{"title":"Impact of Mouth Breathing on Dental Caries in Children and Its High Medical Costs.","authors":"Huiyi Deng, Chenyu Zhao, Qintai Yang, Xuekun Huang","doi":"10.1177/01455613251370571","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mouth breathing (MB) is a pediatric public health concern potentially increasing dental caries risk. We investigated risk factors, relationships between clinical characteristics and medical costs, and their effects on caries severity.</p><p><strong>Study design: </strong>Observation study.</p><p><strong>Setting: </strong>Analysis of clinical characteristics, medical costs, and dental caries in MB children.</p><p><strong>Participants: </strong>Eighty-six children with MB secondary to adenoid hypertrophy (AH) and/or tonsillar hypertrophy, recruited from an ENT department (June-August 2023).</p><p><strong>Measurements: </strong>MB diagnosis via validated criteria; dental caries assessment; questionnaire on demographics, medical history, body mass index, Paediatric Yorkhill Malnutrition Score, perinatal factors, feeding practices, oral hygiene, parental education, and costs.</p><p><strong>Results: </strong>Caries prevalence was 40.7% (35/86). Caries correlated significantly with longer MB duration (<i>P</i> = .013), higher total IgE (<i>P</i> = .004), and delayed toothbrushing initiation (<i>P</i> = .001). AH severity (assessed by Pharyngeal Airway Space, <i>P</i> = .013; choanal obstruction grade, <i>P</i> = .006) correlated with caries. Non-caries children showed higher breastfeeding rates (<i>P</i> = .026). Multivariate analysis identified formula feeding (odds ratio (OR) = 10.099, <i>P</i> = .026), longer disease duration (OR = 1.495, <i>P</i> = .035), and delayed oral hygiene initiation (OR = 2.171, <i>P</i> = .025) as independent caries predictors. Medical costs positively correlated with maternal education (<i>r</i> = 0.280, <i>P</i> = .009), AH grade (<i>r</i> = 0.345, <i>P</i> = .001), disease duration (<i>r</i> = 0.383, <i>P</i> < .001), and prematurity (<i>r</i> = 0.457, <i>P</i> < .0001), with maternal education exerting the strongest cost influence. Delayed toothbrushing (<i>r</i> = 0.213) and formula feeding (<i>r</i> = 0.219) positively correlated with higher decayed, missing, filled teeth/decayed, missing, or filled surfaces (affected surfaces) indices.</p><p><strong>Conclusion: </strong>MB-associated caries is highly prevalent and costly. Multiple modifiable risk factors contribute to its occurrence in children.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251370571"},"PeriodicalIF":0.7000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ear, nose, & throat journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/01455613251370571","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background: Mouth breathing (MB) is a pediatric public health concern potentially increasing dental caries risk. We investigated risk factors, relationships between clinical characteristics and medical costs, and their effects on caries severity.
Study design: Observation study.
Setting: Analysis of clinical characteristics, medical costs, and dental caries in MB children.
Participants: Eighty-six children with MB secondary to adenoid hypertrophy (AH) and/or tonsillar hypertrophy, recruited from an ENT department (June-August 2023).
Measurements: MB diagnosis via validated criteria; dental caries assessment; questionnaire on demographics, medical history, body mass index, Paediatric Yorkhill Malnutrition Score, perinatal factors, feeding practices, oral hygiene, parental education, and costs.
Results: Caries prevalence was 40.7% (35/86). Caries correlated significantly with longer MB duration (P = .013), higher total IgE (P = .004), and delayed toothbrushing initiation (P = .001). AH severity (assessed by Pharyngeal Airway Space, P = .013; choanal obstruction grade, P = .006) correlated with caries. Non-caries children showed higher breastfeeding rates (P = .026). Multivariate analysis identified formula feeding (odds ratio (OR) = 10.099, P = .026), longer disease duration (OR = 1.495, P = .035), and delayed oral hygiene initiation (OR = 2.171, P = .025) as independent caries predictors. Medical costs positively correlated with maternal education (r = 0.280, P = .009), AH grade (r = 0.345, P = .001), disease duration (r = 0.383, P < .001), and prematurity (r = 0.457, P < .0001), with maternal education exerting the strongest cost influence. Delayed toothbrushing (r = 0.213) and formula feeding (r = 0.219) positively correlated with higher decayed, missing, filled teeth/decayed, missing, or filled surfaces (affected surfaces) indices.
Conclusion: MB-associated caries is highly prevalent and costly. Multiple modifiable risk factors contribute to its occurrence in children.
背景：口腔呼吸（MB）是一个儿科公共卫生问题，可能会增加龋齿风险。我们调查了危险因素，临床特征和医疗费用之间的关系，以及它们对龋齿严重程度的影响。研究设计：观察性研究。背景：分析MB儿童的临床特征、医疗费用和龋齿。参与者：86名继发于腺样体肥大（AH）和/或扁桃体肥大的MB儿童，从耳鼻喉科招募（2023年6月- 8月）。测量：通过验证标准诊断MB；龋齿评估；关于人口统计、病史、体重指数、儿科约克希尔营养不良评分、围产期因素、喂养方式、口腔卫生、父母教育和费用的问卷调查。结果：龋患病率为40.7%（35/86）。龋齿与MB持续时间较长有显著相关性(P =。013)，总IgE较高(P =。004)和延迟开始刷牙（P = .001）。AH严重程度（以咽部气道间隙评估，P = 0.013）；006)与龋齿相关。无龋儿童母乳喂养率较高（P = 0.026）。多因素分析确定配方奶喂养(优势比(OR) = 10.099, P =。026)，病程较长(OR = 1.495, P =。035)，延迟口腔卫生开始时间（OR = 2.171, P = 0.35）。[25]作为独立的龋齿预测因子。医疗费用与母亲受教育程度呈正相关(r = 0.280, P =。009)， AH等级(r = 0.345, P =。001)、病程（r = 0.383, P r = 0.457, P r = 0.213）和配方奶喂养（r = 0.219）与较高的蛀牙、缺牙、补牙/蛀牙、缺牙、补牙面（受影响面）指数呈正相关。结论：mb相关性龋发病率高，费用高。多种可改变的危险因素有助于其在儿童中的发生。
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