regression models were used to estimate the ratios of means (RMs; for count oral outcomes) and prevalence ratios (PRs; for dichotomous oral outcomes). RESULTS: Serum 25(OH)D was inversely associated with the number of decayed teeth in a dose-response gradient (<30.0 nmol/L: RM 1.41, 95% CI 1.07-1.85; 30.0-49.9 nmol/L: 1.14, 0.98-1.32 and ≥75.0 nmol/L: 0.84, 0.67-1.04, as compared to the 50.0-74.9 nmol/L group, P for trend <.001). Each 25 nmol/L decrease in 25(OH)D level was associated with a 15% (RM 1.15, 95% CI 1.05-1.26) increase in the mean number of decayed teeth. Serum 25(OH)D <30.0 nmol/L was associated with a 35% higher prevalence of severe periodontitis (PR 1.35, 95% CI 1.00-1.83). No association was observed between 25(OH)D and the number of natural teeth. CONCLUSION: The present study suggested that serum 25(OH)D level had an inverse and dose-response association with the number of decayed teeth, and serum 25(OH)D <30 nmol/L was associated with a higher prevalence of severe periodontitis in this Norwegian adult population.

ENDOCRINE REGULATION OF ERYTHROID LINEAGE OF HEMATOPOIESIS IN CHILDREN LIVING UNDER A LOW-DOSE RADIATION EXPOSURE AFTER THE CHORNOBYL NPP ACCIDENT. / ENDOKRYNNA REGULIaTsIIa ERYTROTsYTARNOÏ LANKY GEMOPOEZU V DITEI, IaKI ZhYVUT' NA RADIOAKTYVNO ZABRUDNENYKh TERYTORIIaKh PISLIa AVARIÏ NA ChAES.

OBJECTIVE: Elucidation of relationship between the levels of thyroid-stimulating hormone (TSH), free serum thyroxine, serum and urine cortisol and parameters of erythroid lineage of hematopoiesis to estimate the thyroid functionin children of prepubertal, pubertal, and postpubertal age permanently residing under a low-dose radiation exposureto determine the premorbid state of thyroid function. MATERIALS AND METHODS: Children aged 3 to 18 years old (n = 203) living in the most intensively radionuclide-contaminated regions of Kyiv, Zhytomyr and Chornihiv oblasts of Ukraine after the Chornobyl NPP accident wereenrolled. Complaints of ossalgia, arthralgia, fatigue, bone fractures in the history, bone dysembryogenetic stigmata,hypermobility syndrome degree, and types of somatic diseases were taken into account. Peripheral blood countparameters, biochemical indices of blood serum were studied, namely the levels of total protein, cholesterol, creatinine and alkaline phosphatase activity. Levels of the free thyroxine, pituitary TSH, serum and daily urine cortisol, anddoses of radiation exposure were determined. RESULTS: The radiation dose values in children ranged from (0.35 ± 0.09) mSv to (0.54 ± 0.12) mSv. There was nodifference between the parameters of erythroid lineage of hematopoiesis depending on radiation dose. At the levels of serum TSH up to 1.0 µIU/ml no correlation was found with cortisol levels; at TSH levels of 1.0-3.0 µIU/ml thecorrelation coefficient was r = 0.31; at TSH levels higher than 3.0 µIU/ml the correlation coefficient was r = 0.61probably indicating a compensatory role of adrenal cortex in children at risk of thyroid disease development. In children with joint hypermobility grade II there was a higher incidence of dentofacial anomalies (χ2 = 6.9), deformitiesof lower extremities (χ2 = 6.9), and dental caries (χ2 = 4.3) (p < 0.05). There was a direct correlation between theserum TSH level (over 3 µIU/ml) and micrognathia (brachygnathia) (r = 0.62) indicating the impact of thyroid disease on dentofacial development. The TSH at a level of upper limit of the reference range values may contribute toa decreased RBC count in peripheral blood, increased average volume and hemoglobin content in erythrocyte beingassociated with the initial manifestations of thyroid dysfunction. CONCLUSIONS: Abnormal endocrine regulation of hematopoiesis affects the connective tissue, stromal microenvironment of bone marrow, and accordingly the erythroid branch of hematopoiesis in children, which may be relevant inthe development and course of oncohematological diseases.

Association of genetically predicted blood sucrose with coronary heart disease and its risk factors in Mendelian randomization.

