Common Risk Factors Underlie Caries and Periodontitis: Integrality Approach

Objectives: In the last decades, the caries taxes remained challenging, with peridontitis increasing worldwide. We have observed a confluence of caries and periodontitis indicators across the life cycle. Now, we hypothesized that, besides socioeconomic determinants, these diseases share common risk factors. We investigated the leading factors for non-communicable diseases: obesity and behavior (tobacco use, alcohol consumption, unhealthy diet consumption) and a healthy diet as a protector of oral diseases.
Methods: Population-based study used data from the American population in a temporal lapse of almost two decades (NHANES III, n=10,150; NHANES 2011-2014, n=3,553). A theoretical model was built to investigate socioeconomic and risk factors with oral diseases using Structural Equation Modeling. Socioeconomic Status was a latent variable formed by the poverty index and level of education. Unhealthy Diet was deduced from ice cream, cakes, chocolates, beverage sugar, snacks, and red processed meat. Healthy Diet was deduced from fruits, vegetables, grains, and cereals. The outcome was The Chronic Oral Diseases Burden, a latent variable deduced from moderate probing depth (PD) (4-5mm), moderate clinical attachment level (CAL) (3-4mm), decayed teeth, and teeth with pulp involvement.
Results: Worse Socioeconomic Status and Unhealthy Diet were associated with a higher Chronic Oral disease burden (p<0.05) in NHANES III and NHANES 2011-2014. Smoking and obesity increased the Chronic Oral Diseases Burden values, while the Healthy Diet reduced the Chronic Oral Diseases in NHANES III (p<0.05).
Conclusions: Our results support a transdisciplinary approach to caries and periodontitis. This integrality vision is urgent, directing efforts to commercial, economic, and social determinants in health and behavioral risk factors for tackling the NCDs altogether.