Abstract
Evidence suggests a possible association between ambient air pollutants and oral diseases. Nevertheless, information regarding the relationship between air pollutants and pulpitis is scarce and inconclusive. In view of this, the present study aimed to investigate the relationship between short-term exposure to air pollution and outpatient visits for pulpitis. Daily data on outpatient visits for pulpitis, air pollutants, and meteorological data in Hefei, China, was collected from January 1, 2015 to December 31, 2021. The association between exposure to air pollutants and pulpitis outpatient visits was evaluated using distributed lag non-linear model (DLNM) and a generalized linear model (GLM). Furthermore, stratified analyses were performed by gender, age and season. A total of 93,324 records of outpatient visits for pulpitis were included in this study. The results showed that exposure to NO2, PM2.5, and CO were positively correlated with an increased risk of pulpitis outpatient visits. Each 10 μg/m3 increase in NO2 and PM2.5 concentration, at lag 0–2 day, was associated with a 2.4% (relative risk (RR) = 1.024, 95% confidence interval (CI): 1.014–1.035) and 0.5% (RR = 1.005, 95% CI: 1.000–1.010) increase in pulpitis outpatient visits, respectively. With a 1 mg/m3 increase in CO concentration, the risk of pulpitis outpatient visits increased by 9.1% (RR = 1.091, 95% CI: 1.031–1.154, lag 0–1 day). Intriguingly, exposure to O3 was associated with a decreased risk of pulpitis outpatient visits (RR = 0.990, 95% CI: 0.984–0.995, lag 0–5 day). Subgroup analysis revealed that in the warm season, exposure to PM2.5, O3, and CO was related with a significantly higher outpatient risk of pulpitis than in the cold season. Additionally, the influence of PM2.5 and CO exposure at age < 65 years was significantly stronger than at age ≥ 65 years. In conclusion, exposure to ambient NO2, PM2.5, and CO is associated with an increase in pulpitis outpatient visits in Hefei, China. Conversely, exposure to O3 reduces the risk of outpatient visits for pulpitis. Age and season are effect modifiers of these associations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The authors declare that the data and materials will be available to readers upon request.
References
Avsar A, Darka O, Topaloglu B, Bek Y (2008) Association of passive smoking with caries and related salivary biomarkers in young children. Arch Oral Biol 53:969–974. https://doi.org/10.1016/j.archoralbio.2008.05.007
Bala GP, Rajnoveanu RM, Tudorache E, Motisan R, Oancea C (2021) Air pollution exposure-the (in)visible risk factor for respiratory diseases. Environ Sci Pollut Res Int 28:19615–19628. https://doi.org/10.1007/s11356-021-13208-x
Bhaskaran K, Gasparrini A, Hajat S, Smeeth L, Armstrong B (2013) Time series regression studies in environmental epidemiology. Int J Epidemiol 42:1187–1195. https://doi.org/10.1093/ije/dyt092
Chen Y, He YS, Feng YT et al (2022) The effect of air pollution exposure on risk of outpatient visits for Sjogren’s syndrome: a time-series study. Environ Res 214:114017. https://doi.org/10.1016/j.envres.2022.114017
Ding S, Sun S, Ding R, Song S, Cao Y, Zhang L (2022) Association between exposure to air pollutants and the risk of inflammatory bowel diseases visits. Environ Sci Pollut Res Int 29:17645–17654. https://doi.org/10.1007/s11356-021-17009-0
Ferreira AS, Macedo C, Silva AM, Delerue-Matos C, Costa P, Rodrigues F (2022) Natural products for the prevention and treatment of oral mucositis-a review. Int J Mol Sci:23. https://doi.org/10.3390/ijms23084385
Gao X, Colicino E, Shen J et al (2019) Impacts of air pollution, temperature, and relative humidity on leukocyte distribution: an epigenetic perspective. Environ Int 126:395–405. https://doi.org/10.1016/j.envint.2019.02.053
Gasparrini A (2014) Modeling exposure-lag-response associations with distributed lag non-linear models. Stat Med 33:881–899. https://doi.org/10.1002/sim.5963
GBD (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392:1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7
Glencross DA, Ho TR, Camina N, Hawrylowicz CM, Pfeffer PE (2020) Air pollution and its effects on the immune system. Free Radic Biol Med 151:56–68. https://doi.org/10.1016/j.freeradbiomed.2020.01.179
Glickman GN (2009) AAE Consensus Conference on Diagnostic Terminology: background and perspectives. J Endod 35:1619–1620. https://doi.org/10.1016/j.joen.2009.09.029