We assessed the associations of genetically instrumented blood sucrose with risk of coronary heart disease (CHD) and its risk factors (i.e., type 2 diabetes, adiposity, blood pressure, lipids, and glycaemic traits), using two-sample Mendelian randomization. We used blood fructose as a validation exposure. Dental caries was a positive control outcome. We selected genetic variants strongly (P < 5 × 10-6) associated with blood sucrose or fructose as instrumental variables and applied them to summary statistics from the largest available genome-wide association studies of the outcomes. Inverse-variance weighting was used as main analysis. Sensitivity analyses included weighted median, MR-Egger and MR-PRESSO. Genetically higher blood sucrose was positively associated with the control outcome, dental caries (odds ratio [OR] 1.04 per log10 transformed effect size [median-normalized standard deviation] increase, 95% confidence interval [CI] 1.002-1.08, P = 0.04), but this association did not withstand allowing for multiple testing. The estimate for blood fructose was in the same direction. Genetically instrumented blood sucrose was not clearly associated with CHD (OR 1.01, 95% CI 0.997-1.02, P = 0.14), nor with its risk factors. Findings were similar for blood fructose. Our study found some evidence of the expected detrimental effect of sucrose on dental caries but no effect on CHD. Given a small effect on CHD cannot be excluded, further investigation with stronger genetic predictors is required.

Diabetes status affects long-term changes in coronal caries - The SHIP Study.

We estimated effects of diabetes mellitus and metabolic control on long-term change in coronal caries and restorative status using 11-year-follow-up data from the population-based Study of Health in Pomerania. Data of 3731 participants with baseline and 5- and 11-year follow-up information were included. Diabetes was defined via self-reported physician´s diagnosis or intake of glucose-lowering drugs or hemoglobin A1c (HbA1c) ≥6.5% or fasting blood glucose levels ≥11.1 mmol/l. The diabetes status was defined as no diabetes (HbA1c < 6.5% or non-fasting blood glucose <11.1 mmol/l), subjects with known or undetected diabetes mellitus and HbA1c ≤ 7% (well-controlled diabetes), and subjects with known or undetected diabetes mellitus and HbA1c > 7% (poorly-controlled diabetes). The caries status was clinically assessed using the half-mouth method and the Decayed Missing Filled Surfaces (DMFS) index and its component scores were determined. Covariate-adjusted linear mixed models were evaluated. Rates in change in DMFS were significantly higher in subjects with poorly-controlled diabetes compared to subjects without diabetes. Subjects with poorly- and well-controlled diabetes had significantly higher rates in change in Missing Surfaces (MS) compared to subjects without diabetes. For the DFS, rates in change were significantly lower for subjects with well-controlled diabetes and higher for subjects with poorly-controlled diabetes as compared to subjects without diabetes. Concordantly, all rates in change increased proportional to HbA1c levels. Effects were even more pronounced in subjects with diabetes duration of ≥5 years. Subjects with poorly-controlled diabetes are at higher risk for caries progression compared to subjects without diabetes, especially in case of longer disease duration.

Association of oral health status with the CD4+ cell count in children living with HIV in Phnom Penh, Cambodia.

The association between oral and overall health, and particularly between dental and immune health, in children living with HIV remains unclear. This study examined the association between the decayed, missing and filled teeth (DMFT) score and CD4+ cell counts in 142 children living with HIV aged 8-15 years (male, 51%) from Phnom Penh, Cambodia. Other indicators of oral health (e.g., debris index, salivary flow, salivary pH and oral health-related quality of life) and overall health (e.g., nutritional status and quality of life) were also evaluated. DMFT scores were negatively associated with the CD4+ cell count in male children (ß: -0.13, 95% confidence interval [CI]: -0.25, -0.02). In all children, positive associations were observed between salivary pH and CD4+ count (ß: -0.645, 95% CI: 0.02, 1.25) and between salivary flow and height-for-age Z-score (ß: 1.22, 95% CI: 0.50, 1.95). The debris index was negatively associated with the height-for-age Z-score (ß: -2.04, 95% CI: -3.38, -0.71). In summary, oral health was associated with immune and nutritional status. Oral health policies for children living with HIV should be emphasised, and further studies should evaluate the mechanism underlying the relationship between oral and overall health.

Genetic and Early-Life Environmental Influences on Dental Caries Risk: A Twin Study.

