Skip to main content

Advertisement

SpringerLink
Log in

Oral health of overweight and obese children and adolescents: a comparative study with a multivariate analysis of risk indicators

  • Original Scientific Article
  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the oral health status of overweight and obese children compared to normal weight children and to explore the effect of risk indicators, including stress, on the oral health of the children.

Methods

For this cross-sectional study, 7–15-year-old children were enrolled: divided into a group of overweight and obese and a group of normal weight children. Parent-reported questionnaires were used to for data collection demographic data, children’s medical and developmental history, brushing frequency and dietary habits. Participants’ state and trait anxiety levels were evaluated using STAIC questionnaires while saliva cortisol was measured as a biomarker of stress. Dental Caries (DMFT/dmft), periodontal health (plaque index–PI and gingival index–GI), saliva flow rate and buffer capacity were recorded at the dental clinic by two calibrated examiners. Student’s t-test, Pearson’s r and Fisher’s exact test were used for bivariate associations and backward stepwise multivariate regression analysis for each oral health outcome was performed (P ≤ 0.05).

Results

Overweight and obese children had significantly higher DMFT (3.92 ± 4.69 vs. 1.30 ± 2.49, P < 0.001), PI (0.9 ± 0.5 vs. 0.45 ± 0.52, P < 0,001) and GI (0.38 ± 0.39 vs. 0.18 ± 0.47, P < 0,001), salivary cortisol AUC (128.3 ± 55.5 vs. 99.4 ± 35.7, P = 0.004), lower saliva flow rate and decreased “high” saliva buffer capacity. There were no differences for the STAIC measures between the groups. Child’s weight affected periodontal parameters but not dental caries, when controlling for other risk indicators.

Conclusion

Oral status of overweight and obese children was worse compared to normal weight children and this did not correlate to stress variables.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and materials

By request from the authors.

References

  • Agouropoulos A. Oral health status of preschool children in the Prefecture of Attica and effectiveness of a two year preventive program for this population doctoral dissertation, Athen’s 2012.

  • Alm A, Fåhraeus C, Wendt L-K, Koch G, Andersson-Gäre B, Birkhed D. Body adiposity status in teenagers and snacking habits in early childhood in relation to approximal caries at 15 years of age. Int J Paediatr Dent. 2008;18:189–96.

    Article  Google Scholar 

  • Bleich SN, Vercammen KA. The negative impact of sugar-sweetened beverages on children’s health: an update of the literature. BMC Obes. 2018. https://doi.org/10.1186/s40608-017-0178-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chi DL, Luu M, Chu F. A scoping review of epidemiologic risk factors for pediatric obesity: implications for future childhood obesity and dental caries prevention research. J Public Health Dent. 2017;77:S8-31.

    Article  Google Scholar 

  • Cinar AB, Murtomaa H. Interrelation between obesity, oral health and life-style factors among Turkish school children. Clin Oral Invest. 2011;15:177–84.

    Article  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.

    Article  Google Scholar 

  • Fadel HT, Pliaki A, Gronowitz E, Mårild S, Ramberg P, Dahlèn G, et al. Clinical and biological indicators of dental caries and periodontal disease in adolescents with or without obesity. Clin Oral Investig. 2014;18:359–68.

    Article  Google Scholar 

  • Goldberg P, Matsson L, Anderson H. Partial recording of gingivitis and dental plaque in children of different ages and in young adults. Community Dent Oral Epidemiol. 1985;13:44–6.

    Article  Google Scholar 

  • Hanrahan K, McCarthy AM, Kleiber C, Lutgendorf S, Tsalikian E. Strategies for salivary cortisol collection and analysis in research with children. Appl Nurs Res. 2006;19:95–101.

    Article  Google Scholar 

  • Hayden C, Bowler JO, Chambers S, Freeman R, Humphris G, Richards D, et al. Obesity and dental caries in children: a systematic review and meta-analysis. Commun Dent Oral Epidemiol. 2013;41:289–308.

