Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood – The Tinea Capitis Cohort
Identifieur interne : 000847 ( Pmc/Checkpoint ); précédent : 000846; suivant : 000848Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood – The Tinea Capitis Cohort
Auteurs : Yuval Vered [Israël] ; Angela Chetrit [Israël] ; Harold D. Sgan-Cohen [Israël] ; Tova Amitai [Israël] ; Jonathan Mann [Israël] ; Hadas Even-Nir [Israël] ; Siegal Sadetzki [Israël]Source :
- Frontiers in Public Health [ 2296-2565 ] ; 2016.
Abstract
While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low–moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (
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DOI: 10.3389/fpubh.2016.00018
PubMed: 26942172
PubMed Central: 4763082
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Sgan-Cohen</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University</institution>,<addr-line>Jerusalem</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Amitai, Tova" sort="Amitai, Tova" uniqKey="Amitai T" first="Tova" last="Amitai">Tova Amitai</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mann, Jonathan" sort="Mann, Jonathan" uniqKey="Mann J" first="Jonathan" last="Mann">Jonathan Mann</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University</institution>,<addr-line>Jerusalem</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Even Nir, Hadas" sort="Even Nir, Hadas" uniqKey="Even Nir H" first="Hadas" last="Even-Nir">Hadas Even-Nir</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sadetzki, Siegal" sort="Sadetzki, Siegal" uniqKey="Sadetzki S" first="Siegal" last="Sadetzki">Siegal Sadetzki</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Sackler Faculty of Medicine, Tel Aviv University</institution>,<addr-line>Tel Aviv</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26942172</idno><idno type="pmc">4763082</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763082</idno><idno type="RBID">PMC:4763082</idno><idno type="doi">10.3389/fpubh.2016.00018</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000635</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000635</idno><idno type="wicri:Area/Pmc/Curation">000635</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000635</idno><idno type="wicri:Area/Pmc/Checkpoint">000847</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000847</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood – The Tinea Capitis Cohort</title><author><name sortKey="Vered, Yuval" sort="Vered, Yuval" uniqKey="Vered Y" first="Yuval" last="Vered">Yuval Vered</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University</institution>,<addr-line>Jerusalem</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chetrit, Angela" sort="Chetrit, Angela" uniqKey="Chetrit A" first="Angela" last="Chetrit">Angela Chetrit</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sgan Cohen, Harold D" sort="Sgan Cohen, Harold D" uniqKey="Sgan Cohen H" first="Harold D." last="Sgan-Cohen">Harold D. Sgan-Cohen</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University</institution>,<addr-line>Jerusalem</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Amitai, Tova" sort="Amitai, Tova" uniqKey="Amitai T" first="Tova" last="Amitai">Tova Amitai</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mann, Jonathan" sort="Mann, Jonathan" uniqKey="Mann J" first="Jonathan" last="Mann">Jonathan Mann</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University</institution>,<addr-line>Jerusalem</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Even Nir, Hadas" sort="Even Nir, Hadas" uniqKey="Even Nir H" first="Hadas" last="Even-Nir">Hadas Even-Nir</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sadetzki, Siegal" sort="Sadetzki, Siegal" uniqKey="Sadetzki S" first="Siegal" last="Sadetzki">Siegal Sadetzki</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Sackler Faculty of Medicine, Tel Aviv University</institution>,<addr-line>Tel Aviv</addr-line>,<country>Israel</country></nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Frontiers in Public Health</title><idno type="eISSN">2296-2565</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low–moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (<italic>p</italic> = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19–2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40–3.50) and 1.05 per 1 cGy (95% CI: 1.01–1.09), respectively. Childhood exposure to ionizing radiation (0.2–0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Barasch, A" uniqKey="Barasch A">A Barasch</name></author><author><name sortKey="Coke, Jm" uniqKey="Coke J">JM Coke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnson, Nw" uniqKey="Johnson N">NW Johnson</name></author><author><name sortKey="Warnakulasuriya, S" uniqKey="Warnakulasuriya S">S Warnakulasuriya</name></author><author><name sortKey="Gupta, Pc" uniqKey="Gupta P">PC Gupta</name></author><author><name sortKey="Dimba, E" uniqKey="Dimba E">E Dimba</name></author><author><name sortKey="Chindia, M" uniqKey="Chindia M">M Chindia</name></author><author><name sortKey="Otoh, Ec" uniqKey="Otoh E">EC Otoh</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Cheng, Sc" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Front Public Health</journal-id><journal-id journal-id-type="iso-abbrev">Front Public Health</journal-id><journal-id journal-id-type="publisher-id">Front. Public Health</journal-id><journal-title-group><journal-title>Frontiers in Public Health</journal-title></journal-title-group><issn pub-type="epub">2296-2565</issn><publisher><publisher-name>Frontiers Media S.A.