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Associations of Dietary and Lifestyle Factors on Dental Health Issues A mong A dults W ithin the United States Kaitlin A. Burkhart University of Florida Supervised by Dr. Jeanette Andrade PhD, RDN/LDN, FAND Food Science & Human Nutrition Department
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Abstract Dietary and lifestyle factors may be associated with dental health. The purpose of this study was to explore the associations between dietary and lifestyle factors on dental health. A cross sectional online study was conducted among 202 participating adults, using an 89 item survey from June August 2021 . The survey included a food frequency questionnaire sourced from er Institute, as well as sections regarding lifestyle and health habits, demographics, and dental history. Significant positive c orrelations were found with dental health issues and following a special diet ( r=0.13; p=0.03) and medical conditions ( r=0.18; p=0.02). Significant negative correlations were found with dental health issues and energy ( r= 0.16; p=0.01), vitamin A ( r= 0.21; p=0.00), phosphorus ( r= 0.16; p=0.01), and education ( r= 0.12; p=0.04). All other variables appeared to have no associations with dental health issues. Future studies should be directed towards solidifying whether specific nutrients have a direct effect on dental health, beyond association. Dental professionals should also be encouraged to share nutrition information with patients to prevent dietary or lifestyle factors from contributing to poor dental health.
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1. Introduction In recent decades , the relationship between dental health and overall health and well be ing has been strengthened 1 . Other than the significance of teeth in essential life activities like eating, the health of the mouth can have direct manifestations throughout the entire body and accompanying disease s . For example, one study 2 found that perio dontal disease has direct effects on glycemic control in people with diabetes. Additionally, one study found that mouth bacteria contribute to inflammation in the heart lining, potentially causing infection 3 . Optimal dental health is important for more than just eating and hygiene and may increase the risk for diseases and conditions, if not care d for properly. Beyond its relationship with tot al health, poor dental health can also have an extreme impact on 4 . Dental health issues can cause pain that interferes with daily activities such as exercise or work Dental health issues can also h ave an effect on 5 , as chewing and swallowing of food could be compromised. Even mental health can be affected, as many people with extreme dental health issues report depression, 6 showing how dental health can make an impact on someon Many factors, though, may prevent one from properly taking care of their dental health . Access to care plays a significant role 7 , as the inability to visit a dentist prevents dental health issues from getting corrected. Overall , health kn owledge is also important to maintain dental health 8 , something that can be impacted by access and education. Someone will be less likely to make dental health a priority if they do not know why it is important. Hygiene is also important 9 , as
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brushing teet h removes plaque, leading to the prevention of diseases like dental caries or periodontal disease. And lastly, nutrition is a pivotal factor contributing to a healthy mouth, as a well balanced diet helps maintain strong teeth and prevent disease 10 . Nutri tion provides the foundation within the mouth, responsible for creating strong teeth and healthy gums. A balanced diet itself is important in maintaining the dental microbiome and proper gum health 11 . Calcium and vitamin D play important roles in bone and teeth formation 12 , working together to develop the calcified tissue of teeth. Nutrients overall have been shown to play important roles in both the preeruptive and posteruptive period of teeth, impacting the chemical environment, mineralization, plaque flora, and mouth immunity 13 . Nutrition is not only important for maintenance of dental health, but also for prevention of dental diseases. Dental caries and gum disease are the two most prevalent dental health diseases in the United States 14 . Balanced d iets have been shown to play a role in preventing dental caries 15 . Sugar intake is a factor directly influencing the development and progression of caries 16 . Dental caries develops as bacteria in the mouth metabolize sugar to produce acid that breaks down enamel 17 . It has been suggested that lower sugar intake will help prevent the disease 18 . In regard to periodontal disease, vitamin C has been shown to have impacts in preventing the disease 1 2 , through reducing inflammation and increasing collagen synthesis . Other vitamins and minerals have also been shown to have anti inflammatory roles in periodontal disease 19 , although more studies are needed. Overall, nutrition is important in preventing and managing dental health diseases . Knowing which nutrients have a n impact on dental health, and how exactly they impact these diseases is not fully understood but important for maintaining proper dental health.
