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Influence of metabolic-linked early life factors on the eruption timing of the first primary tooth

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Abstract

Aim

Early eruption of permanent teeth has been associated with childhood obesity and diabetes mellitus, suggesting links between tooth eruption and metabolic conditions. This longitudinal study aimed to identify pre-, peri- and postnatal factors with metabolic consequences during infancy that may affect the eruption timing of the first primary tooth (ETFT) in children from an ethnically heterogeneous population residing within the same community.

Material and methods

Participants were recruited (n = 1033) through the GUSTO (Growing Up in Singapore Towards healthy Outcomes) birth cohort (n = 1237). Oral examinations were performed at 3-month intervals from 6 to 18 months of age. Crude and adjusted analyses, with generalized linear modelling, were conducted to link ETFT to potential determinants occurring during pregnancy, delivery/birth and early infancy.

Results

Overall mean eruption age of the first primary tooth was 8.5 (SD 2.6) months. Earlier tooth eruption was significantly associated with infant’s rate of weight gain during the first 3 months of life and increased maternal childbearing age. Compared to their Chinese counterparts, Malay and Indian children experienced significantly delayed tooth eruption by 1.2 and 1.7 months, respectively.

Conclusions

Infant weight gain from birth to 3 months, ethnicity and maternal childbearing age were significant determinants of first tooth eruption timing. Early life influences can affect primary tooth development, possibly via metabolic pathways.

Clinical relevance

Timing of tooth eruption is linked to general growth and metabolic function. Therefore, it has potential in forecasting oral and systemic conditions such as caries and obesity.

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Acknowledgments

This study was funded by Singapore’s National Medical Research Council (NMRC/CIRG/1341/2012: R-221-000-059-511) and supported by the Singapore National Research Foundation under its TCR Flagship Programme on Developmental Pathways to Metabolic Disease (NMRC/TCR/004-NUS/2008 and NMRC/TCR/012-NUHS/2014). A special thanks is extended to the GUSTO sub-domains for their great support; Professor Michael Kramer for his important advice and input; and Pang Wei Wei, Izzuddin Bin Mohd Aris, Tan Pei Ting and Priyangi Alwis for their valuable contributions. The continuous and skilful help of the home visitors and the clinical team from the National University Hospital and the KK Women’s and Children’s Hospital, as well as the database and biostatistics teams, is deeply appreciated.

Author information

Authors and Affiliations

  1. Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore, Singapore

    Carolina Un Lam, Chin-Ying Stephen Hsu, Robert Yee, Meijin Cai, Seang Mei Saw & Peter Gluckman

  2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    David Koh

  3. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Yung Seng Lee

  4. Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), Brenner Centre for Molecular Medicine, Singapore, Singapore

    Mary Foong-Fong Chong

  5. Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital (KKH), Singapore, Singapore

    Kenneth Kwek

  6. Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Keith Godfrey

  7. Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Yap Seng Chong

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  1. Carolina Un Lam
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  2. Chin-Ying Stephen Hsu
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  8. Kenneth Kwek
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  9. Seang Mei Saw
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  12. Yap Seng Chong
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Corresponding author

Correspondence to Chin-Ying Stephen Hsu.

Ethics declarations

Ethical Approval

All work involving human participants was approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB Ref: 2009/00021) and SingHealth Centralized Institutional Review Board (CIRB Ref: 2009/280/D).

Informed Consent

Written informed consent was obtained from all participants prior to their inclusion in the study.

Conflict of interest

The authors declare that they have no competing interests.

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Un Lam, C., Hsu, CY.S., Yee, R. et al. Influence of metabolic-linked early life factors on the eruption timing of the first primary tooth. Clin Oral Invest 20, 1871–1879 (2016). https://doi.org/10.1007/s00784-015-1670-6

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  • DOI: https://doi.org/10.1007/s00784-015-1670-6

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