Glodkowska N, Emerich K (2020) The impact of environmental air pollution on the prevalence of molar incisor hypomineralization in schoolchildren: a cross-sectional study. Adv Clin Exp Med 29:1469–1477. https://doi.org/10.17219/acem/128227
Gregorczyk-Maga I, Celejewska-Wojcik N, Gosiewska-Pawlica D et al (2019) Exposure to air pollution and oxidative stress markers in patients with potentially malignant oral disorders. J Physiol Pharmacol:70. https://doi.org/10.26402/jpp.2019.1.09
Gu S, Li D, Lu B, Huang R, Xu G (2020) Associations between ambient air pollution and daily incidence of pediatric hand, foot and mouth disease in Ningbo, 2014-2016: a distributed lag nonlinear model. Epidemiol Infect 148:e46. https://doi.org/10.1017/S0950268820000321
Hao J, Yang Z, Huang S et al (2019) The association between short-term exposure to ambient air pollution and the incidence of mumps in Wuhan, China: a time-series study. Environ Res 177:108660. https://doi.org/10.1016/j.envres.2019.108660
Hayes RB, Lim C, Zhang Y et al (2020) PM2.5 air pollution and cause-specific cardiovascular disease mortality. Int J Epidemiol 49:25–35. https://doi.org/10.1093/ije/dyz114
He L, Norris C, Cui X et al (2022) Oral cavity response to air pollutant exposure and association with pulmonary inflammation and symptoms in asthmatic children. Environ Res 206:112275. https://doi.org/10.1016/j.envres.2021.112275
Hu D, Cui L, Qi Y et al (2020) Identification of potential markers for internal exposure to ambient ozone in oral cavity of healthy adults. Environ Res 190:109907. https://doi.org/10.1016/j.envres.2020.109907
Inchingolo AM, Malcangi G, Ferrante L et al (2023) Damage from carbonated soft drinks on enamel: a systematic review. Nutrients:15. https://doi.org/10.3390/nu15071785
Jia S, Sarkar S, Zhang Q et al (2018) Characterization of diurnal variations of PM(2.5) acidity using an open thermodynamic system: a case study of Guangzhou, China. Chemosphere 202:677–685. https://doi.org/10.1016/j.chemosphere.2018.03.127
Jiang W, Xie W, Ni B, Zhou H, Liu Z, Li X (2021) First trimester exposure to ambient gaseous air pollutants and risk of orofacial clefts: a case-control study in Changsha. China Bmc Oral Health 21:530. https://doi.org/10.1186/s12903-021-01876-7
Kabulbekov AA, Amrin KR (1991) Effects of air pollution on the etiology of dental caries. Gig Sanit:6–8
Kassebaum NJ, Smith A, Bernabe E et al (2017) Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 96:380–387. https://doi.org/10.1177/0022034517693566
Lamont RJ, Koo H, Hajishengallis G (2018) The oral microbiota: dynamic communities and host interactions. Nat Rev Microbiol 16:745–759. https://doi.org/10.1038/s41579-018-0089-x
Lin Z, Chen P, Yuan Z et al (2022) Fine particulate matter, airway inflammation, stress response, non-specific immune function and buccal microbial diversity in young adults. Environ Pollut 308:119692. https://doi.org/10.1016/j.envpol.2022.119692
Lu P, Zhang Y, Lin J et al (2020) Multi-city study on air pollution and hospital outpatient visits for asthma in China. Environ Pollut 257:113638. https://doi.org/10.1016/j.envpol.2019.113638
Lysy J, Karkazi F, Stanko P, Novak B (2021) The influence of mouth breathing on skeletal and dental features of splanchnocranium. Bratisl Lek Listy 122:196–199. https://doi.org/10.4149/BLL_2021_031
Petersen PE (2009) Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization. Community Dent Oral Epidemiol 37:1–8. https://doi.org/10.1111/j.1600-0528.2008.00448.x
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C (2005) The global burden of oral diseases and risks to oral health. Bull World Health Organ 83:661–669
Pulliero A, Traversi D, Franchitti E, Barchitta M, Izzotti A, Agodi A (2021) The interaction among microbiota, epigenetic regulation, and air pollutants in disease prevention. J Pers Med:12. https://doi.org/10.3390/jpm12010014
Qian Y, Gao Y, Cai B, Zhang W, Wang X, Chen R (2022) Low ambient temperature as a novel risk factor of oral diseases: a time-series study. Sci Total Environ 810:152229. https://doi.org/10.1016/j.scitotenv.2021.152229
Rao A, Ahmed MK, Taub PJ, Mamoun JS (2016) The correlation between maternal exposure to air pollution and the risk of orofacial clefts in infants: a systematic review and meta-analysis. J Oral Maxillofac Res 7:e2. https://doi.org/10.5037/jomr.2016.7102
Richert R, Ducret M, Alliot-Licht B, Bekhouche M, Gobert S, Farges JC (2022) A critical analysis of research methods and experimental models to study pulpitis. Int Endod J 55(Suppl 1):14–36. https://doi.org/10.1111/iej.13683
