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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 34434

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Special Issue Editors

Dr. Amit Arora

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Guest Editor

Associate Professor, School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
Interests: maternal and child health; social determinants of health; health equity; health literacy; health promotion; life-course epidemiology; socio-economic inequality in health; non-communicable diseases; global health
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Fatemeh Vida Zohoori

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Guest Editor

School of Health & Life Sciences, Centre for Public Health Research, Teesside University, Middlesbrough Tees Valley TS1 3BX, UK
Interests: public health and nutrition；oral health and fluorides；dietary assessment methods；biomarkers of exposure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oral diseases impair quality of life and have a negative impact on self-esteem, eating ability, causing pain, anxiety and impaired social functioning. They present a significant burden on health care systems around the world and are also recognised as a significant contributor to general health.

Excess consumption of sugars is harmful for both general and oral health. There is large quantity of good quality and strong evidence to suggest an association between high intake of free sugars and both general and oral health related diseases. Diet and nutrition play an important role in the promotion and maintenance of good oral health throughout the entire life course. Their role in the etiology and prevention of oral diseases is well established. Some of the oral conditions influenced by diet and nutrition include dental caries, developmental defects of enamel, dental erosion, periodontal disease, and oral cancer.

For the first time in 1990, the World Health Organization (WHO) recommended the consumption of free sugars to be less than 10% of our dietary intake. The WHO updated the recommendations in 2003, again recommending populations consume <10% energy intake from free sugars. In 2015, using the WHO revised framework for Guideline Development the WHO developed a Guideline for Sugars Intake for Adults and Children which made a strong recommendation that individuals limit consumption of free sugars to <10% of energy intake and preferabley to <5% energy intake, to protect oral health throughout the life-course.

This Special Issue is intended to provide current research and policy developments on diet, nutrition and oral health. This Special Issue is open to any subject area of public health, health promotion, economics, and policy related to the diet and nutritional determinants of oral health across the life course. The listed keywords suggest just a few of the many possibilities.

Assoc. Prof. Dr. Amit Arora
Prof. Dr. Fatemeh Vida Zohoori
Guest Editors

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Keywords

diet
nutrition
sugars
dental caries
periodontal disease
dental erosion
impact of tooth loss on nutrition
sugar sweetened beverages
common risk factors in oral diseases

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Published Papers (9 papers)

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Research

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19 pages, 403 KiB

Open AccessArticle

Nutritional Health Knowledge and Literacy among Pregnant Women in the Czech Republic: Analytical Cross-Sectional Study

by Klára Papežová, Zlata Kapounová, Veronika Zelenková and Abanoub Riad

Int. J. Environ. Res. Public Health 2023, 20(5), 3931; https://doi.org/10.3390/ijerph20053931 - 22 Feb 2023

Cited by 5 | Viewed by 4946

Abstract

Adequate nutrition and the nutritional status of pregnant women are critical for the health of both the mother and the developing foetus. Research has shown a significant impact of nutrition on the child’s health and the future risk of developing chronic noncommunicable diseases (NCDs), such as obesity, diabetes, hypertension, and cardiovascular disease. There is currently no data on the level of nutritional knowledge of Czech pregnant women. This survey aimed to evaluate their level of nutritional knowledge and literacy. An analytical cross-sectional study was conducted in two healthcare facilities in Prague and Pilsen between April and June 2022. An anonymous self-administered paper-form questionnaire for assessing the level of nutritional knowledge (40 items) and the Likert scale for assessing nutrition literacy (5 items) were used. A total number of 401 women completed the questionnaire. An individual’s nutritional knowledge score was calculated and compared with demographic and anamnestic characteristics using statistical methods. The results showed that only 5% of women achieved an overall nutritional score of 80% or more. University education (p < 0.001), living in the capital city (p < 0.001), experiencing first pregnancy (p = 0.041), having normal weight and being overweight (p = 0.024), and having NCDs (p = 0.044) were statistically significantly associated with a higher nutritional knowledge score. The lowest knowledge scores were found in the areas of optimal energy intake, optimal weight gain, and the role of micronutrients in diet during pregnancy. In conclusion, the study shows limited nutrition knowledge of Czech pregnant women in some areas of nutrition. Increasing nutritional knowledge and nutrition literacy in Czech pregnant women is crucial for supporting their optimal course of pregnancy and the future health of their offspring. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

