Author(s) and paper Language |
Year |
Study site |
Age group (years) |
Sample |
Study design |
Definition of the main exposure (obesity) |
Outcome definition (caries) |
Results |
Downs & Black Score Appraiser 1/ Score Appraiser 2 |
|
Honne et al 19 English |
2012 |
Índia (Udupi district) |
13 to 15 |
462 |
Cross-sectional |
BMI (weight/height 2 ) Normal = BMI <25 Overweight = BMI (25 - 29.9) Obesity = BMI 30 |
DMFT |
Crude analysis - Reference group: normal weight group 1. overweight and obesity OR = 3.67 95%CI 1.79;7.56 Adjusted Analysis – daily sugar consumption, school type, gender and age. 2. overweight and obesity OR = 3.68 95%CI 1.79;7.56 Positive statistical association |
14/12 Good scientific evidence |
Cinar et al 8 English |
2011 |
Denmark |
15 |
824 |
Cross-sectional |
BMI (weight/height 2 ) Normal = BMI for age between (≤ 5 th percentile and <95 th percentile) Overweight = BMI percentile for age between 85-95 Obesity = BMI for age greater than the 95 th percentile. |
DMFT |
No association between obesity and dental caries in the crude analysis and adjusted for variables related to lifestyle (drinking milk for breakfast and frequency of brushing). No statistical association |
10/8 |
Cinar & Murtomaa 9 English |
2011 |
Turkey (Kadikoy district) |
10 to 12 |
611 (360 public school) 254 (private school) |
Cross-sectional |
BMI (weight/height 2 ) Self-reported |
DMFS |
Crude and adjusted analysis There was no association between BMI and DMFS in the crude or adjusted analysis for the lifestyle (frequency of brushing teeth and milk consumption at breakfast and at bedtime) No statistical association |
8/7 |
Modéer et al 27 English |
2010 |
Sweden (Stockholm) |
Obese = (10.3 to 17.2) Not obese = (11 to 18.3) |
65 obese 65 non-obese |
Cross-sectional |
BMI (weight/height 2 ) Normal = BMI <25 Obesity = BMI> 30 |
DMFT analyzing only the decayed component and radiographs |
Crude Analysis reference group of normal weight. 1. Obesity: OR = 1.31 95%CI 1.11;1.56 Adjusted Analysis: 1. Age, sex, chronic illness, medications, and salivary flow: OR = 1.30 95%CI 1.08;1.58 2. Adjusted for parental education and country of birth of parents: OR = 1.36 95%CI 1.12;1.64 Remained associated after adjustments. Positive statistical association |
11/10 Good scientific evidence |
Sanchez-Pérez et al 36 English |
2010 |
México (City México) |
7 to 11 |
135 accepted 110 |
Prospective cohort |
BMI (weight/height 2 ) Obesity = Above the 95 th percentile Risk of obesity = between the 85-95 percentile Normal = (5 th percentile between -50) Underweight = below the 5 thpercentile |
DMFS |
There was no association between BMI and dmfs (adjusted for age, deciduous dentition, sex, socioeconomic status) in the middle of the study. The longitudinal effect suggests that children with higher BMI experienced lower levels of dmfs (deciduous dentition) There was no association between BMI and CPOs (perma nent dentition) (adjusted for age, permanent dentition, sex, socioeconomic status) in the middle of the study. No statistical association |
11/11 Good scientific evidence |
Cereceda et al 6 Spanish |
2010 |
Chile (Santiago) |
5 to 15 |
1190 |
Cross-sectional |
BMI (weight/height 2 ) Underweight = BMI below the 5 th percentile Normal = BMI for age < 85 th percentile and higher than 5 th percentile Overweight = BMI percentile 85-95 Obesity = BMI ≥ 95 |
Deciduous dentition- DMFT. Permanent Dentition- DMFT |
No association between BMI and deciduous teeth (DMFT) and permanent teeth (DMFT) Reference: normal weight Crude Analysis Underweight = OR = 0.36 95%CI 0.12;1.03 Overweight = OR = 0.86 95%CI 0.61;1.21 Obesity = OR = 0.96 95%CI 0.66;1.37 Adjusted Analysis: Adjusted (age and sex) Underweight = OR = 0.35 95%CI 0.12;1.01 Overweight = OR = 0.86 95%CI 0.61;1.21 Obesity = OR = 0.96 95%CI 0.66;1.38 No statistical association |
12/12 Good scientific evidence |
Gerdin et al 15 English |
2008 |
Sweden (Ostergotland) |
4 to 7; 10 and 12 |
6 and 12 years old = 2303 10 years old = 4305 (when caries was measured) |
Prospective cohort |
BMI (weight/height 2 ) Normal = BMI < 25 Overweight = BMI > 25 Obesity = BMI > 30 |
Decayed teeth and filled - (10 years) Decayed teeth and filled proximal surfaces - (12 years) |
BMI as a continuous variable at age 4 and caries at age 12 adjusted for socioeconomic status and sex = 0.048 (p = 0.021) BMI at age 5 and caries at age 12 adjusted for socioeconomic status and sex = 0.007 (p = 0.050) BMI at age 5 and caries at age 12 adjusted for socioeconomic status and sex = 0.032 (p = 0.017) BMI at age 5 and caries at age 12 adjusted for socioeconomic status and sex = 0.024 (p = 0.010) BMI had independent effect, though weakened by decay at age 12. Positive statistical association |
12/10 Good scientific evidence |