Righolt AJ, Jevdjevic M, Marcenes W, Listl S (2018) Global-, regional-, and country-level economic impacts of dental diseases in 2015. J Dent Res 97:501–507. https://doi.org/10.1177/0022034517750572
Rossi HL, See LP, Foster W et al (2020) Evoked and spontaneous pain assessment during tooth pulp injury. Sci Rep 10:2759. https://doi.org/10.1038/s41598-020-59742-5
Shishniashvili TE, Margvelashvili VV, Suladze NN, Kobakhidze KA (2012) Correlation between the ecological risk factors and significant index of caries in young children. Georgian Med News:30–33
Vo T, Wu CZ, Lee IT (2020) Potential effects of noxious chemical-containing fine particulate matter on oral health through reactive oxygen species-mediated oxidative stress: promising clues. Biochem Pharmacol 182:114286. https://doi.org/10.1016/j.bcp.2020.114286
Winkler O, Hadnagy W, Idel H (2001) Cytokines detectable in saliva of children as appropriate markers of local immunity of the oral cavity--an approach for the use in air pollution studies. Int J Hyg Environ Health 204:181–184. https://doi.org/10.1078/1438-4639-00092
Wu H, Dong C, Xiao W et al (2022) Associations between PM(2.5) exposure and infant growth: a mediation analysis of oral microbiota. Sci Total Environ 823:153688. https://doi.org/10.1016/j.scitotenv.2022.153688
Wu W, Zhang Y (2018) Effects of particulate matter (PM2.5) and associated acidity on ecosystem functioning: response of leaf litter breakdown. Environ Sci Pollut Res Int 25:30720–30727. https://doi.org/10.1007/s11356-018-2922-1
Yang TH, Masumi S, Weng SP, Chen HW, Chuang HC, Chuang KJ (2015) Personal exposure to particulate matter and inflammation among patients with periodontal disease. Sci Total Environ 502:585–589. https://doi.org/10.1016/j.scitotenv.2014.09.081
Yu P, Xu R, Li S et al (2022) Associations between long-term exposure to PM(2.5) and site-specific cancer mortality: a nationwide study in Brazil between 2010 and 2018. Environ Pollut 302:119070. https://doi.org/10.1016/j.envpol.2022.119070
Zhao CN, Xu Z, Wu GC et al (2019) Emerging role of air pollution in autoimmune diseases. Autoimmun Rev 18:607–614. https://doi.org/10.1016/j.autrev.2018.12.010
Zhu X, Chen C, Zhang B et al (2021) Acute effects of personal exposure to fine particulate matter on salivary and urinary biomarkers of inflammation and oxidative stress in healthy adults. Chemosphere 272:129906. https://doi.org/10.1016/j.chemosphere.2021.129906
Ziade N, Bouzamel M, Mrad-Nakhle M et al (2021) Prospective correlational time-series analysis of the influence of weather and air pollution on joint pain in chronic rheumatic diseases. Clin Rheumatol 40:3929–3940. https://doi.org/10.1007/s10067-021-05735-2
Acknowledgments
We appreciate all of the staff and participants who helped with data access and data collection for this study.
Funding
This work was supported by the Natural Science Foundation of Universities of Anhui province (KJ2020A0164), the Natural Science Foundation of Anhui Province, China (No. 1508085SQH222) and the 2022 Disciplinary Construction Project in School of Dentistry, Anhui Medical University (2022xkfyts05).
Author information
Authors and Affiliations
Contributions
Wuli Li, Xirun Zong, and Yi-Sheng He: writing original draft, data collection ,and formal analysis. Tiantian Meng, Ying Tang, Qi Yang, and Qing Huang: data curation, formal analysis, and validation. Yuanyin Wang, Song Li, and Hai-Feng Pan: conceptualization, methodology, supervision, review, and editing. The final version has been reviewed, edited, and approved by all authors.
Corresponding author
Ethics declarations
Ethics approval
This study was approved by the Ethical Committee of Anhui Medical University.
Consent to participate
This is not applicable. The study did not include any personal information about individuals in any way.
Consent for publication
All authors agree with publication in this journal.
Competing interests
The authors declare no competing interests.
Additional information
Responsible Editor: Lotfi Aleya
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
ESM 1
(DOCX 350 kb)
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Li, W., Zong, X., He, YS. et al. Association between short-term exposure to ambient air pollution and outpatient visits for pulpitis in Hefei, China: a time series study. Environ Sci Pollut Res 30, 78607–78618 (2023). https://doi.org/10.1007/s11356-023-28095-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11356-023-28095-7