10 pages, 358 KiB

Open AccessArticle

Estimated Dietary Fluoride Intake by 24-Month-Olds from Chocolate Bars, Cookies, Infant Cereals, and Chocolate Drinks in Brazil

by Tamara Teodoro Araujo, Samanta Mascarenhas Moraes, Thamyris de Souza Carvalho, Larissa Tercilia Grizzo and Marilia Afonso Rabelo Buzalaf

Int. J. Environ. Res. Public Health 2023, 20(4), 3175; https://doi.org/10.3390/ijerph20043175 - 11 Feb 2023

Viewed by 2069

Abstract

The use of fluoride (F) in the prevention of dental caries is established. However, a high amount of F intake during tooth development can cause dental fluorosis The aim of this study was to analyze variations in F concentrations in chocolate bars (CB), chocolate cookies (CC), infant cereals (IC), and chocolate milk drinks (CD) to determine the daily intake of F from different sources by children at the age of risk for developing dental fluorosis. Distinct brands of CB, CC, IC, and CD were analyzed. Fluoride was separated by hexamethyldisiloxane-facilitated diffusion. Analysis was made in triplicate with an F ion-specific electrode. F ingestion (mg/kg body weight) was evaluated with the suggested consumption (0.05–0.07 mg/kg/day) for children aged 24 months (12 kg). The concentrations for all the analyzed products ranged from 0.025 to 1.827 µg/g F. The mean (range) F concentrations were CB= 0.210 ± 0.205 µg/g (0.073–0.698, n = 8), CC = 0.366 ± 0.416 µg/g (0.320–1.827, n = 9), IC = 0.422 ± 0.395 µg/g (0.073–1.061, n = 5), and CD = 0.169 ± 0.170 µg/mL (0.025–0.443, n = 12). The products that had the highest concentration in the categories CB, CC, IC, and CD, respectively, were Nescau-Ball (0.698 µg/g), Passatempo (1.827 µg/g), Milnutri (1.061 µg/g), and Toddynho (0.443 µg/mL). The consumption of only one unit of Toddynho (CD) is equivalent to more than 11% of the maximum suggested daily intake for a 24-month-old child (0.07 mg/kg body weight). When one product from each category is consumed together only once a day, this consumption is equivalent to approximately 24% of the suggested daily intake of fluoride for a 24-month-old child. The presence of high levels of fluoride in certain products suggests that they play a significant role in overall fluoride intake. It is crucial to closely monitor the fluoride content of food and drinks that are consumed by children who are at risk for dental fluorosis, and for product labels to clearly display the fluoride concentrations. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

18 pages, 383 KiB

Open AccessArticle

Dietitians’ Experiences of Providing Oral Health Promotion to Clients with an Eating Disorder: A Qualitative Study

by Tiffany Patterson-Norrie, Lucie Ramjan, Mariana S. Sousa and Ajesh George

Int. J. Environ. Res. Public Health 2022, 19(21), 14193; https://doi.org/10.3390/ijerph192114193 - 30 Oct 2022

Cited by 3 | Viewed by 2212

Abstract

(1) Background: Eating disorders (EDs) can seriously impact oral health, leading to irreversible dental damage. Dietitians play a key role in the care of people with an ED and are well-placed to promote oral health. However, there is currently little understanding of how dietitians perceive their role in this space. This study aimed to explore the perceptions and role of dietitians in providing oral health promotion to their clients in an ED clinical setting. (2) Methods: This descriptive qualitative study used semi-structured interviews to explore the perceptions of 14 registered dietitians practicing across seven states in Australia. Participants were recruited using a combination of purposive and snowball sampling. A hybrid thematic analysis approach was undertaken to identify and describe the key themes generated from the data. (3) Results: Generally, dietitians were insightful and knowledgeable of the oral health issues that clients with an ED may be experiencing. However, dietitians’ practices across education, screening, and referrals were inconsistent. Challenges such as inadequate training, unknown referral pathways, and clear guidelines were cited as significant barriers to practice. (4) Conclusions: The results reinforce the need for education and the development of targeted strategies that address challenges to oral health promotion in dietetic practice. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

10 pages, 419 KiB

Open AccessArticle

Strategies to Support Sustained Participant Engagement in an Oral Health Promotion Study for Indigenous Children and Their Families in Australia

by Megan L. Hammersley, Joanne Hedges, Brianna F. Poirier, Lisa M. Jamieson and Lisa G. Smithers

Int. J. Environ. Res. Public Health 2022, 19(13), 8112; https://doi.org/10.3390/ijerph19138112 - 1 Jul 2022

