Lead exposure and the risk of dental caries
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OBJECTIVES: Despite continued efforts to decrease environmental lead exposure, it remains a public health concern in the U.S. The aim of this study was to investigate the influence of lead exposure on dental caries risk among different populations. METHODS: We used data from Detroit Dental Health Project (DDHP), a cohort study of a representative sample of low-income African–American families in Detroit, Michigan, to investigate the influence of lead toxicity on dental caries risk among children, and to assess the effect of blood lead level on the caries experience among their caregivers. Data from Dental Longitudinal Study (DLS), a closed-panel prospective cohort study of oral health and aging, was used to assess the cross-sectional and longitudinal relationships between bone lead level as a cumulative measure of lead exposure and dental caries among older men. The outcome measure for cross-sectional analyses was dmfs/DMFS, which is the number of decayed surfaces, missing, and filled surfaces for each subject. Then adjusted new dmfs/DMFS increments were used for the longitudinal analyses. Descriptive and bivariate analyses were conducted on dental caries outcome by lead biomarkers. Multiple regression and GEE models were conducted controlling for confounding. RESULTS: History of lead toxicity (≥ 10µg/dl) and children’s caries risk was significantly associated in both cross-sectional analysis (PR = 1.50, p-value=0.003) and longitudinal analysis (IRR= 1.36, p-value=0.02). These associations were independent of confounding factors such as age, brushing frequency, soda consumption, income, and child and caregiver’s caries experience. On other hand, no significant associations were found between blood lead level and dental caries experience among African American adults (β=2.3, p-value=0.5), nor between high tibia/patella lead level and dental caries incident among older adult (β=0.1, p-value=0.7 for tibia, and β=0.3, p-value=0.1 for patella) . CONCLUSION: The results suggest that children with a history of lead toxicity are at a higher risk of developing dental caries compared to other children. However, there is no significant association between lead exposure and dental caries among adults. Therefore, children with a history of lead toxicity should be given special consideration in caries risk assessment and caries prevention programs.