Non-Cochrane · aetiology · PM39164714
Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and meta-analysis.
Bakhoda Mohammad Reza, Haghighat Lari Mohammad Mehdi, Khosravi Gholamreza, et al. · BMC oral health · 2024 · PubMed · doi:10.1186/s12903-024-04733-5
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
21
current version
GRADE rated
0
No studies
0
Included studies
24
linked below
No studies 0 · 0%Ungraded 21 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children (no age limit specified) | Children aged ~4-18 years (n=22 studies, 40673 participants; 16 studies in the caries meta-analysis) |
| Intervention | Obesity indices (BMI, waist circumference, birth weight/size, overweight/obesity) | BMI categorical and continuous, waist circumference; also LGA/SGA, LBW/VLBW/ELBW, overweight/obese |
| Comparison | Different levels/categories of the obesity index (e.g., normal weight vs overweight/obese) | Lowest/normal BMI category or per-unit continuous reference; lower waist circumference |
| Outcomes | Dental caries in children, reported as OR, HR, or RR with 95% CI | Dental caries / early childhood caries (ECC) (meta-analyzed, 16 studies); erosive tooth wear, gingivitis, plaque reported in some studies |
| Study designs | Observational studies (cross-sectional, cohort, case-control); RCTs, animal, adult and pregnancy studies excluded | Cross-sectional (~13), prospective cohort (~8), case-control (~4) |
| Timing | No time/language restriction (published up to December 2023) | Predominantly cross-sectional; cohorts with ~4-8 year follow-up |
Search date: December 2023. Databases: PubMed; MEDLINE; SCOPUS; EMBASE; Google Scholar
Questions and results
Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight)
Population: Children (approx. 4-18 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries / early childhood caries (ECC) Adjustment for age: yes In the Adjustment for age: yes subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.04, 95% CI 0.84 to 1.30; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.04 [0.84, 1.30] | 6 studies | Ungraded |
Dental caries / early childhood caries (ECC) Age: 7-15 years In the Age: 7-15 years subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.25, 95% CI 0.87 to 1.81; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.25 [0.87, 1.81] | 7 studies | Ungraded |
Dental caries / early childhood caries (ECC) Study design: cross-sectional In the Study design: cross-sectional subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.58, 95% CI 1.20 to 2.08; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.58 [1.20, 2.08] | 9 studies | Ungraded |
Dental caries / early childhood caries (ECC) Children in the highest BMI category are more likely to have childhood dental caries (ECC) than those in the lowest category (pooled OR 1.44, 95% CI 1.16 to 1.78; I2=88.9%); ungraded. Source: Results 'Meta-analysis'; Abstract; Fig. 2 (forest plot, overall diamond) · same question in other reviews | OR 1.44 [1.16, 1.78] | 16 studies | Ungraded |
Dental caries / early childhood caries (ECC) Region: European countries In the Region: European countries subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 0.81, 95% CI 0.36 to 1.81; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 0.81 [0.36, 1.81] | 3 studies | Ungraded |
Dental caries / early childhood caries (ECC) Study design: case-control In the Study design: case-control subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.31, 95% CI 0.77 to 2.22; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.31 [0.77, 2.22] | 4 studies | Ungraded |
Dental caries / early childhood caries (ECC) Sample size: >900 In the Sample size: >900 subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.59, 95% CI 1.25 to 2.02; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.59 [1.25, 2.02] | 8 studies | Ungraded |
Dental caries / early childhood caries (ECC) Region: Asian countries In the Region: Asian countries subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.70, 95% CI 1.25 to 2.32; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.70 [1.25, 2.32] | 6 studies | Ungraded |
Dental caries / early childhood caries (ECC) Country population: large In the Country population: large subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.56, 95% CI 1.09 to 2.21; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.56 [1.09, 2.21] | 9 studies | Ungraded |
Dental caries / early childhood caries (ECC) Adjustment for sex: no In the Adjustment for sex: no subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.74, 95% CI 1.13 to 2.68; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.74 [1.13, 2.68] | 6 studies | Ungraded |
Dental caries / early childhood caries (ECC) Adjustment for sex: yes In the Adjustment for sex: yes subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.30, 95% CI 0.99 to 1.71; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.30 [0.99, 1.71] | 10 studies | Ungraded |
Dental caries / early childhood caries (ECC) Study design: cohort In the Study design: cohort subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.27, 95% CI 1.07 to 1.56; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.27 [1.07, 1.56] | 3 studies | Ungraded |
Dental caries / early childhood caries (ECC) Region: American countries In the Region: American countries subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.28, 95% CI 0.91 to 1.81; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.28 [0.91, 1.81] | 7 studies | Ungraded |
Dental caries / early childhood caries (ECC) Country population: small In the Country population: small subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.31, 95% CI 0.95 to 1.81; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.31 [0.95, 1.81] | 7 studies | Ungraded |
Dental caries / early childhood caries (ECC) Adjustment for age: no In the Adjustment for age: no subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.68, 95% CI 1.29 to 2.18; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.68 [1.29, 2.18] | 10 studies | Ungraded |
Dental caries / early childhood caries (ECC) Sample size: <900 In the Sample size: <900 subgroup, the BMI (highest vs lowest)-childhood caries association was not significant (OR 1.25, 95% CI 0.77 to 2.02; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.25 [0.77, 2.02] | 8 studies | Ungraded |
Dental caries / early childhood caries (ECC) Age: <7 years In the Age: <7 years subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.59, 95% CI 1.22 to 2.07; ungraded). Source: Table 2 (subgroup analysis for the association of BMI and risk of childhood dental caries) · same question in other reviews | OR 1.59 [1.22, 2.07] | 9 studies | Ungraded |