Cited by 1 | Viewed by 2082

Abstract

The health inequities of Indigenous peoples compared with non-Indigenous peoples are significant and long-standing across many countries. Colonisation and dispossession of land and culture has led to profound and devastating consequences on the health of Indigenous peoples. A lack of trust and cultural security of health services remains a barrier to participation in health care services. Similarly, engagement in research activities is also hindered by a history of unethical research practices. Creating partnerships between researchers and Indigenous communities is key in developing research studies that are culturally appropriate, acceptable and relevant to the needs of Indigenous peoples. Baby Teeth Talk was a randomised controlled trial conducted with Indigenous children and their mothers in South Australia that tested an intervention involving dental care, anticipatory guidance on oral health and dietary intake, and motivational interviewing. The study was developed in consultation and partnership with local Indigenous communities in South Australia and overseen by the study’s Aboriginal reference group. The recruitment and retention of participants in the study has been strong over numerous waves of follow-up. The purpose of this paper is to describe the strategies employed in the study that contributed to the successful and sustained engagement of the participants. These strategies included the establishment of an Aboriginal reference group, building relationships with organisations and community, flexibility of appointment scheduling and allocating adequate time, reimbursement for participant time, developing rapport with participants, encouraging participant self-determination, and adaptation of dietary data collection to better suit participants. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

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10 pages, 318 KiB

Open AccessArticle

Dental Consequences of Vitamin D Deficiency during Pregnancy and Early Infancy—An Observational Study

by Deanna M. Beckett, Jonathan M. Broadbent, Carolina Loch, Erin K. Mahoney, Bernadette K. Drummond and Benjamin J. Wheeler

Int. J. Environ. Res. Public Health 2022, 19(4), 1932; https://doi.org/10.3390/ijerph19041932 - 9 Feb 2022

Cited by 17 | Viewed by 3604

Abstract

Vitamin D (25OHD) status during pregnancy is closely correlated with foetal and new-born 25OHD. Calcification for primary teeth begins from the fourth month of intrauterine life and from birth for permanent teeth. Dental consequences of severe 25OHD deficiency are well documented; however, consequences are less documented for milder degrees of 25OHD deficiency. This study examined the dental consequences of vitamin D deficiency/insufficiency during gestation and infancy in a cohort of 81 New Zealand children. Pregnancy and birth data for the children and their mothers and 25OHD status during gestation, birth and at five months were obtained, and dental examinations were conducted. Associations between 25OHD and enamel defects or caries experience were investigated. Of the 81 children, 55% had experienced dental caries and 64% had at least one enamel defect present. Vitamin D insufficiency (25OHD < 50 nmol/L) at all timepoints was not associated with enamel defect prevalence, but during third trimester pregnancy it was associated with an increased caries risk IRR of 3.55 (CI 1.15–10.92) by age 6. In conclusion, maternal 25OHD insufficiency during the third trimester of pregnancy was associated with greater caries experience in primary dentition. No association was found between early life 25OHD and enamel defect prevalence or severity. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

21 pages, 848 KiB

Open AccessArticle

Common Determinants of Dental Caries and Obesity in Children: A Multi-Ethnic Nested Birth Cohort Study in the United Kingdom

by Magdalena F. Uerlich, Sarah R. Baker, Peter F. Day, Lucy Brown and Mario V. Vettore

Int. J. Environ. Res. Public Health 2021, 18(23), 12561; https://doi.org/10.3390/ijerph182312561 - 29 Nov 2021

Cited by 14 | Viewed by 4539

Abstract

The article examines the common determinants of childhood dental caries and obesity. Longitudinal data from the Born in Bradford cohort study (BiB1000) (n = 1735) and dental data (dental general anaesthetics (GA) and oral health survey 2014/15) (n = 171) were used to test a framework on the social determinants of childhood dental caries (decayed, missing, filled teeth (dmft) index) and obesity (body mass index (BMI)). The BiB1000 data were collected at pregnancy week 26–28 and after birth at 6, 12, 18, 24 and 36 months. The determinants were demographics, wellbeing, socio-economic status (SES), dietary behaviours and physical activity behaviour of the children. Missing data were accounted for through multiple imputation (MI). The framework was tested through structural equation modelling. Overall, the model fit was adequate. No alcohol consumption of the mother after giving birth, higher frequency of child drinking sugar-sweetened beverages, emotional and behavioural difficulties of the child and being male were directly associated with both BMI and dental caries. Caregivers uninvolved or indulgent feeding style were associated with higher BMI and less dental caries. Social deprivation was associated with lower BMI and higher dmft. Five determinants were directly associated with BMI only. Fifteen indirect paths were significant for both child dental caries and BMI. The findings suggest common determinants for both childhood obesity and dental caries. Common risk factor approach seems appropriate for planning future health promotion programmes. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

