ArticleInternational journal of hygiene and environmental health2024
Metal mixtures and oral health among children and adolescents in the National Health and Nutrition Examination Survey (NHANES), 2017-2020.
Article in International journal of hygiene and environmental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Risk prediction models for dental caries in children and adolescents: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- Electrochemical Biosensing Strategies for Oral Health: From Engineered Interfaces to Advanced Transistor Architectures.Advanced healthcare materials · 2026Review
- Association between heavy metals exposure and depression: findings of the NHANES from 2003 to 2020.European journal of medical research · 2026Article
- Article
- Systematic Review of Lead Exposure and Its Effects on Caries and Aesthetics in Children and Adolescents.Healthcare (Basel, Switzerland) · 2025Review
- Association between exposure to environmental pollutants and increased oral health risks, a comprehensive review.Frontiers in public health · 2024Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
introductionDental caries is the most common non-communicable human disease, yet little is known about the role of environmental metals, despite teeth consisting of a hard matrix of trace elements. We conducted a cross-sectional study of associations between environmental metals and objective assessment of dental caries and subjective assessments of oral health among a representative sample of U.S. children and adolescents.
methodsData were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes.
resultsThe blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07). DISCUSSION: Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.
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