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Therefore, the purpose of this study was to explore the associations between dietary and lifestyle factors and dental health. It is hypothesized that as dietary intakes and healthy lifestyle factors decrease , that dental health issue incidence will increase. 2. Methodology 2.1 Recruitment Participants of this cross sectional study were recruited online using the program Qualtrics from June until August 2021. Inclusion criteria were participants that were 18 years of age and older and resided within the United States. Participants who did not meet these criteria were excluded. Of the 240 survey responses, 202 participants completed the survey in its entirety, thus were included within the analysis. All sections of the study were approved exempt by the Institutional Review Board of the University of Florida #202100006. 2.2 Survey An 89 item survey was administered that consisted of 4 sections: dietary habits (62 items), lifestyle and health habits (16 items), demographics (6 items), and dental history (5 items). Demographics focused on sex, age, race/ethnicity, education and income level. Dietary Habits: Participants re Questionnaire 2 0 . This questionnaire originally included five food categories dairy, fruits, vegetables, meats, sweets, baked goods, and beverages with a total of 61 food/beverage items
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based on the frequency of consuming those items over the past year. The instrument was modified to reflect a total of 62 items from five food/beverage categories: dairy (8), fruits (7), vegetables (9), animal and plant based proteins (13), sweets, b aked goods and fats (9), grains, rice , and pasta (9) and beverages (7), over the past 30 days to reduce recall bias 2 1 , 2 2 . Participants indicated the frequency that they consumed these items from never or less than once per month, 1 3 times per month, 1 tim e per week, 2 4 times per week, 1 time per day, 2 3 times per day, 4 5 times per day, 6+ times per day. Separately, the food frequency questionnaire data was converted to actual quantities consumed and summed by food group. Each frequency was converted to an TABLE 1 | Conversion factors Frequency of consumption 6 or more tim es a day 4 5 times per day 2 3 times per day Once per day 5 6 times per week 2 4 times per week Once per week 1 3 times per month Never or less than once per month X factor 6 4.5 2.5 1 0.79 0.43 0.14 0.07 0 Once food frequency values were converted to x factors and multiplied by their respective nutrient values, the food item values for each participant were summed by food group. Then, te total for each nutrient (Table 2).
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TABLE 2 | Calculation of energy and nutrients Participant Food A (calories) Food B (calories) Food Group A Total (calories) Food C (calories) Food D (calories) Food Group B Total (calories) Total Calories Participant A x y x+y A b a+b x+y+a+b Once calculated, the totals had no numerical limit and were completely based off of the x factor calorie, sugar, fiber, calcium, vitamin A, vitamin C, vitamin D, and phosphorus intake. Lifestyle and Health Habits: In this section, participants responded to a diet and health habit questionnaire that included participants self reporting their height in feet and inches , self reported weight in pounds, current diseases/conditions, changes to dietary habits since COVID 19, addition of sugar and consumption of visible fat on animal products, frequency of eating out, adhering to a diet, taking vitamins, and smoking habits. Responses varied between dichotomous (e.g. , yes/no), free response, scale based, check all that apply, and multiple choice. Dental History: Participants were asked to select or write about any dental conditions they have been diagnosed with over the past 5 years, the frequency of visiting a dentist, and if dentist(s)/hygienist(s) communicated with them about dental health and diet. A dental health score was calculated based on severity and treatment of health conditions. A lower score was indicative of better health ; based on the scores, participants were characterized as having little to no dental issues, moderate dental issues , or severe dental issues . If a participant had more than one li sted
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condition, dental health scores were summed to give a total score. Values assigned to each condition are shown in Table 3 below. TABLE 3 | Scores for health condition Dental Health Condition Assigned Score Dental Caries (cavities) 1 Dental Erosion 1 Gum/Periodontal Disease 2 Dental Cancer 2 2.3 Statistical Analyses Frequency counts and percentages were tabulated for demographic variables and dietary habits, lifestyle and health habits, and dental health. A one sample t test determined differences between dental health scores (little to no, moderate or severe) and dietary habit s . Dental health scores were compared numerically with dietary habit frequencies for each individual nutrient. S pearman correlation s w ere also conducted to determine the association s betwe en dental health , dietary and lifestyle habits , and demographics , which were assigned numbers for the purpose of the statistical analysis . Significance was determined with a p using SPSS v26. 3. Results 3.1 Participant Dem ographics A total of 202 participants were included in the analysis of this study. The largest portion of participants were female (79.7%) and between the ages of 30 49 years old (28.2%). Most participants were not of Hispanic or Latino background (96.5%) and identified as white (89.1%).