OBJECTIVES: To explore the relative contributions of genetic and environmental influences on dental caries risk and to investigate fetal and developmental risk factors for dental caries. METHODS: We recruited children from 250 twin pregnancies midgestation and collected demographic, health, and phenotypic data at recruitment, 24 and 36 weeks' gestational age, birth and 18 months, and 6 years of age. 25-hydroxyvitamin D was quantified in mothers at 28 weeks' gestation and in infants at birth. Dental caries and enamel defects were measured at six years of age. We compared concordance for the presence of any caries and advanced caries in monozygotic and dizygotic twin pairs. To investigate environmental risk factors for caries, we fitted multiple logistic regression models using generalized estimating equations to adjust for twin correlation. RESULTS: A total of 345 twins underwent dental assessment, with 111 (32.2%) showing signs of any caries and 83 (24.1%) having advanced caries. There was no evidence of higher concordance in monozygotic twins compared with dizygotic twins, with a difference of 0.05 (95% confidence interval -0.14 to 0.25; P = .30) and 0.00 (95% confidence interval -0.26 to 0.26; P = .50) for any caries and advanced caries, respectively, suggesting that environmental factors, rather than genetics, are the predominant determinant of caries risk. After adjusting for potential confounders, lack of community water fluoridation, hypomineralized second primary molars, dichorionic placenta, and maternal obesity were associated with caries. CONCLUSIONS: Environmental rather than genetic factors drive dental caries risk and arise as early as prenatal life.

Vitamin D and health in the Mediterranean countries.

Vitamin D, traditionally well known for its role in maintaining optimal health through its contribution to calcium metabolism and skeletal health, has received increased attention over the past two decades, with considerable focus being placed on its nonskeletal benefits. This paper is a narrative review of the nonskeletal health benefits of vitamin D, of particular interest to inhabitants of Mediterranean countries, namely, autism, cancer, cardiovascular disease, chronic obstructive pulmonary disease, dental caries, diabetes mellitus, erectile dysfunction, hypertension, metabolic syndrome, respiratory tract infections, all-cause mortality, and pregnancy and birth outcomes, because of the relatively high incidence and/or prevalence of these disorders in this region. Currently, the best evidence is coming out of observational studies related to serum 25-hydroxyvitamin D [25(OH)D] concentrations. Vitamin D clinical trials have generally been poorly designed and conducted, usually being based on vitamin D dose rather than 25(OH)D concentration. The optimal 25(OH)D concentration is above 75 nmol/l (30 ng/ml), with even better health outcomes in the range of 100-150 nmol/l. Achieving these concentrations with vitamin D3 supplements will require 1000-4000 IU/day of vitamin D3. Sensible sun exposure should also be encouraged. Countries should also consider fortifying grain and dairy products with vitamin D3.

Serum levels of proinflammatory cytokines are high in early childhood caries.

It is unknown whether serum levels of proinflammatory cytokines would be high in children with early childhood caries (ECC). This study investigated the association between serum levels of proinflammatory cytokines and severity of caries in preschoolers younger than 72 months. A case-control study was performed with a random sample of 72 children with ECC and 80 caries-free children. The explanatory variables were serum levels of proinflammatory cytokines (IL-6, TNF-α, and NGAL) and the outcome was severity of ECC (number of decayed teeth). Thecrudeanalyses were used toestimate the association between each cytokine and ECC. Then, the analyses were adjusted for socioeconomic factors, excess weight and sugar sweetened beverages consumption using Poisson regression models. The estimated coefficients were expressed as Means Ratio (MR), with 95% confidence intervals (CI). In the crude analyses, the highest tertiles of IL-6 (MR = 1.47, IC = 1.09-2.00, p = 0.012), TNF-α (MR = 1.33, CI = 1.00-1.78, p = 0.040) and NGAL (MR = 2.20, CI = 1.39-3.49, p = 0.001) were associated to ECC. After adjustment, the highest tertiles of IL-6 levels (MR = 1.54, IC = 1.13-2.10, p = 0.005), and NGAL (MR = 1.71, CI = 1.04-2.80, p = 0.032) remained associated to ECC; while TNF-α was no longer associated to ECC (MR = 1.31, CI = 0.98-1.75, p = 0.066). Higher serum levels of proinflammatory cytokines were associated to severity of caries in preschoolers, suggesting that chronic inflammation underlies ECC.

Salivary and Serum Antioxidant and Oxidative Stress Markers in Dental Caries.