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Review

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32 pages, 728 KiB

Open AccessReview

Eating Advice for People Who Wear Dentures: A Scoping Review

by Paula Moynihan and Roshan Varghese

Int. J. Environ. Res. Public Health 2022, 19(14), 8846; https://doi.org/10.3390/ijerph19148846 - 21 Jul 2022

Cited by 7 | Viewed by 4361

Abstract

Objective: A scoping review of available advice to address eating problems experienced by people who wear dentures was conducted in accordance with the PRISMA statement. The objective was to identify and map type, volume, and content of the available eating advice. Methods: Medline, CINAHL, and grey literature databases and Google were searched. Relevant content pertaining to study type, peer-review vs. grey literature, country of origin, advice content, and methods to evaluate effectiveness was mapped. Results: Of the 4591 records identified from peer-reviewed literature, 56 full papers underwent duplicate screening, resulting in 26 papers (from Germany (n = 1), Europe (n = 1), India (n = 2), Japan (n = 7), UK (n = 6), USA (n = 6), or other (n = 3)) being included in the review. These yielded 18 different items of relevant eating advice. Of the 258 screened websites, 63 were included, yielding 30 different items of eating advice. The most-cited advice was to eat soft food and avoid hard and sticky food, cut food into bite-sized pieces, and chew on both sides of the mouth and chew slowly and thoroughly. The identified advice was not supported by reference to peer-reviewed evidence. Advice included some conflicting messages and some advice was non-compliant with authoritative nutritional advice (e.g., avoid red meat, take a vitamin supplement). Conclusion: There is support for providing eating advice at the time of denture provision. A broad range of advice based on clinical experience to support people who wear dentures to overcome the functional limitations exists. However, the efficacy of this advice in improving diet and eating experience has not been tested. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

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16 pages, 2541 KiB

Open AccessReview

A Scopus-Based Bibliometric Analysis of Global Research Contributions on Milk Fluoridation

by Kehinde Kazeem Kanmodi, Jacob Njideka Nwafor, Afeez Abolarinwa Salami, Eyinade Adeduntan Egbedina, Lawrence Achilles Nnyanzi, Temitope Oluwabukola Ojo, Ralph M. Duckworth and Fatemeh Vida Zohoori

Int. J. Environ. Res. Public Health 2022, 19(14), 8233; https://doi.org/10.3390/ijerph19148233 - 6 Jul 2022

Cited by 7 | Viewed by 2490

Abstract

Fluoridated-milk schemes have been developed and implemented in many countries to prevent dental caries. This study aimed to evaluate the impact/influence of scientific publications, researchers, and institutions conducting research on milk fluoridation; to explore the international and inter-institutional collaboration and illustrate scientific output trends; and to pinpoint research hotspots in milk fluoridation research. This bibliometric analysis of original research articles on milk fluoridation includes all of the original articles published in peer-reviewed journals systematically extracted from the SCOPUS database. In total, 108 articles were included in this study, with a total of 11,789 citations. A majority (67.6%) of these articles were in the subject area of ‘dentistry’, 22.2% externally funded, 14.8% published in the journal, Caries Research, 7.4% authored/co-authored by Twetman S, 6.5% by authors from Universidad de Chile, and the UK had the highest output (24.1%). The network visualizations showed that those countries with current/past histories of implemented milk fluoridation programs were interconnected on the network visualization map, and they were predominantly the hotspots for original research on milk fluoridation. This study also identified inequalities in research outputs on the topic. With the current enormous global burden of dental caries in children, particularly in low- and middle-income countries, there is an urgent need for greater and more equitable funding of milk fluoridation research globally. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

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27 pages, 3228 KiB

Open AccessReview

Interventions Targeting Bottle and Formula Feeding in the Prevention and Treatment of Early Childhood Caries, Overweight and Obesity: An Integrative Review

by Heilok Cheng, Rebecca Chen, Maxim Milosevic, Chris Rossiter, Amit Arora and Elizabeth Denney-Wilson

Int. J. Environ. Res. Public Health 2021, 18(23), 12304; https://doi.org/10.3390/ijerph182312304 - 23 Nov 2021

Cited by 8 | Viewed by 5445

Abstract

Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory. Full article

(This article belongs to the Special Issue Diet, Nutrition and Oral Health)

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