Environmental Science and Pollution Research

, Volume 22, Issue 20, pp 15636–15645 | Cite as

Urinary heavy metals, phthalates, phenols, thiocyanate, parabens, pesticides, polyaromatic hydrocarbons but not arsenic or polyfluorinated compounds are associated with adult oral health: USA NHANES, 2011–2012

  • Ivy ShiueEmail author
Research Article


Links between environmental chemicals and human health have emerged over the last few decades, but the effects on oral health have been less studied. Therefore, it was aimed to study the relationships of different sets of urinary chemical concentrations and adult oral health conditions in a national and population-based setting. Data was retrieved from the United States National Health and Nutrition Examination Surveys, 2011–2012 including demographics, self-reported oral health conditions and urinary environmental chemical concentrations (one third representative sample of the study population). Chi-square test, t test, and survey-weighted logistic and multi-nominal regression modeling were performed. Of 4566 American adults aged 30–80, 541 adults (11.9 %) reported poor teeth health while 1020 adults (22.4 %) reported fair teeth. Eight hundred fifty-five people (19.1 %) claimed to have gum disease, presented with higher levels of urinary cadmium, cobalt and polyaromatic hydrocarbons. Six hundred three adults (13.3 %) had bone loss around the mouth, presented with higher levels of cadmium, nitrate, thiocyanate, propyl paraben and polyaromatic hydrocarbons. Eight hundred forty-five adults (18.5 %) had tooth loose not due to injury, presented with higher level of cadmium, thiocyanate and polyaromatic hydrocarbons. Eight hundred forty-five adults (18.5 %) with higher levels of lead, uranium, polyaromatic hydrocarbons but lower level of triclosan noticed their teeth did not look right. Three hundred fifty-one adults (7.7 %) often had aching in the mouth and 650 (14.3 %) had it occasionally, presented with higher levels of phthalates, pesticides and polyaromatic hydrocarbons. Benzophenone-3 and triclosan elicited protective effects. Regulation of environmental chemicals in prevention of adult oral health might need to be considered in future health and environmental policies.


Chemicals Risk factor Oral health Gum disease Self-rated teeth health Bone loss Toothache 



Dr. Ivy Shiue would like to thank reviewer 3 for providing insightful feedback to complement to the Discussion section.

