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Lead Exposure and the Risk of Dental Caries in Urban Children

Amin, Maryse R.

Abstract Details

2014, PhD, University of Cincinnati, Medicine: Epidemiology (Environmental Health).
Importance: Tooth decay is a significant public health problem in the United States. Greater rates of dental caries are observed in lead-exposed individuals, however the impact of prenatal and postnatal lead exposure on tooth decay in a longitudinal prospective study design has not been evaluated. Objective: To examine the relationship between prenatal, postnatal childhood lead exposure, risk of dental caries and salivary flow rate in late adolescence. Design: A longitudinal prospective cohort study measuring prenatal and postnatal blood lead levels from maternal, neonatal, early childhood, average childhood (quarterly and biannual from 3 to 78 months), late adolescence and measures of dental caries, gingival inflammation, bleeding, plaque, salivary flow, dietary intake and oral hygiene in late adolescence. Setting: Participants were given dental caries examinations and various questionnaires such as demographic, nutritional and oral hygiene questionnaires administered at a Cincinnati urban community pediatric clinic during late adolescence. Participants: Two hundred and six predominately African-American male and female adolescents (16 to 22 years of age) from the longitudinal Cincinnati Lead Study cohort were recruited. Main outcomes and Measures: Tooth decay quantified as the number of decayed, missing and filled surfaces (DMFS) in permanent teeth and the number of decayed, missing and filled permanent teeth (DMFT) and stimulated salivary flow rate. Results: A significant positive association between average childhood (3 to 78 months) blood lead levels and DMFS and DMFT during late adolescence between (16 to 22 years of age) was observed. A significant quadratic relationship was also observed at the highest average childhood blood lead levels, a downward trend was observed in DMFS and DMFT measured during late adolescence. Statistically significant covariates were the number of sealants present, lactobacilli count in saliva and maternal high school education. When adjusted for mutans streptococci, ever smoking, flossing and the number of adults and children living in household, average childhood blood lead levels were associated with reduced salivary flow rate. Conclusions and Relevance: Early childhood (postnatal) blood lead levels were associated with an increased number of dental caries and decreased salivary flow rate in late adolescence. Our study findings support the public health initiative to promote primary prevention of dental caries by targeting and monitoring children with blood lead levels at or above the current reference value of 5 μg/dL.
Kim Dietrich, Ph.D. (Committee Chair)
Murray Dock, D.D.S. M.S.D (Committee Member)
Bruce Lanphear, M.D. M.P.H. (Committee Member)
Richard Hornung, Dr.P.H. (Committee Member)
147 p.

Recommended Citations

Citations

  • Amin, M. R. (2014). Lead Exposure and the Risk of Dental Caries in Urban Children [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1406901155

    APA Style (7th edition)

  • Amin, Maryse. Lead Exposure and the Risk of Dental Caries in Urban Children. 2014. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1406901155.

    MLA Style (8th edition)

  • Amin, Maryse. "Lead Exposure and the Risk of Dental Caries in Urban Children." Doctoral dissertation, University of Cincinnati, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1406901155

    Chicago Manual of Style (17th edition)