    Article  Google Scholar 

  • Kotanidou EP, Grammatikopoulou MG, Spiliotis BE, Kanaka-Gantenbein C, Tsigga M, Galli-Tsinopoulou A. Ten-year obesity and overweight prevalence in Greek children: a systematic review and meta-analysis of 2001–2010 data. Hormones. 2013;12:537–49.

    Article  Google Scholar 

  • Li L-W, Wong HM, Sun L, Wen YF, McGrath CP. Anthropometric measurements and periodontal diseases in children and adolescents: a systematic review and meta-analysis. Adv Nutr. 2015a;6:828–41.

    Article  Google Scholar 

  • Li L-W, Wong HM, Peng S-M, McGrath CP. Anthropometric measurements and dental caries in children: a systematic review of longitudinal studies. Adv Nutr. 2015b;6:52–63.

    Article  Google Scholar 

  • Livingstone MBE, Black AE. Markers of the validity of reported energy intake. J Nutr. 2003;133:895S-920S.

    Article  Google Scholar 

  • Manohar N, Hayen A, Fahey P, Arora A. Obesity and dental caries in early childhood: a systematic review and meta-analyses. Obes Rev. 2020;21:e12960. https://doi.org/10.1111/obr.12960.

    Article  PubMed  Google Scholar 

  • Martens L, De Smet S, Yusof MYPM, Rajasekharan S. Association between overweight/obesity and periodontal disease in children and adolescents: a systematic review and meta-analysis. Eur Arch Paediatr Dent. 2017. https://doi.org/10.1007/s40368-017-0272-1.

    Article  PubMed  Google Scholar 

  • Modéer T, Blomberg CC, Wondimu B, Julihn A, Marcus C. Association between obesity, flow rate of whole saliva, and dental caries in adolescents. Obesity. 2010;18:2367–73.

    Article  Google Scholar 

  • Modéer T, Blomberg C, Wondimu B, Lindberg TY, Marcus C. Association between obesity and periodontal risk indicators in adolescents. Int J Pediatr Obes. 2011;6:e264-270.

    Article  Google Scholar 

  • Oulis CJ, Tsinidou K, Vadiakas G, Mamai-Homata E, Polychronopoulou A, Athanasouli T. Caries prevalence of 5, 12 and 15-year-old Greek children: a national pathfinder survey. Community Dent Health. 2012;29:29–32.

    PubMed  Google Scholar 

  • Paisi M, Kay E, Bennett C, Kaimi I, Witton R, Nelder R, Lapthorne D. Body mass index and dental caries in young people: a systematic review. BMC Pediatr. 2019;19:122.

    Article  Google Scholar 

  • Pannuzio E, Amancio OMS, de Vitalle MS, Souza DN, Mendes FM, Nicolau J. Analysis of the stimulated whole saliva in overweight and obese school children. Rev Assoc Med Bras. 2010;56:32–6.

    Article  Google Scholar 

  • Pervanidou P, Chrousos GP. Posttraumatic stress disorder in children and adolescents neuroendocrine perspectives. Sci Signal. 2012;5:6.

    Article  Google Scholar 

  • Pervanidou P, Bastaki D, Chouliaras G, Papanikolaou K, Laios E, Kanaka-Gantenbein C, et al. Circadian cortisol profiles, anxiety and depressive symptomatology, and body mass index in a clinical population of obese children. Stress. 2013;16:34–43.

    Article  Google Scholar 

  • Psychountaki M, Zervas Y, Karteroliotis K, Spielberger C. Reliability and validity of the Greek version of the STAIC. Eur J Psychol Assess. 2003;19:124–30.

    Article  Google Scholar 

  • Rai K, Hegde AM, Shetty S, Shetty S. Estimation of salivary cortisol in children with rampant caries. J Clin Pediatr Dent. 2010;34:249–52.

    Article  Google Scholar 

  • Reeves AF, Rees JM, Schiff M, Hujoel P. Total body weight and waist circumference associated with chronic periodontitis among adolescents in the United States. Arch Pediatr Adolesc Med. 2006;160:894–9.