Higher BMI (continuous / per-unit increment) vs Lower BMI (continuous reference / per 1 kg/m2 decrement)
Population: Children (approx. 4-18 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries in children Non-linear dose-response (restricted cubic splines) A significant non-linear association was found between BMI and childhood dental caries, with higher risk at higher BMI and also among underweight children; ungraded (no single pooled estimate). Source: Results 'Meta-analysis'; Statistical analysis (two-stage random-effects non-linear dose-response); Fig. 5 (spline curve) · same question in other reviews | Fig. 5: significant non-linear (restricted cubic spline) dose-response between BMI and childhood dental caries; relative risk rises at higher BMI (curve reaches ~2.4-2.9 at BMI 30-35) and is also elevated among… | NR | Ungraded |
Dental caries in children Continuous BMI, direct pooling (studies reporting BMI as a continuous variable) Pooling studies that used BMI as a continuous variable showed no significant association between per-unit BMI and childhood dental caries (OR 1.01, 95% CI 0.99 to 1.03; I2=3.5%); ungraded. Source: Results 'Meta-analysis'; Fig. 3 (forest plot, overall diamond) · same question in other reviews | OR 1.01 [0.99, 1.03] | 4 studies | Ungraded |
Dental caries in children Linear dose-response (GLST, per 1 kg/m2 BMI increment) A significant linear dose-response was reported between each 1 kg/m2 increment in BMI and childhood dental caries (OR 1.01, 95% CI 1.00 to 1.03; I2=78.7%); ungraded. Source: Results 'Meta-analysis'; Statistical analysis (GLST linear trend); Fig. 6 (forest plot, overall diamond) · same question in other reviews | OR 1.01 [1.00, 1.03] | 16 studies | Ungraded |
Higher waist circumference vs Lower waist circumference
Population: Children (approx. 4-18 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries in children Waist circumference was not significantly associated with childhood dental caries (pooled OR 1.08, 95% CI 0.90 to 1.30; I2=47.7%); ungraded. Source: Results 'Meta-analysis'; Fig. 4 (forest plot, overall diamond) · same question in other reviews | OR 1.08 [0.90, 1.30] | 2 studies | Ungraded |
Included primary studies 24
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Schuler 2018 Dental Caries and Developmental Defects of Enamel in the Primary Dentition of Preterm Infants: Case-Control Observational Study DOI:10.1159/000480124 | 1 other review | not stated | not extracted yet | not extracted yet |
| Aung 2021 Body mass index and dental caries in New Zealand pre‐school children: A population‐based study DOI:10.1111/jpc.15500 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Boustedt 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Costa 2013 Early childhood caries and body mass index in young children from low income families. PMID:23462435 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Feldens 2021 Early-Life Patterns of Sugar Consumption and Dental Caries in the Permanent Teeth: A Birth Cohort Study. PMID:34428768 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Hong 2008 Obesity and Dental Caries in Children Aged 2‐6 Years in the United States: National Health and Nutrition Examination Survey 1999‐2002 DOI:10.1111/j.1752-7325.2008.00083.x | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Honne 2012 Relationship between obesity/overweight status, sugar consumption and dental caries among adolescents in South India DOI:10.1111/j.1601-5037.2011.00534.x | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Karki 2019 Body mass index and dental caries experience in Nepalese schoolchildren DOI:10.1111/cdoe.12465 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Kay 2010 Is there a relationship between Birthweight and subsequent growth on the development of Dental Caries at 5 years of age? A cohort study DOI:10.1111/j.1600-0528.2010.00548.x | this review only | Dental caries in children | not extracted yet | not extracted yet |
| Marro 2020 matched by author and year (probable) | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Marro 2021 Associations between obesity, dental caries, erosive tooth wear and periodontal disease in adolescents: a case–control study DOI:10.1007/s40368-020-00534-w | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Marshall 2007 Dental caries and childhood obesity: roles of diet and socioeconomic status DOI:10.1111/j.1600-0528.2006.00353.x | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Methuen 2021 Dental caries among Finnish teenagers participating in physical activity and diet intervention: association with anthropometrics and… PMID:34229689 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Mohamed 2022 matched by author and year (probable) | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Nava 2010 matched by author and year (probable) | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Paisi 2018 Obesity and caries in four-to-six year old English children: a cross-sectional study. PMID:29454320 | this review only | Dental caries in children | not extracted yet | not extracted yet |
| Paulo 2014 Food insecurity and dental caries in schoolchildren: a cross‐sectional survey in the western <scp>B</scp>razilian <scp>A</scp>mazon DOI:10.1111/eos.12124 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Paulo et al. 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Peng 2014 Is dental caries experience associated with adiposity status in preschool children? DOI:10.1111/ipd.12039 | this review only | Dental caries in children | not extracted yet | not extracted yet |
| Pham 2019 Factors related to dental caries in 10-year-old Vietnamese schoolchildren. PMID:30390300 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Piovesan 2022 Hidden Markov models in biology. PMID:20221923 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
| Piovesan et al. 2022 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Tschammler 2019 Erosive tooth wear and caries experience in children and adolescents with obesity DOI:10.1016/j.jdent.2019.02.005 | this review only | Dental caries in children | not extracted yet | not extracted yet |
| Yen 2021 Infection control in long-term care facilities. PMID:20211813 | this review only | Dental caries / early childhood caries (ECC) | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Relationship between preterm, low birth weight and early childhood caries: a meta-analysis of the case-control and cross-sectional study. (2020) | 1 | 0.02 |