Dental caries is the most common, chronic, noncommunicable, preventable oral disease worldwide. Oxidation may play an important role in dental caries initiation and progression. Antioxidants in body fluids protect cells. The aim of this study was to evaluate salivary and serum total antioxidant capacity (TAC) and malondialdehyde (MDA) levels in dental caries. A total of 118 healthy caries-free and caries-active male and female students participated. Caries was detected clinically. Unstimulated whole-saliva samples and blood samples were obtained. Sialochemical analysis was carried out by spectrophotometric assay. Data were analyzed with the Student t test using STATA 11. Salivary and serum TAC levels in the case and control groups did not show any significant differences. Mean salivary MDA levels in the case and control groups were 0.71 ± 0.1 and 0.35 ± 0.06 nmol/mL, respectively. The results showed significantly higher levels of salivary and serum MDA in the case group compared to the healthy control group. The oxidative stress marker was significantly higher in the caries group compared to the healthy control group. Antioxidants were not significantly different between the two groups. MDA can be produced by dental caries, resulting in a decrease in antioxidant levels, causing disease progression. Further studies are necessary to determine whether MDA is the cause or effect of the disease.

A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children.

BACKGROUND: A recent study in Canada reported that vitamin D deficiency is associated with dental caries. Because Koreans have been reported to be deficient in vitamin D, we investigated the relationship between dental caries and reduced serum vitamin D levels in Korean children. The purpose of this study was to analyze the relationships between blood vitamin D [25(OH)D] concentrations and dental caries in the permanent dentition of Korean children. METHODS: Data were collected from the Korea National Health and Nutrition Examination Survey performed in 2008-2013. A total of 1688 children (10-12 years of age) were enrolled. Vitamin D intake was measured through analysis of 25-hydroxy vitamin D [25(OH)D] levels. Caries experience in permanent dentition was assessed using the decay-missing-filled teeth (DMFT) index and decayed-missing-filled (DMF) rate. Statistical analyses included complex samples Chi-square tests, complex samples logistic regression analyses, and Pearson's correlations. RESULTS: The group with 25(OH) D levels lower than 50 nmol/L had a higher proportion of children with caries in the permanent dentition and permanent first molar than the group with 25(OH)D levels of 50 nmol/L or more. When external factors, such as sex, were controlled, 25(OH)D levels were not significantly correlated with caries, but were significantly correlated with first molar caries. Children with 25(OH)D levels lower than 50 nmol/L were 1.295 times more likely to have first molar caries than those with 25(OH)D levels of 50 nmol/L or more. Additionally, 25(OH)D levels and DMFT were negatively correlated; however, the degree of correlation was not strong. CONCLUSIONS: The association between 25(OH)D and dental caries is still not clear. However, our findings suggested that vitamin D insufficiency may be a risk factor for dental caries.

Dental caries and vitamin D3 in children with growth hormone deficiency: A STROBE compliant study.

Vitamin D may prevent dental caries. To date, no attempts have been made to examine the correlation between the incidence of caries and the concentrations of vitamin D in children with pituitary growth hormone deficiency.The study observed patients of the Department of Endocrinology and Diabetology of the University Paediatric Hospital of the Medical University of Lublin treated with human recombinant growth hormone for pituitary growth hormone deficiency (GHD). The study was conducted between October 2014 and June 2015. The study group consisted of 121 children and adolescents (6-17 years old), including 56 children from rural areas and 65 children from urban areas. The study group was stratified by area of residence.In our study, the increase in vitamin D3 [25(OH)D] levels reduced the D component by 0.66 per each 10 ng/mL of vitamin D3 concentration. The percentage of children with active caries in rural areas is 91.07% (n = 51), which is significantly higher than the percentage of children with active caries in urban areas (81.54%, n = 53).To date, information regarding the potential possibility of reducing the incidence of dental caries by means of increasing the levels of vitamin D was sidelined by paediatricians and dentists alike. Therefore, this aspect of caries prevention should be highlighted.

Vitamin D status and dental caries in healthy Swedish children.