    Article  Google Scholar 

  • Scorzetti L, Marcattili D, Pasini M, Mattei A, Marchetti E, Marzo G. Association between obesity and periodontal disease in children. Eur J Paediatr Dent. 2013;14:181–4.

    PubMed  Google Scholar 

  • Słotwińska SM, Słotwiński R. Host response, obesity, and oral health. Cent Eur J Immunol. 2015;40(2):201–5.

    Article  Google Scholar 

  • Stangvaltaite-Mouhat L, Furberg AS, Drachev SN, Trovik TA. Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort. BMC Oral Health. 2021;21:53.

    Article  Google Scholar 

  • Tikhonova S, Booij L, D’Souza V, Crosara KTB, Siqueira WL, Emami E. Investigating the association between stress, saliva and dental caries: a scoping review. BMC Oral Health. 2018;13:41.

    Article  Google Scholar 

  • Ueda H, Yagi T, Amitani H, Asakawa A, Ikeda S, Miyawaki S, et al. The roles of salivary secretion, brain-gut peptides, and oral hygiene in obesity. Obes Res Clin Pract. 2013;7:e321-329.

    Article  Google Scholar 

  • Vanaelst B, Michels N, Clays E, Herrmann D, Huybrechts I, Sioen I, et al. The association between childhood Stress and body composition, and the role of stress-related lifestyle factors—cross-sectional findings from the baseline ChiBS survey. Int J Behav Med. 2013;21:292–301.

    Article  Google Scholar 

  • Vanderas AP, Manetas C, Papagiannoulis L. Urinary catecholamine levels in children with and without dental caries. J Dent Res. 1995;74:1671–8.

    Article  Google Scholar 

  • Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1:11–25.

    Article  Google Scholar 

  • Zeigler CC, Persson GR, Wondimu B, Marcus C, Sobko T, Modéer T. Microbiota in the oral subgingival biofilm is associated with obesity in adolescence. Obesity. 2014;20:157–64.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 11527, Athens, Greece

    Eleni Panagiotou, Andreas Agouropoulos & George Vadiakas

  2. First Department of Pediatrics, Medical School, Aghia Sophia Children’s Hospital, National and Kapodistrian University of Athens, 1 Thivon Str, Goudi, 11527, Athens, Greece

    Panagiota Pervanidou, George Chouliaras & Christina Kanaka-Gantenbein

  3. Alkiviadou 169, 18535, Piraeus, Greece

    Eleni Panagiotou

Authors
  1. Eleni Panagiotou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andreas Agouropoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George Vadiakas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Panagiota Pervanidou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. George Chouliaras
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christina Kanaka-Gantenbein
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

PE: conception and design of the study, reviewed the literature, data acquisition (questionnaires, clinical examination), drafted the initial manuscript. AA: conception and design of the study, data acquisition (clinical examination), reviewed the literature, carried out the initial analyses, supervised data collection, reviewed and revised the manuscript. CG: analyzed the data, prepared tables and figures, and reviewed and revised the manuscript. VG: conceptualized and designed the study, supervised data collection and reviewed and revised the manuscript. PP: conceptualized and designed the study, supervised data collection, and reviewed and revised the manuscript. K-GC: conceptualized and designed the study, critically revised the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Eleni Panagiotou.

Ethics declarations

Ethical approval

The experimental protocol was approved by the Ethics Committee of the “Aghia Sophia” Children’s Hospital and the Ethics Research Committee of the Dental School of the National and Kapodistrian University of Athens (NKUA). The study was conducted according to the declaration of Helsinki.

Consent to participate

A written informed consent was obtained from the parents.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Panagiotou, E., Agouropoulos, A., Vadiakas, G. et al. Oral health of overweight and obese children and adolescents: a comparative study with a multivariate analysis of risk indicators. Eur Arch Paediatr Dent 22, 861–868 (2021). https://doi.org/10.1007/s40368-021-00643-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40368-021-00643-0

Keywords

Search

Navigation