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A study of Australian twins suggests that environmental factors play a more important role than genetics in determining the risk of caries in children.
The researchers followed 345 twins from 24 weeks gestation to 6 years old, when they all had a dental exam. By the age of six, 32% of children had tooth decay and 24% had advanced decay.
To determine how much the risk of cavities could be influenced by genetics, the researchers examined the number of cavities per pair of identical twins, with identical genetic variations, and fraternal twins, sharing about half of their variations.
The risk that both siblings develop a form of tooth decay or advanced caries was similar for identical and fraternal pairs, suggesting that genetics do not explain much of the risk of these oral health problems.
"As a result, the risk factors appear to be primarily environmental and potentially modifiable," said Mihiri Silva, lead author of the University of Melbourne study, and the Murdoch Children's Research Institute of the Royal Children's Hospital. from Melbourne.
"This could dispel the idea that individuals are genetically predisposed to have bad teeth and should lead us to find ways to address the risk factors we know are important for dental health," Silva said by e-mail .
According to pediatric researchers, approximately 60-90% of school-aged children suffer from tooth decay, which can lead to pain, infection and hospitalization. Toothache can also lead to school absences, poor nutrition, compromised growth and development, as well as a deterioration in the quality of life of children and parents.
The study team writes that infant caries is also the most important predictor of poor oral health in adulthood.
Some previous research has questioned the role that genetics can play in caries formation, but research to date has not made it clear what role environmental or lifestyle factors might play in this area. risk.
In this study, both twins had cavities in 29 pairs; in 33 other pairs of twins, only one child was affected.
Both children had advanced caries in 26 pairs of twins and 31 other couples only one child with advanced caries.
Three environmental factors in particular appeared to affect the risk of caries: maternal obesity, tooth enamel mineralization defects and lack of fluoridation of water in the community.
The study was not a controlled experiment designed to prove if, or how, any of these factors could directly cause tooth decay or cavities.
But it is possible that maternal obesity may influence the risk of oral health problems in children due to common eating or lifestyle habits in the home or biological processes that affect susceptibility to dental problems. said Silva. Obese mothers, for example, may be more likely to feed children with unhealthy foods that may contribute to caries.
At the same time, fluoridation of drinking water has been shown to reduce the risk of cavities, but is not universally available in public drinking water.
And defects in tooth enamel mineralization that lead to a weak enamel that can easily decompose and form cavities can begin to develop in the uterus and infancy. This can be caused by certain medications that women take during pregnancy or by young children, as well as by poor nutrition and certain diseases during early childhood.
The good news is that environmental factors such as this one can be controlled to improve oral health.
"Based on the findings of all existing research – including ours – parents and families should focus on practicing healthy habits in general, including a low-sugar diet and regular brushing of teeth. ", Silva advised.
"Enamel defects" can be detected and treated early to reduce problems, so making sure that children undergo an early dental examination from the age of 39, a year can minimize problems later, "added Silva. "Our study also shows that public health initiatives such as water fluoridation in communities continue to play an important role in the prevention of tooth decay."
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