Behavior Risk Factors for Noncommunicable Diseases and Caries in Adolescents: A Population Study

Caries is the most widespread noncommunicable disease (NCD) globally and can predict fatality NCDs in the future, such as diabetes and cardiovascular diseases. Therefore, we hypothesized that the behavioral risk factors for those NCDs may be present in adolescents with caries. The objective was analyzing the association of unhealthy diet, tabagism, and alcohol with caries in adolescents.

This population-based study with a cross-sectional design used data from 2,515 adolescents aged 18-19 years, born in São Luís-MA, Brazil, and part of the RPS Cohort Consortium. The exposures were the latent variables of the unhealthy diet pattern (sugars, fast foods, and salty snacks) and addictive behaviors (tabagism and risk of alcohol dependence). The outcome was the number of decayed teeth. The model adjustment considered the socioeconomic status (head of household education, adolescent education, economic class, and monthly family income) as a distal determinant and the oral biofilm as a mediator between the exposures and the outcome, analyzed by structural equation modeling, using the Mplus 8.0 software.

Unhealthy diet pattern was associated with a higher number of decayed teeth directly (SC = 0.092, p ≤ 0.001) and indirectly via dental biofilm (SC = 0.020, p ≤ 0.001). Addictive behaviors were associated with a higher number of decayed teeth indirectly via dental biofilm (SC = 0.019, p = 0.013). The unhealthy diet pattern and addictive behaviors were associated with each other (CP = 0.199, p < 0.001).

Besides sugars, other behavioral risk factors for NCDs underlie caries, emphasizing the importance of comprehensive adolescent health care.