Background: Vitamin D is crucial for mineralized tissue formation and immunological functions. The purpose of this study was to evaluate the association between vitamin D status and dental status in healthy children with vitamin D supplementation in infancy and at 6 years of age. Method: Eight-year-old children who had participated in a vitamin D intervention project when they were 6 years old were invited to participate in a dental follow-up study. They had fair or darker skin complexion and represented two geographically distant parts of Sweden. 25-hydroxy vitamin D in serum had been measured at 6 years of age and after a 3-month intervention with 25, 10 or 2 (placebo) µg of vitamin D3 per day. Two years later, caries and enamel defects were scored, self-reported information on e.g., oral behavior, dietary habits and intake of vitamin D supplements was collected, and innate immunity peptide LL37 levels in saliva and cariogenic mutant streptococci in tooth biofilm were analyzed. The outcome variables were caries and tooth enamel defects. Results: Dental status was evaluated in 85 of the 206 children in the basic intervention study. Low vitamin D levels were found in 28% at baseline compared to 11% after the intervention, and 34% reported continued intake of vitamin D supplements. Logistic regression supported a weak inverse association between vitamin D status at 6 years of age and caries 2 years later (odds ratio 0.96; p = 0.024) with minor attenuation after an adjustment for potential confounders. Multivariate projection regression confirmed that insufficient vitamin D levels correlated with caries and higher vitamin D levels correlated with being caries-free. Vitamin D status at 6 years of age was unrelated to enamel defects but was positively associated with saliva LL37 levels. Conclusion: An association between vitamin D status and caries was supported, but it was not completely consistent. Vitamin D status at 6 years of age was unrelated to enamel defects but was positively associated with LL37 expression. Trial registration: The basic intervention study was registered at ClinicalTrials.gov with register number NCT01741324 www.clinicaltrials.gov/ct2/show/NCT02347293 on November 26, 2012.

Suboptimal Serum Vitamin D Associated with Early Childhood Caries in Special Health Care Needs Children.

Purpose: To investigate the association between suboptimal serum vitamin D and early childhood caries (ECC) among children who received care at Seattle Children's Hospital (SCH) between 1999 and 2014.Methods: This cross-sectional study examined one- to six-year-old children in their primary dentition, with an American Society of Anesthesiologists (ASA) health status of II to IV, serum vitamin D, and dental data. Serum vitamin D was categorized as optimal (at least 75 nanomoles per liter) or suboptimal (less than 75 nanomoles per liter). Associations between serum vitamin D and caries were assessed using bivariate and multivariable (modified) Poisson regression models. Multivariable models were adjusted for age, race, ASA classification, season of vitamin D collection, and gastrostomy tube (G-tube) feeding status.Results: The mean age of 276 subjects was 3.4±1.5 years; 50.4 percent was female, 48.9 percent was Caucasian, 81.5 percent was ASA III status, 36.2 percent was G-tube fed, and 33.3 percent had ECC. Children with suboptimal 25-hydroxy vitamin D status were twice as likely to have ECC than children with optimal levels (relative risk = 2.14; 95 percent confidence interval = 1.45 to 3.16). The association between serum vitamin D and ECC was observed among children with neurologic (P<0.001) and genetic (P<0.001) conditions.Conclusions: Suboptimal 25-hydroxy vitamin D status was associated with increased risk for ECC in children with special health care needs. Interventions beyond the realm of the mouth are relevant for this highly vulnerable population and awareness of their vitamin D status should be considered.

Blood Lead Levels and Dental Caries in U.S. Children Who Do Not Drink Tap Water.

INTRODUCTION: 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. METHODS: 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=5,677). The threshold for elevated blood lead level was ≥3 µg/dL. A binary outcome indicated presence or absence of dental caries experience. Multivariable generalized linear models estimated adjusted prevalence ratios with 95% confidence limits. RESULTS: In analysis conducted in 2017, 15% of children and adolescents did not drink tap water, 3% had elevated blood lead levels ≥3 µg/dL, and 50% had dental caries experience. Children and adolescents who did not drink water were less likely than tap water drinkers to have an elevated blood lead level (adjusted prevalence ratios=0.62, 95% confidence limits=0.42, 0.90). Nonconsumers of tap water were more likely to have dental caries (adjusted prevalence ratios=1.13, 95% confidence limits=1.03, 1.23). Results persisted after adjustment for other covariates and using a higher threshold for elevated blood lead level. CONCLUSIONS: In this nationally representative U.S. survey, children and adolescents who did not drink tap water had lower prevalence of elevated blood lead levels and higher prevalence of dental caries than those who drank tap water.

Evaluation and association of serum iron and ferritin levels in children with dental caries.