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The largest portion of participants had post graduate degrees (43.6%) with incomes of $150,000 or more (22. 3 %) (see TABLE 4 ). TABLE 4 | Participant Demographics Variables Frequency (n=202 ) Sex Male 40 ( 20% ) Female 161 ( 79.7% ) Not Reported 1 ( 0.5% ) Age 18 24 5 ( 2. 5 % ) 25 29 9 ( 4. 5 % ) 30 49 57 ( 28.2% ) 50 59 34 ( 16.8% ) 60 69 49 ( 24. 3 % ) 70+ 44 ( 21. 8 % ) Not Reported 4 ( 2.0 % ) Hispanic/ Latino No 195 ( 96.5% ) Yes 4 ( 3. 5 % ) Racial Background White 180 ( 89.1% ) Asian or Pacific Islander 9 ( 4. 5 % ) American Indian or Native American 2 ( 1.0 % ) Black 6 ( 3.0 % ) Other 4 ( 2.0 % ) Not Reported 1 ( 0.5% ) TABLE 4 | (cont.) Variables Frequency ( n=202 ) Education Less than a high school graduate 0 ( 0.0% ) 12 th grade or GED 6 ( 3.0 % ) Vocational/trade school 4 ( 2.0 % ) Some college or associate degree 33 ( 16.3% ) 71 ( 35. 2 % ) Post graduate degree 88 ( 43. 6 % ) Income Less than $25,0000 10 ( 4.9% ) $25,000 to $34,999 17 ( 8.4% ) $35,000 to $49,999 24 ( 11. 9 % ) $50,000 to $74,999 33 ( 16.3% ) $75,000 to $99,999 32 ( 15.8% ) $100,000 to $149,999 37 ( 18.3% ) $150,000 or more 45 ( 22. 3 % ) Not Reported 4 ( 2.0 % )
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3.2 Lifestyle and Dental Health Frequencies The majority of participants d id not follow a special diet (78.2%) and took at least one type of supplement daily (63. 4 %). Most participants had a normal BMI (40.1%) and have not smoked in the past (70.8%) or currently (93. 1 %). The majority of participants reported at least one chronic health condi tion (63.86%) (see TABLE 5 ). TABLE 5 | Lifestyle Frequencies (n=202) Variable Frequency ( n=202) Special Diet Yes 43 (21. 3 %) No 158 (78.2%) Not reported 1 (0.5%) Supplementation Yes 128 (63. 4 %) No 74 (36.6%) BMI Underweight 8 ( 4.0 %) Normal 81 (40.1%) Overweight 58 (28.7%) Obese 55 (27.2%) Past Smoker Yes 59 (29.2%) No 143 (70.8%) Current Smoker Yes 13 (6.4%) No 188 (93. 1 %) Not reported 1 (0.5%) Medical Conditions Yes 129 (63. 9 %) No 73 (36.1%) 3.3 Dental Health Score Of the 202 participants, more than half were calculated to have little to no dental issues (51. 5 %), some were found to have moderate dental health issues (38.1%), and a small percentage were found to have severe dental health issues (10.4%) (s ee TABLE 6 ).
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TABLE 6 | Dental Health Score Score Frequency (n=202) 0 (little to no dental health issues) 104 (51. 5 %) 1 (moderate dental health issues) 77 (38.1%) 2 (severe dental health issues) 21 (10.4%) 3.4 Incidence of Dental Health Issues Over 5 Years Of the 202 participants, about a third (32.7%) reported having dental caries over the past 5 years. Some reported periodontal disease (10.4%) , and a small percentage reported dental erosion (5.94%). Dental cancer was not reported by any participants , and about half of the participants reported no dental health issues (50.99%) (see TABLE 7 ). TABLE 7 | Dental Health Issues Frequencies Dental Health Issue Frequency (n=202) Dental Caries 66 (32. 7 %) Periodontal Disease 21 (10.4%) Dental Cancer 0 (0%) Dental Erosion 12 (5.9%) Not Reported 103 (5 1.0 %) 3.5 Dietary Habits and Dental Health Score s Dietary intakes remained relatively consistent among dental health scores for sugars, fiber, calcium, vitamin C, and vitamin D. To compare groups, the participants with moderate to severe dental health issues were combined. Based on a one sample t test, th ere was a significant difference between energy and nutrients consumed between groups, in which the moderate to severe dental health issues consumed significantly less energy and fiber, calcium, vitamins A and C and phosphorus and significantly more vitami n D compared to the little to no dental health issue group (see TABLE 8 ).
