The Healthy Eating Index and coronal dental caries in US adults

Abstract

The purpose of this cross-sectional study was to examine if Healthy Eating Index (HEI-2015) scores are associated with coronal caries experience and odds of untreated coronal caries in adults age 20 years and older. Data on decayed, missing and filled teeth (DMFT), untreated coronal caries and HEI-2015 scores were obtained from 7,751 adults who completed a dental examination and two 24-hour dietary recalls in NHANES cycles 2011–12 and 2013–14. HEI-2015 scores were categorized into quintiles, with HEI quintile I being least compliant with 2015–2020 US Dietary Guidelines. The authors used multivariable linear regression to assess associations of HEI-2015 with DMFT, and logistic regression for associations with untreated coronal caries. All regression models were controlled for age, gender, race/ethnicity, current cigarette use, family income-to-poverty threshold ratio, last dental visit, education, and ever told had a heart attack. Relative to HEI quintile I, the adjusted odds of any untreated coronal caries were: quintile V (OR=0.61, 95% CI= 0.46–0.80), IV (OR=0.66, 95% CI= 0.53–0.84), III (OR=0.76. 95% CI= 0.56–1.04) and II (OR=0.93, 95% CI= 0.66–1.31). Participants who met the recommendations for the total fruits, whole fruits, greens and beans, and added sugars components of the HEI-2015 score were less likely to have untreated coronal caries than those who failed to meet the recommendations. Overall, mean coronal DMFT also decreased as HEI-2015 scores increased but trends were not consistent in all racial/ethnic groups. Greater compliance with US Dietary Guidelines is associated with lower prevalence and odds of untreated caries in adults. Dietary counseling for caries prevention by dental professionals should incorporate comprehensive dietary guidelines that are consistent with those intended for enhancing overall health and reducing risk of common systemic diseases.