BACKGROUND: Iron deficiency anemia accounts for 90% of all types of anemia in the world. Although the prevalence has declined in recent years, it remains an important pediatric public health problem. Iron deficiency has also been associated with dental caries. It impairs salivary gland function causing reduced salivary secretion and buffering capacity leading to increased caries activity. AIM: The aim of the study is to explore an association between dental caries and serum levels of iron and ferritin in children aged 3-12 years. Subjectsand Methods: The study group included 120 children, hospitalized for uncomplicated medical problems. Blood reports were evaluated to determine serum iron and ferritin levels. Dental caries experience was assessed using deft index. STATISTICAL ANALYSIS USED: The collected data were tabulated and analyzed using Student's t-test and Pearson's correlation coefficient. RESULTS: Out of 120 children, 38 children showed low serum iron levels of which 31 children had dental caries and nine out of 15 children in the high serum iron level group showed dental caries. High ferritin levels were seen in three children among which two children were caries-free and only one child had a low ferritin level who also had a positive deft score. CONCLUSION: Based on the results, it was concluded that there is an inverse association between serum iron levels and dental caries whereas there is no association between serum ferritin levels and dental caries.

Salivary Iron (Fe) Ion Levels, Serum Markers of Anemia and Caries Activity in Pregnant Women.

Introduction Anemia is a very frequent event among pregnant women. There are evidences of differences in the incidence of dental caries between pregnant and non-pregnant women, but the relationship between salivary iron (Fe) and serum markers of anemia and caries development has not been investigated. Objective To evaluate the correlation between salivary (Fe) and serum iron (Fe, ferritin and hemoglobin) parameters in pregnant women with the development of dental caries. Methods A prospective cohort was conducted with 59 women. The outcome of interest was represented by new dental caries lesions during pregnancy, using the Nyvad criteria. Pregnant women were evaluated at three clinical times: up to the 16th week of gestational age (GA) (T1), in the last trimester of pregnancy (T2), and postpartum (T3), at the Mother and Child Unit of University Hospital of the Universidade Federal do Maranhão. A stimulated saliva sample was collected for biochemical analysis of salivary Fe, and a blood sample was collected early in the morning. The correlation between salivary and serum Fe was evaluated through the Pearson correlation test. Analysis of variance (ANOVA) and Kruskal-Wallis were used to compare the means of anemia parameters at different times. The Student's t and Mann-Whitney tests were used to compare the anemia parameters between the groups of pregnant women (with and without new caries lesions). Results Serum Fe concentrations were higher in the first trimester of pregnancy and lower after delivery (p = 0.036). It was also observed that the ferritin concentrations were higher in the first trimester and lower at the end of gestation (p = 0.011). There was no association between the expositions of salivary iron and anemia, and the development of dental caries. There was a positive correlation between serum Fe in T1 and salivary Fe in T2 (p < 0.05). Conclusion The serum markers of anemia were more prevalent in the last trimester of pregnancy.

Association between numbers of decayed teeth and HbA1c in Japanese patients with type 2 diabetes mellitus.

BACKGROUND: Dental caries (DC) are more prevalent in individuals with diabetes than in healthy individuals. However, the association between glycaemic control and DC has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We therefore assessed the association between glycated haemoglobin (HbA1c) serum concentrations and the prevalence of DC in patients with T2DM. METHODS: Retrospective analyses of data pertaining to 108 Japanese patients with T2DM hospitalized because of poor or worsened glycaemic control were included. We divided the patients based on HbA1c into two groups: HbA1c level ≥75 mmol/mol (9.0%) as poorly controlled T2DM, and HbA1c level <75 mmol/mol (9.0%) as a control group. We compared the association of lifestyle factors, dental caries, and periodontal health between patients with poorly controlled T2DM and controls. Stepwise multiple regression analyses were performed to evaluate the association between HbA1c, the absolute number of decayed teeth (DT), the sum of decayed, missing, and filled teeth, and the Met Need Index (MNI). RESULTS: DT was higher and MNI was lower in patients with poorly controlled T2DM as compared to that in controls (P = 0.006 and P = 0.004, respectively). Multiple regression analyses revealed a significant association between HbA1c levels and DT (adjusted ß = 0.039, 95% confidence interval [CI], 0.005 to 0.072, P = 0.025) and the MNI (adjusted ß = -0.216, 95% CI -0.374 to -0.058, P = 0.008). CONCLUSIONS: DT and MNI were associated with HbA1c in T2DM patients.