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TABLE 8 | One sample t test between nutrient intakes based on dental health scores Nutrient Little to no dental health issues (n=104) Means (SD) Moderate to severe dental health issues (n=98) Means (SD) p values* Energy (kcal) 171 5 (70 6 ) 154 2 (70 2 ) <0.001 Sugars (g) 60 (34) 59 ( 50 ) <0.001 Fiber (g) 2 8 (1 9 ) 23 (1 4 ) <0.001 Calcium (mg) 728 (43 1 ) 67 9 (5 40 ) <0.001 Vitamin A (ug) 78 1 (5 40 ) 565 (38 6 ) <0.001 Vitamin C (mg) 76 ( 50 ) 66 ( 50 ) <0.001 Vitamin D (IU) 88 (85) 93 (119) <0.001 Phosphorus (mg) 1160 (528) 1031 (529) <0.001 3.6 Association s Between Dental Health and Dietary and Lifestyle Habits The Spearman correlation showed significant positive associations with dental health and following a special diet (r=0.13; p=0.03) and medical conditions (r=0.18; p=0.02). The Spearman correlation showed significant negative associations with dental health and energy (r= 0.16, p=0.01), vitamin A (r= 0.21; p=0.00), phosphorus (r= 0.16; p=0.01), and education (r= 0.12, p=0.04). All other variables appeared to have no associations with dental health (see TABLE 9 ).
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TABLE 9 | Spearman correlatio ns with dental health, dietary and lifestyle habits and demographics Variables Correlation Coefficient Significance* N Sugar 0.09 0.12 202 Energy 0.16 0.01* 202 Fiber 0.09 0.09 202 Calcium 0.11 0.06 202 Vitamin A 0.21 0.00* 202 Vitamin C 0.06 0.12 202 Vitamin D 0.03 0.36 202 Phosphorus 0.16 0.01* 202 Special Diet 0.13 0.03* 201 Supplementation 0.09 0.09 202 Sex 0.09 0.09 201 Age 0.08 0.14 199 Ethnicity 0.06 0.12 202 Race 0.02 0.39 201 Education 0.12 0.04* 202 Income 0.11 0.06 198 BMI 0.06 0.20 202 Smoking 0.05 0.26 202 Medical Conditions 0.18 0.02* 129 Correlation is significant at the 0.05 level. 4. Discussion This study explored the associations between dental health. It was hypothesized that as dietary intake and healthy lifestyle habits decrease , that dental health issue incidence will increase. Results from this study found that participants who had moderate /severe dental health issues consumed less energy and nutrients compared to participants with little to no dental health issues. Negative associations in this study were found between dental health and energy, vitamin A, phosphorus, and education. These findings indicate that dental health issues increase as energy, vitamin A, and phosphorus intakes decrease, and as education level decreases. Positive associations were found between dental health and following a special diet and medical c onditions. These findings indicate that as dental health issues increase, following of a special diet and incidence of medical conditions increase. It should also
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be noted that the correlations found in this study were relatively low, although a correlatio n did exist indicating some relationship between dental health and certain factors. Regarding energy, participants with little to no dental health issues consumed more calories than those with moderate to severe dental health issues. The average energy f or those presenting moderate to severe dental health issues was below the recommended energy intakes of 2000 kcals for women and 2500 kcals for men 2 3 . This population could consume a lower energy diet due to a more sedentary lifestyle, however participants were not asked to disclose their activity habits in the survey. If activity habits were relatively normal across participants, t his low calorie consumption could be indicative of other deficiencies and could be due to difficulty eating as a re sult of persistent mouth pain. One study 2 4 reported similar findings, noting that adults experiencing tooth loss were consuming less calories than those who were not. These results are in line with the present study, although tooth loss was not directly me asured in this study. However, dental caries and periodontal disease, leading reasons for tooth loss 2 5 , were reported by 43% of participants in this study. Therefore, tooth loss could be already likely or a future condition for th e se participants. Vitamin A was also less consumed in those with moderate to severe dental health issues, compared to those with little to no dental health issues. Vitamin A intake met the EAR s (Estimated Average Requirement) of 500 ug for females and 620 ug for males 2 6 for those w ith little to no dental health issues . For those with moderate to severe d ental health issues, the EAR for females was met but not the EAR for males. Although the average vitamin A intake for participants with moderate to severe dental health issues was meeting the female EAR, the intake was still not meeting the RDA (Recommended Dietary Allowance) of 700 ug for females, the intake necessary to meet the needs of 98% of the population. This
