Dental Caries and Systemic Inflammation in Adolescents: Findings from a Population-Based Study

INTRODUCTION: Dental caries, the most prevalent noncommunicable disease (NCD) in adolescence, may represent a hidden link to systemic inflammatory processes, a common underlying mechanism shared by all major NCDs. Accordingly, this study investigated whether dental caries was associated with systemic inflammatory burden in adolescents. METHODS: This population-based study utilized data from the RPS Brazilian Birth Cohort Consortium, specifically the 18-19-year follow-up conducted in São Luís, Brazil (n = 441). The main exposures included the visible plaque index (VPI), number of decayed teeth, DMFT index (decayed, missing, and filling), and PUFA index. The outcome was the allostatic inflammatory load, calculated as the sum of biomarkers - IL-6, IL-18, IL-1β, TNF-α, and C-reactive protein (CRP) - that fell within the high-risk range (≥75th percentile of the sample distribution). Each biomarker contributed one point, resulting in a total score ranging from 0 to 5. Crude and adjusted coefficients were estimated using regression models. RESULTS: The number of decayed teeth (β = 0.031, p = 0.015) and the VPI (β = 0.006, p = 0.001) were positively associated with higher allostatic inflammatory load scores. Among individual biomarkers, both the number of decayed teeth (β = 8.95, SE = 4.09, p = 0.02) and the VPI (β = 1.09, SE = 0.50, p = 0.03) were positively associated with IL-18 levels, whereas no significant associations were observed for the DMFT or PUFA indices (p > 0.05). CONCLUSION: Dental caries was associated with systemic inflammation in adolescence, possibly reflecting shared underlying risk factors and highlighting the relevance of integrating oral health into strategies addressing common risk factors for non-communicable diseases.