Early Respiratory Infections and Dental Caries in the First 27 Years of Life: A Population-Based Cohort Study

Abstract

Early-life respiratory tract infections (RTIs) and dental caries are among the most common infectious diseases worldwide. The relations between early RTIs and development of caries in permanent teeth have not been studied earlier. We assessed childhood RTIs as potential predictors of caries in young adulthood in a 20-year prospective population-based cohort study (The Espoo Cohort Study). Information on lower respiratory tract infections (LRTIs) that had required hospitalization was retrieved from the National Hospital Discharge Registry (n = 1623). Additional information on LRTIs and upper RTIs (URTIs) was assessed based on the questionnaire reports that covered the preceding 12 months. Caries was measured as the number of teeth with fillings (i.e. filled teeth, FT) reported in the 20-year follow-up questionnaire. The absolute and relative excess numbers of FT were estimated applying negative binomial regression. The mean number of FT in young adulthood was 1.4 greater among subjects who had experienced LRTIs requiring hospitalization before the age of 2 years (SD 4.8) compared to those without any such infections (SD 3.4), and the adjusted relative excess number of FT was 1.5 (95% CI 1.0–2.2). LRTIs up to 7 years were associated with an absolute increase of 0.9 in the mean FT number, the adjusted relative excess being 1.3 (1.0–1.8). Also the questionnaire-based LRTIs (adjusted relative excess 1.3; 95% CI 0.9–1.8) and URTIs (adjusted relative excess 1.4, 1.0–1.8) before the age of 2 years predicted higher occurrence of FT. Findings suggest that early RTIs have a role in the development of dental caries in permanent teeth.

Dental Caries and Developmental Defects of Enamel in the Primary Dentition of Preterm Infants: Case-Control Observational Study

“…This is in contrast to data from Nelson et al [2010] but there is some evidence that early respiratory infections are associated with dental caries [Alaki et al, 2008;Widmer, 2010;Rantala et al, 2016]. The specific mechanisms of dental caries occurrence in children with early respiratory problems are probably related to mouth breathing and DDE.…”

Dental caries is associated with lower respiratory tract infections: A population-based cohort study

“…However, it is also possible that LRTI could cause caries. We have previously shown in the Espoo Cohort Study that the occurrence of LRTIs in the early childhood predicts the risk of FT in young adulthood [7].…”

“…In year 1997, we conducted a 6-year follow-up survey of the cohort, with a follow-up rate of 77.3 % [9][10]. We conducted a 20-year follow-up study in years 2010-2011 with 1,623 participants (response rate = 63.2 % of the baseline study population) [7,11]. The current study population consisted of 1,592 participants including those with all the information on the exposure and outcome variables.…”

“…We obtained information on age, sex and family socioeconomic status (SES) from the baseline questionnaire, information on early LRTIs from both the baseline questionnaire and the National Hospital Discharge Register [7], and information on smoking (categorized as being nonsmoker, ex-smoker or current smoker) from the 20-year follow-up questionnaire. We categorized family SES as high if either parent had an academic degree and both parents were white-collar workers (e.g.…”

“…There is some evidence suggesting that the occurrence of middle ear and respiratory tract infections during the early childhood may have a role in development of childhood caries [3] and/or development defects of enamel in permanent teeth [4], which exposes defected surfaces to caries [5,6]. In our previous article, we reported that the occurrence of LRTIs in the early childhood predicted the development of dental caries in the 20-year prospective population-based Espoo Cohort Study [7]. However, the underlying mechanisms in the causation are not clear.…”