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suggests that vitamin A intakes of participants with moderate to severe dental health issues were on the lower end, and the intakes were certainly lower than the participants with little to no dental health issues. The observation of lower vitamin A intakes in participants with moderate to severe dental health issues is in line with o ne stud y 2 7 , which indicate s that older adults, who had dental health issues, had l ower vitamin A intake . These association s could be expla ined by the proposed role of vitamin A in preventing impaired tooth formation and periodontis 2 8 . However, these results could also be explained due to the fact that vitamin A sources are typically fruit and vegetables, foods that often involve a lot of che wing. If participants were experiencing missing teeth or mouth pain in general, they could stray away from fruits and vegetables to avoid the pain, resulting in low vitamin A values. Another stud y 29 suggested that mouth pain and tooth loss typically result in low diet quality, and particularly low fruit and vegetable consumption. Therefore, this reasoning could explain why participants with more dental health issues displayed lower vitamin A intakes. Similarly, participants with moderate to severe dental he alth issues consumed less phosphorus compared to participants with little to no dental health issues. Phosphorus intake for both dental health issue groups were significantly above the EAR of 580 mg 30 , meaning neither group were deficient in phosphorus. Phosphorus does play a role in bone and teeth formation 3 1 , so lower phosphorus intakes could be indicative of more dental health issues, like tooth loss or decay. Other studies 2 4 did report lower phosph orus intakes for people with extreme tooth loss compared to lack of tooth loss, which agrees with the results of the present study. Finally, negative associations were found between dental health issues and education. Participants with moderate to severe dental health issues were found to have less education than
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participants with little to no dental health issues. O ne study somewhat support s this idea 3 2 , indicating that higher levels of health literacy are associated with higher levels of dental health. mouth that might need immediate attention as well as the a bility to better comprehend instruction from a dentist. Although studies on the relationship of education and dental health in adults are lacking, it has been shown 3 3 that highly educated parents report better dental health in their children. Children comi ng from less educated parents not only had lower dental health scores, but also poor nutrition. The expectations for children regarding hygiene and nutrition are most likely the same expectations for oneself . I f a parent is promoting proper dental health t o their child, they are most likely following those guidelines themselves. Therefore, more studies on education and dental health in adults could be useful, but it makes sense that someone with more health education would better understand the importance o f diet for dental health. Positive associations in this study were found with dental health and being on a special diet and medical conditions. Participants with moderate to severe dental health issues were found to follow one or more special diets compa red to participants with little to no dental health issues. Potential reasoning for this could be that s pecial diets can lack or be excessive in certain foods, contributing to dental health issues. Some studies have explored this concept, and one 3 4 has some evidence that vegetarian diets , for example, can result in increased risk for dental erosion, a factor measured in this study. The proposed reason for this outcome is that vegetarian diets often lack adequate amounts of certain essential amino ac ids 3 5 , which could impair the ability to maintain dental tissues. In this study, 6% of participants reported dental erosion, so vegetarian diets could be a factor to consider. That being said, studies are currently lacking in regard to the
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effects of vario us diets on dental health, as there is an abundance of diets , and they are constantly changing. More data on this topic could be beneficial. Although following a special diet could be due to many different reasons, some participants could also have a preex isting medical condition , such as diabetes , that contributed to this special diet. Therefore, it is unclear whether the special diet or the medical condition are directly contributing to the higher incidence of dental health issues , as medical conditions c an also have an impact on dental health. C ertain studies 3 6 report that diseases like diabetes are associated with higher incidences of dental health issues like periodontitis. Therefore, future studies could be conducted to explore different diets and their impact on dental health, as well as any confounding factors that could also be contributing to dental health issues. A positive association was also found between dental he alth and medical conditions in this study . Participants with moderate to severe dental health issues were found to have more medical conditions than those with little to no dental health issues. The relationship between dental health and total health has b een a topic of research for many years, and certain studies 2 have confirmed the impacts medical conditions can have on dental health as well as the opposite. Medical conditions can have manifestations in dental health, like type 2 diabetes, which can cause an increased prevalence of dental caries due to hypersalivation 3 7 . Dental health conditions can also influence the development of medical conditions. For example, the bacteria produced in periodontal disease has been shown 3 8 to cause changes in blood vess els, contributing to cardiovascular disease. These observations show that dental health and total health intertwine quite intricately, so taking care of both is important. On another note, the severity of medical o maintain proper nutrition and dental hygiene,