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26942172</article-id><article-id pub-id-type="pmc">4763082</article-id><article-id pub-id-type="doi">10.3389/fpubh.2016.00018</article-id><article-categories><subj-group subj-group-type="heading"><subject>Public Health</subject><subj-group><subject>Original Research</subject></subj-group></subj-group></article-categories><title-group><article-title>Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood – The Tinea Capitis Cohort</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Vered</surname><given-names>Yuval</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/307555"></uri></contrib><contrib contrib-type="author"><name><surname>Chetrit</surname><given-names>Angela</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/177650"></uri></contrib><contrib contrib-type="author"><name><surname>Sgan-Cohen</surname><given-names>Harold D.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Amitai</surname><given-names>Tova</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mann</surname><given-names>Jonathan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Even-Nir</surname><given-names>Hadas</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/180344"></uri></contrib><contrib contrib-type="author"><name><surname>Sadetzki</surname><given-names>Siegal</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="corresp" rid="cor1">*</xref><uri xlink:type="simple" xlink:href="http://frontiersin.org/people/u/171557"></uri></contrib></contrib-group><aff id="aff1"><sup>1</sup><institution>Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University</institution>,<addr-line>Jerusalem</addr-line>,<country>Israel</country></aff><aff id="aff2"><sup>2</sup><institution>Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research</institution>,<addr-line>Tel Hashomer</addr-line>,<country>Israel</country></aff><aff id="aff3"><sup>3</sup><institution>Sackler Faculty of Medicine, Tel Aviv University</institution>,<addr-line>Tel Aviv</addr-line>,<country>Israel</country></aff><author-notes><fn fn-type="edited-by"><p>Edited by: Frank De Vocht, University of Bristol, UK</p></fn><fn fn-type="edited-by"><p>Reviewed by: Igor Burstyn, Drexel University, USA; Eva Batistatou, University of Manchester, UK; Ruth Jimenez Saavedra, INSHT, Spain</p></fn><corresp content-type="corresp" id="cor1">*Correspondence: Siegal Sadetzki, <email>siegals@gertner.health.gov.il</email></corresp><fn fn-type="other" id="fn001"><p>Specialty section: This article was submitted to Radiation and Health, a section of the journal Frontiers in Public Health</p></fn></author-notes><pub-date pub-type="epub"><day>23</day><month>2</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>4</volume><elocation-id>18</elocation-id><history><date date-type="received"><day>25</day><month>11</month><year>2015</year></date><date date-type="accepted"><day>01</day><month>2</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2016 Vered, Chetrit, Sgan-Cohen, Amitai, Mann, Even-Nir and Sadetzki.</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>Vered, Chetrit, Sgan-Cohen, Amitai, Mann, Even-Nir and Sadetzki</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p></license></permissions><abstract><p>While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low–moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (<italic>p</italic> = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19–2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40–3.50) and 1.05 per 1 cGy (95% CI: 1.01–1.09), respectively. Childhood exposure to ionizing radiation (0.2–0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.</p></abstract><kwd-group><kwd>ionizing radiation</kwd><kwd>dental caries</kwd><kwd>public health</kwd><kwd>DMF index</kwd><kwd>risk assessment</kwd></kwd-group><counts><fig-count count="1"></fig-count><table-count count="4"></table-count><equation-count count="0"></equation-count><ref-count count="39"></ref-count><page-count count="8"></page-count><word-count count="6208"></word-count></counts></article-meta></front></pmc><affiliations><list><country><li>Israël</li></country></list><tree><country name="Israël"><noRegion><name sortKey="Vered, Yuval" sort="Vered, Yuval" uniqKey="Vered Y" first="Yuval" last="Vered">Yuval Vered</name></noRegion><name sortKey="Amitai, Tova" sort="Amitai, Tova" uniqKey="Amitai T" first="Tova" last="Amitai">Tova Amitai</name><name sortKey="Chetrit, Angela" sort="Chetrit, Angela" uniqKey="Chetrit A" first="Angela" last="Chetrit">Angela Chetrit</name><name sortKey="Even Nir, Hadas" sort="Even Nir, Hadas" uniqKey="Even Nir H" first="Hadas" last="Even-Nir">Hadas Even-Nir</name><name sortKey="Mann, Jonathan" sort="Mann, Jonathan" uniqKey="Mann J" first="Jonathan" last="Mann">Jonathan Mann</name><name sortKey="Sadetzki, Siegal" sort="Sadetzki, Siegal" uniqKey="Sadetzki S" first="Siegal" last="Sadetzki">Siegal Sadetzki</name><name sortKey="Sadetzki, Siegal" sort="Sadetzki, Siegal" uniqKey="Sadetzki S" first="Siegal" last="Sadetzki">Siegal Sadetzki</name><name sortKey="Sgan Cohen, Harold D" sort="Sgan Cohen, Harold D" uniqKey="Sgan Cohen H" first="Harold D." last="Sgan-Cohen">Harold D. 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