Salivary Iron (Fe) Ion Levels, Serum Markers of Anemia and Caries Activity in Pregnant Women / Níveis de íon ferro (Fe) salivar, marcadores séricos de anemia, e atividade de cárie em mulheres grávidas

Abstract Introduction Anemia is a very frequent event among pregnant women. There are evidences of differences in the incidence of dental caries between pregnant and nonpregnant women, but the relationship between salivary iron (Fe) and serummarkers of anemia and caries development has not been investigated. Objective To evaluate the correlation between salivary (Fe) and serum iron (Fe, ferritin and hemoglobin) parameters in pregnant women with the development of dental caries. Methods A prospective cohort was conducted with 59 women. The outcome of interest was represented by new dental caries lesions during pregnancy, using the Nyvad criteria. Pregnant women were evaluated at three clinical times: up to the 16th week of gestational age (GA) (T1), in the last trimester of pregnancy (T2), and postpartum (T3), at the Mother and Child Unit ofUniversityHospital of the Universidade Federal doMaranhão.A stimulated saliva sample was collected for biochemical analysis of salivary Fe, and a blood sample was collected early in the morning. The correlation between salivary and serum Fe was evaluated through the Pearson correlation test. Analysis of variance (ANOVA) and Kruskal-Wallis were used to compare the means of anemia parameters at different times. The Student's t and Mann-Whitney tests were used to compare the anemia parameters between the groups of pregnant women (with and without new caries lesions). Results SerumFe concentrationswere higher in the first trimester of pregnancy and lower after delivery (p = 0.036). It was also observed that the ferritin concentrations were higher in the first trimester and lower at the end of gestation (p = 0.011). Therewas no association between the expositions of salivary iron and anemia, and the development of dental caries. There was a positive correlation between serum Fe in T1 and salivary Fe in T2 (p < 0.05). Conclusion The serummarkers of anemiaweremore prevalent in the last trimester of pregnancy.

Resumo Introdução A anemia é um evento muito frequente entre mulhres grávidas. Existem evidências de diferenças na incidência de cárie dentária entre mulheres grávidas e não grávidas,mas a relação entre o íon ferro (Fe) salivar, osmarcadores séricos de anemia e o desenvolvimento de cárie não foi investigada. Objetivo Avaliar a correlação entre os parâmetros salivares (Fe) e séricos (Fe, ferritina e hemoglobina) em gestantes e o desenvolvimento de cárie dentária. Métodos Uma coorte prospectiva foi conduzida com 59 mulheres. O desfecho de interesse foi representado por novas lesões de cárie durante a gravidez, medido pelo critério Nyvad. Mulheres grávidas foram avaliadas em três tempos clínicos: até a 16ª semana de idade gestacional (IG) (T1), no último trimestre de gravidez (T2), e no puerpério (T3), na Unidade Materno-infantil do Hospital Universitário da Universidade Federal do Maranhão. A amostra de saliva estimulada foi coletada para análise bioquímica de Fe salivar, e a amostra de sangue foi coletada no início da manhã. A correlação entre o Fe salivar e o Fe sérico foi avaliada através do teste de correlação de Pearson. Os testes ANOVA e Kruskal-Wallis foram utilizados para comparar parâmetros de anemia em diferentes momentos. Os testes t de Student e Mann-Whitney foram utilizados para comparar os parâmetros da anemia entre os grupos de gestantes (come sem lesões de cárie). Resultados As concentrações séricas de Fe foram maiores no primeiro trimestre de gestação e menores após o parto (p = 0,036). Observou-se também que as concentrações de ferritina forammaiores no primeiro trimestre emenores no final da gestação (p = 0,011). Não houve associação entre as exposições e o desenvolvimento de cárie dentária. Houve correlação positiva entre o Fe sérico em T1 e o Fe salivar em T2 (p < 0,05). Conclusão Os marcadores séricos de anemia foram mais prevalentes no último trimestre de gestação.

Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study.

The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad's criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95-0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98-0.99), ferritin (IRR = 0.99, 95%CI 0.98-0.99), erythrocyte (IRR = 0.71, 95%CI 0.50-0.99), hemoglobin (IRR = 0.84, 95%CI 0.73-0.96), hematocrit (IRR = 0.93, 95%CI 0.88-0.98), MCV (IRR = 0.91, 95%CI 0.86-0.96), and MCH (IRR = 0.83, 95%CI 0.74-0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.