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dental health. Malnutrition is a side effect common for many chronic diseases measured in this study, like cancer 39 , GI issues (nausea, vomiting, or diarrhea), and liver disease 4 0 . Prolonged malnutrition can have various effects on dental health, including caries, tongue inflammation, and periodontal disease 4 1 . Debilitating symptoms also accompany many chronic diseases that can contribute to an inability to maintain proper hygiene 4 2 . Therefore, medical conditions could easily have an effect on dental health in many different ways, directly or indirectly. In this study, no associations were found between dental health and several dietary and lifestyle factors. These results are contrary to the hypothesis, as it was predicted that poor dietary intake would be associated with poor dental health. Some results in this study contradicted other studies , like sugars, calcium, vitamin D, and smoking having an effect on dental health . Some studies 4 3 , 18 have referred to high sugar intake as being the leading cause of dental caries, contradictory to the results of this study. However, many of these studies calculate only added sugars rather than the combination of both added and natural sugars, such as in the present study. Future studies may be beneficial in differentiating between the different forms of sugar and whether there is a difference in their influence on dental caries. Vitamin D 4 4 and calcium 4 5 have also been shown to have im portant roles in tooth mineralization and can cause periodontal disease or caries if deficient. These results do not line up with the present study in that participants in this study did not meet the vitamin D or calcium requirements in the little to no de ntal health issues or moderate to severe dental health issues. Vitamin D 4 6 has an EAR of 400 IU for adult s 31 50 years of age, while calcium has an EAR of 800 mg for adults over 31 50 years of age . Both groups were significantly below these RDAs, so misreporting of food and/or
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beverage intake could potentially be an explanation. Smoking has also been shown 4 7 to have effects on dental health, like periodontal disease and sometimes dental cancer. The se results are contrary to the lack of association found in the present study. However, a total of 13 participants reported that they smoked, meaning that a wider pool of participants could heed more promising results. Limitations of this study include s elf reported data, which could specifically have a large impact on dietary intake through the food frequency questionnaire. Many people may not have a vast understanding of what their diet actually consists of and could over or underestimate their food and beverage consumption. Additionally, this study included a high percentage of high income participants. Dental care is often considered a privilege rather than a necessary health expenditure. It is also common for many people across the United States not t o have dental insurance. Considering that about 56.4% of study participants were making more than $75,000 a year, dental care was probably more easily accessed, with or without insurance. If participants in this study were more in the low income range, it could be expected that dental health issues would be more prevalent due to a lack of desire to spend money on dental care. On a similar note, 97.03% of participants had an education beyond a high school diploma. More education could contribute to a better understanding of health issues or of what factors are important in preventing dental health issues. This study was also conducted online , where participants were recruited through ResearchMatch. Lack of access to the internet or an electronic device could
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5. Conclusion This study showed that certain dietary and lifestyle factors could have an impact on dental health issues. Negative association s were found between dental health and energy, vitamin A, phosphorus, and education, meaning more d ental health issues were prevalent in participants consuming lower amounts of these nutrients and for participants with l owe r education. Positive associations were found between dental health and following a special diet and medical conditions, meaning more dental health issues were found for participants consuming special diets and those with medical conditions. Therefore, education al programs should be enhanced in the dental field, specifically among private dentists , to inform patients of associations between dietary habits and dental health . Dentists should be provided with educational materials to properly inform their patients of the qualities of a well balanced diet. Outreach programs should also be targeted towards lower income communities to provide information regarding nutrition for preventative dentistry and free well balanced meals and groceries. This will expand education and resources to all communities to promote healthy eating and d ental health.
