IADR Abstract Archives
Bi-directional temporal relationship between caries and atopic dermatitis among children
Objectives: Both atopic dermatitis (AD) and dental caries (DC) are common chronic childhood diseases, with 10~20% and 20~80% prevalence rates among global communities. Recently the AD-DC relationship between AD (as an exposure) and DC (as an outcome) has gradually surfaced. Following the subclinical ectodermal developmental structural defects (SEDSD) theory, the opposite (DC-AD) temporal relationship is postulated. Since the DC-AD link remains unknown, this study is purposed to assess the comorbidity with two retrospective cohorts to test the association from both directions.
Methods: Based on the TriNetX platform, two retrospective cohorts were set up using the existing data in the US Collaborative Network of 56 global healthcare organizations (HCOs). In the AD-DC cohort, 105,830 children younger than 2 years old, with AD diagnosed more than 2 times, were recruited and the non-AD control group (N=105,830) was established with 1:1 matching of age, sex, race, SES, and medical utilization. Likewise, in the DC-AD cohort, 34,823 children younger than 6 years old with more than 3 times of caries diagnosed were identified together with the matched non-DC group as aforementioned. The log-rank test and Cox-proportional hazard model were employed, respectively, to test the significance of association and estimate the hazard ratios (HRs) between the two diseases.
Results: Both AD-DC and DC-AD links were significant (both p<0.001) with an overall HR of 1.67 (95% CI, 1.56–1.79) and 1.24 (1.11–1.37), respectively. The presence of a bi-directional temporal association supports the comorbidity as predicted by the SEDSD theory.
Conclusions: Early childhood caries and atopic dermatitis may be closely related following similar ectodermal developmental pathways. Early referral and integrated oral/general healthcare for children may be critical for disease and cost control.
Methods: Based on the TriNetX platform, two retrospective cohorts were set up using the existing data in the US Collaborative Network of 56 global healthcare organizations (HCOs). In the AD-DC cohort, 105,830 children younger than 2 years old, with AD diagnosed more than 2 times, were recruited and the non-AD control group (N=105,830) was established with 1:1 matching of age, sex, race, SES, and medical utilization. Likewise, in the DC-AD cohort, 34,823 children younger than 6 years old with more than 3 times of caries diagnosed were identified together with the matched non-DC group as aforementioned. The log-rank test and Cox-proportional hazard model were employed, respectively, to test the significance of association and estimate the hazard ratios (HRs) between the two diseases.
Results: Both AD-DC and DC-AD links were significant (both p<0.001) with an overall HR of 1.67 (95% CI, 1.56–1.79) and 1.24 (1.11–1.37), respectively. The presence of a bi-directional temporal association supports the comorbidity as predicted by the SEDSD theory.
Conclusions: Early childhood caries and atopic dermatitis may be closely related following similar ectodermal developmental pathways. Early referral and integrated oral/general healthcare for children may be critical for disease and cost control.