Conflict of interest



  1. Alaluusua S, Lukinmaa PL (2006) Developmental dental toxicity of dioxin and related compounds—a review. Int Dent J 56:323–331CrossRefGoogle Scholar
  2. Alomary A, Al-Momani IF, Obeidat SM, Massadeh AM (2013) Levels of lead, cadmium, copper, iron, and zinc in deciduous teeth of children living in Irbid, Jordan by ICP-OES: some factors affecting their concentrations. Environ Monit Assess 185:3283–3295CrossRefGoogle Scholar
  3. Arora M, Weuve J, Schwartz J, Wright RO (2008) Association of environmental cadmium exposure with pediatric dental caries. Environ Health Perspect 116:821–825CrossRefGoogle Scholar
  4. Barton HJ (2011) Advantages of the use of deciduous teeth, hair, and blood analysis for lead and cadmium bio-monitoring in children. A study of 6-year-old children from Krakow (Poland). Biol Trace Elem Res 143:637–658CrossRefGoogle Scholar
  5. Brockhaus A, Collet W, Dolgner R, Engelke R, Ewers U, Freier I, Jermann E, Krämer U, Manojlovic N, Turfeld M et al (1988) Exposure to lead and cadmium of children living in different areas of north-west Germany: results of biological monitoring studies 1982–1986. Int Arch Occup Environ Health 60:211–222CrossRefGoogle Scholar
  6. Cleymaet R, Bottenberg P, Slop D, Clara R, Coomans D (1991) Study of lead and cadmium content of surface enamel of schoolchildren from an industrial area in Belgium. Community Dent Oral Epidemiol 19:107–111CrossRefGoogle Scholar
  7. Cope, Dupras (2009) The effects of household corrosive chemicals on human dentition. J Forensic Sci 54:1238–1246CrossRefGoogle Scholar
  8. Dadamio J, Laleman I, Quirynen M (2013) The role of toothpastes in oral malodor management. Monogr Oral Sci 23:45–60CrossRefGoogle Scholar
  9. Gelman A, Hill J, Yajima M (2012) Why we (usually) don’t have to worry about multiple comparisons. J Res Educ Eff 5:189–211Google Scholar
  10. Jamal SA, Reid LS, Hamilton CJ (2013) The effects of organic nitrates on osteoporosis: a systematic review. Osteoporos Int 24:763–770CrossRefGoogle Scholar
  11. Kakei M, Sakae T, Yoshikawa M (2009) Mechanism of cadmium induced crystal defects in developing rat tooth enamel. Proc Jpn Acad Ser B Phys Biol Sci 85:500–507CrossRefGoogle Scholar
  12. Maciejewska K, Drzazga Z, Kaszuba M (2014) Role of trace elements (Zn, Sr, Fe) in bone development: energy dispersive X-ray fluorescence study of rat bone and tooth tissue. Biofactors 40:425–435CrossRefGoogle Scholar
  13. Millen AE (2014) Adequate vitamin d status may prevent subsequent tooth loss. J Evid Based Dent Pract 14:197–199CrossRefGoogle Scholar
  14. Mulligan KJ, Davidson TM, Caruso JA (1990) Feasibility of the direct analysis of urine by inductively coupled argon plasma mass-spectrometry for biological monitoring of exposure to metals. J Anal Atomic Spectrom 5:301–306CrossRefGoogle Scholar
  15. Picoli LC, Watanabe IS, Lopes RA, Sala MA, Picoli F (2004) Effect of cadmium on the floor of the mouth on rats during lactation. Braz Oral Res 18:105–109CrossRefGoogle Scholar
  16. Shiue I (2013a) Urine phthalate concentrations are higher in people with stroke: United States National Health and Nutrition Examination Surveys (NHANES), 2001–2004. Eur J Neurol 20:728–731CrossRefGoogle Scholar
  17. Shiue I (2013b) Association of urinary arsenic, heavy metal, and phthalate concentrations with food allergy in adults: National Health and Nutrition Examination Survey, 2005–2006. Ann Allergy Asthma Immunol 111:421–423CrossRefGoogle Scholar
  18. Shiue I (2013c) Urinary environmental chemical concentrations and vitamin D are associated with vision, hearing, and balance disorders in the elderly. Environ Int 53:41–46CrossRefGoogle Scholar
  19. Shiue I (2014) Higher urinary heavy metal, phthalate, and arsenic but not parabens concentrations in people with high blood pressure, U.S. NHANES, 2011–2012. Int J Environ Res Public Health 11:5989CrossRefGoogle Scholar
  20. Silva MJ, Samandar E, Preau JL Jr, Reidy JA, Needham LL, Calafat AM (2007) Quantification of 22 phthalate metabolites in human urine. J Chromatogr B Analyt Technol Biomed Life Sci 860:106–112CrossRefGoogle Scholar
  21. Stoltzfus JC (2011) Logistic regression: a brief primer. Acad Emerg Med 18:1099–1104CrossRefGoogle Scholar
  22. Tormoehlen LM, Tekulve KJ, Nañagas KA (2014) Hydrocarbon toxicity: a review. Clin Toxicol (Phila) 52:479–489CrossRefGoogle Scholar
  23. Vahter ME (1988) Arsenic. In: Clarkson TW, Friberg L, Nordberg GF, Sager PR (eds) Biological monitoring of toxic metals. Plenum Press, New York, pp 303–321CrossRefGoogle Scholar
  24. Ye X, Kuklenyik Z, Needham LL, Calafat AM (2005) Automated on-line column-switching HPLC-MS/MS method with peak focusing for the determination of nine environmental phenols in urine. Anal Chem 77:5407–5413CrossRefGoogle Scholar
  25. Ye X, Kuklenyik Z, Bishop AM, Needham LL, Calafat AM (2006) Quantification of the urinary concentrations of parabens in humans by on-line solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 844:53–59CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Faculty of Health and Life SciencesNorthumbria UniversityNewcastle upon TyneUK
  2. 2.Owens Institute for Behavioral ResearchUniversity of GeorgiaAthensUSA

Personalised recommendations