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6. References 1. Fiorillo, L. (2019, October 7). Oral health: The first step to well being . Medicina (Kaunas, Lithuania). Retrieved March 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843908/ 2. 2 the connection between oral health and overall ... NCBI bookshelf . (n.d.). Retrieved March 30, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK2 19661/ 3. Bhatnagar, D. M. (2021). Oral Health: A gateway to overall health . Contemporary clinical dentistry. Retrieved March 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525811/ 4. Baiju , R. M., Peter, E., Varghese, N. O., & Sivaram, R. (2017, June). Oral Health and quality of life: Current concepts . Journal of clinical and diagnostic research : JCDR. Retrieved March 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535498 5. Kot ronia, E., Brown, H., Papacosta, A. O., Lennon, L. T., Weyant, R. J., Whincup, P. H., Wannamethee, S. G., & Ramsay, S. E. (2021, July 14). Poor Oral Health and the association with Diet Quality and intake in older people in two studies in the UK and USA . T he British journal of nutrition. Retrieved March 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187263/ 6. J.C. Spanemberg, J.A. Cardoso, E.M.G.B. Slob, J. Lpez Lpez, Quality of life related to oral health and its impact in adults, Journal of Stomatology, Oral and Maxillofacial Surgery, Volume 120, Issue 3, 2019, Pages 234 239, ISSN 2468 7855, https://doi.org/10.1016/j.jormas.2019.02.004
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7. de Abreu, M. H . N. G., Cruz, A. J. S., Borges Oliveira, A. C., Martins, R. de C., & Mattos, F. de F. (2021, December 20). Perspectives on social and environmental determinants of oral health . International journal of environmental research and public health. Retrieved M arch 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708013/ 8. Tadin, A., Poljak Guberina, R., Domazet, J., & Gavic, L. (2022, February 21). Oral hygiene practices and oral health knowledge among students in Split, Croatia . Healthcare (Basel, Sw itzerland). Retrieved March 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872387/ 9. U.S. Department of Health and Human Services. (n.d.). Oral Hygiene . National Institute of Dental and Craniofacial Research. Retrieved March 29, 2023, from htt ps://www.nidcr.nih.gov/health info/oral hygiene#:~:text=If%20you%20protect%20your%20oral,your%20teeth%20for%20a%20l ifetime.&text=To%20keep%20your%20teeth%20healthy,tooth%20decay%20and%20gu m%20disease. 10. National Center for Biotechnology Information . (n.d.). Retrieved March 30, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK534248/ 11. Martinon, P., Fraticelli, L., Giboreau, A., Dussart, C., Bourgeois, D., & Carrouel, F. (2021, January 7). Nutrition as a key modifiable factor for periodontitis and main chronic diseases . Journal of clinical medicine. Retrieved March 29, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827391/
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mods:abstract lang en Dietary and lifestyle factors may be associated with dental health. The purpose of this study was to explore the associations between dietary and lifestyle factors on dental health. A cross- sectional online study was conducted among 202 participating adults, using an 89-item survey from June – August 2021. The survey included a food frequency questionnaire sourced from Dana Farber’s Cancer Institute, as well as sections regarding lifestyle and health habits, demographics, and dental history. Significant positive correlations were found with dental health issues and following a special diet (r=0.13; p=0.03) and medical conditions (r=0.18; p=0.02). Significant negative correlations were found with dental health issues and energy (r=-0.16; p=0.01), vitamin A (r=-0.21; p=0.00), phosphorus (r=-0.16; p=0.01), and education (r=-0.12; p=0.04). All other variables appeared to have no associations with dental health issues. Future studies should be directed towards solidifying whether specific nutrients have a direct effect on dental health, beyond association. Dental professionals should also be encouraged to share nutrition information with patients to prevent dietary or lifestyle factors from contributing to poor dental health.
mods:accessCondition Copyright Kaitlin Anne Burkhart. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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mods:note Awarded Bachelor of Science, summa cum laude, on April 29, 2022. Major: Nutritional Sciences
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