Are obese children at risk of traumatic dental injuries?

This summary is based on the article published in Dental Traumatology: Are overweight/obese children at risk of traumatic dental injuries? A meta-analysis of observational studies (August 2015)

Patrıcia Correa-Faria, Stefano Petti

Context

• Overweight/obese subjects are at higher risk to develop several chronic diseases, such as diabetes, cardiovascular diseases, musculoskeletal disorders, and some forms of cancer ¹.
• Overweight/obesity may also affect oral health, as it is statistically associated with dental caries ², periodontal disease ³, oral cancer ⁴, and, possibly, traumatic dental injuries (TDI) ^5–7.
• The association between overweight/obesity and TDI has been investigated through cross-sectional and cohort studies with controversial results, thus suggesting that the strength of evidence in support of the causal association between these conditions is essentially low ¹².

Purpose of the Analysis

To investigate the association between overweight/obesity and TDI, with the highest possible levels of internal and external validities.

Key Findings

• Causation can only be supposed when the association is statistically significant and when the disease is less frequent in unexposed individuals. These criteria refer to the so-called probabilistic definition of cause and the counterfactual condition ^{62, 63}.
• It is possible then to speculate that overweight/obesity could be a component cause of TDI, as their association resulted statistically significant and TDI was more prevalent among overweight/ obese subjects (28.6%) than among lean children (25.5%).
• The causal association between overweight/obesity and TDI is corroborated by the causal association of obesity with bone fractures ^{64, 65}.
• Bone fractures in obese children are frequent because these subjects are prone to falling ^{64, 65}. Indeed, excess weight in children is directly responsible for both imbalanced gait and instable posture ^70–72. Such an instability is due to the displacement of the center of mass and to functional limitations of joints in obese subjects ^73–75.
• The risk of TDI among overweight/obese children is approximately 22% higher than among lean children and the causal association between these two conditions is plausible.

References

List of references (PDF)