Cinar & Murtomaa 10 English |
2008 |
Finland (Helsinqui) and Turkey (Kadikoy) |
10 to 12 |
338 Finland 611 Turkey |
Cross-sectional |
BMI (self-reported by mothers) Normal = between the percentile (5-85) Risk of obesity = between the (85-95 percentile) Obesity = Above the 95 th percentile. |
DMFT |
There was no association between BMI and caries both in crude and adjusted analysis for the time watching TV per day; regularly having lunch with the family, consumption of fruits or snacks between meals, consumption of “fast food” and drinks a week and if practicing physical activity in leisure time. No statistical association |
9/6 |
Narksawat et al 29 English |
2008 |
Tailand – (5 provinces) |
12 to 14 |
862 |
Cross-sectional |
BMI (weight/height 2 ) Underweight normal overweight obesity |
DMFT |
Adjusted analysis Reference = group of overweight and obesity Normal OR = 1.94 95%CI 1.25;3.00 Underweight OR = 2.22 95%CI 1.27; 4.09 The analysis was adjusted for frequency of brushing, flossing, using toothpaste with fluoride, consumption of snack more than three times a day, visiting the dentist more than twice a year, receiving oral health education, area of residence (urban/rural), age and sex. Negative statistical association |
11/9 |
Kopycha – kedzierawski et al 22 English |
2008 |
United States (NHANES and NHANES III) |
2-18 years old |
10180 of NHANES III 7568 of NHANES |
Cross-sectional |
Body Mass Index-BMI (weight/height 2 ) Normal = BMI for age <85 th percentile. Overweight = BMI percentile 85-95 Obesity = BMI ≥ 95 |
Deciduous dentition DFS - decayed and filled surfaces Permanent dentition- DMFS |
No differences were observed between BMI and COs and CPOs adjusted for sex, race, geographic region, economic status, education of household head, the time of last visit to the dentist and lead levels No statistical association |
13/11 Good scientific evidence |
Marschall et al 24 English |
2007 |
United States (Iowa) |
4,5 to 6,9 |
427 |
Cross-sectional of one cohort |
BMI (weight/height2) Parents and children Normal = BMI <25 Overweight = BMI (25-29.9) Obesity = BMI ≥ 30 |
Decayed or filled surface |
The analysis was adjusted for fluoride intake, maternal education, risk of obesity and soft drinks consumption. Regression analysis found maternal education and the risk of obesity to influence children having twice the risk of caries compared with those with normal weight or overweight. Positive statistical association |
12/11 Good scientific evidence |
Pinto et al 33 English |
2007 |
United States (Pennsylvania) |
Mean 8,7 |
142 |
Cross-sectional |
|
Permanent Decayed surfaces and deciduous carious surfaces |
No association between BMI and caries in the crude and adjusted analysis for age, sex and ethnicity. No statistical association |
10/7 |
Willerhausen et al 41 English |
2007 |
Germany (Johannes Gutenberg ) |
6 to 10 |
2.071 |
Cross-sectional |
BMI (weight/height 2 ) |
Decayed and filled permanent teeth Decayed and filled deciduous teeth |
There is a significant increase in the average of decayed/filled teeth from the normal weight to the obesity category after adjusting for age of the child. (p = 0.0021) Positive statistical association |
9/8 |
Willerhausen et al 40 English |
2007 |
Germany (Johannes Gutenberg ) |
6 to 11 |
1.298 |
Cross-sectional |
BMI (weight/height 2 ) Underweight normal overweight obesity |
Decayed and filled permanent teeth Decayed and filled deciduous teeth |
An association was observed between BMI and caries in both deciduous and permanent dentition. This association remained after adjusting for age. Positive statistical association |
11/8 |
Macek & Mitola 23 English |
2006 |
United States (NHANES) |
2 to 17 |
2 to 5 = 1.719 6 to 17 = 5.889 |
Cross-sectional (survey) |
BMI (weight/height 2 ) Underweight = BMI for age below the 5 th percentile Normal = BMI for age between (≤ 5 thpercentile and < 85 th percentile) Overweight = BMI for age between (≤ 85 th percentile and < 95 th percentile) Obesity = BMI for age > 95 th percentile |
Decayed and filled deciduous teeth DMFT |
There was no association between BMI and caries in the deciduous and permanent dentition in the regression analysis both crude and adjusted for age, sex, race and socioeconomic status Deciduous dentition Group of reference = normal weight Underweight RO = 0.6 95%CI 0.3;1.3 Overweight RO = 1.0 95%CI 0.5;1.7) Obesity = OR = 0.8 95% CI (0.5-1.3) Permanent Dentition Reference = normal weight Underweight = RO = 0.9 95% CI (0.5-1.7) Overweight = RO = 1.1 95%CI 0.9;1.3 Obesity RO = 1.0 95%CI 0.8;1.4 However, it was observed that participants aged between 6-17 years old and overweight had fewer caries than those with normal weight No statistical association |
13/10 Good scientific evidence |