Simon Thornley1, Roger J Marshall2, Katie Bach3, Pauline Koopu3, Gary Reynolds1, Gerhard Sundborn2, Win Le Shwe Sin Ei2. 1. Auckland Regional Public Health Service, Auckland, New Zealand. 2. Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand. 3. Paediatric Services, Oral Health Department, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.
Abstract
OBJECTIVE: To determine whether dental caries, as an indicator of cumulative exposure to sugar, is associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease, in Māori and Pacific children aged 5 and 6 years at their first dental visit. MATERIALS AND METHODS: A cohort study was undertaken which linked school dental service records of caries with national hospital discharge and mortality records. Cox models were used to investigate the strength of the association between dental caries and rheumatic fever incidence. RESULTS: A total of 20 333 children who were free of rheumatic heart disease at enrolment were available for analysis. During a mean follow-up time of 5 years, 96 children developed acute rheumatic fever or chronic rheumatic heart disease. After adjustment for potential confounders, children with five or more primary teeth affected by caries were 57% (95% CI: 20% to 106%) more likely to develop disease during follow-up, compared to children whose primary teeth were caries free. The population attributable to the risk for caries in this cohort was 22%. CONCLUSIONS: Dental caries is positively associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease in Māori and Pacific children. Sugar intake, an important risk factor for dental caries, is also likely to influence the aetiology of rheumatic fever. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVE: To determine whether dental caries, as an indicator of cumulative exposure to sugar, is associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease, in Māori and Pacific children aged 5 and 6 years at their first dental visit. MATERIALS AND METHODS: A cohort study was undertaken which linked school dental service records of caries with national hospital discharge and mortality records. Cox models were used to investigate the strength of the association between dental caries and rheumatic fever incidence. RESULTS: A total of 20 333 children who were free of rheumatic heart disease at enrolment were available for analysis. During a mean follow-up time of 5 years, 96 children developed acute rheumatic fever or chronic rheumatic heart disease. After adjustment for potential confounders, children with five or more primary teeth affected by caries were 57% (95% CI: 20% to 106%) more likely to develop disease during follow-up, compared to children whose primary teeth were caries free. The population attributable to the risk for caries in this cohort was 22%. CONCLUSIONS: Dental caries is positively associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease in Māori and Pacific children. Sugar intake, an important risk factor for dental caries, is also likely to influence the aetiology of rheumatic fever. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Michael G Baker; Jason Gurney; Jane Oliver; Nicole J Moreland; Deborah A Williamson; Nevil Pierse; Nigel Wilson; Tony R Merriman; Teuila Percival; Colleen Murray; Catherine Jackson; Richard Edwards; Lyndie Foster Page; Florina Chan Mow; Angela Chong; Barry Gribben; Diana Lennon Journal: Int J Environ Res Public Health Date: 2019-11-15 Impact factor: 3.390