Association of evironmental cadmium exposure with pediatric dental caries

Manish Arora, Jennifer Weuve, Joel Schwartz, Robert O. Wright

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: Although animal experiments have shown that cadmium exposure results in severe dental caries, limited epidemiologic data are available on this issue. Objectives: We aimed to examine the relationship between environmental cadmium exposure and dental caries in children 6-12 years of age. Methods: We analyzed cross-sectional data, including urine cadmium concentrations and counts of decayed or filled tooth, surfaces, from the Third National Health and Nutrition Examination Survey. We used logistic and zero-inflated negative binomial (ZINB) regression to estimate the association between urine cadmium concentrations and caries experience, adjusting these analyses for potential confounders including environmental tobacco smoke (ETS). Results: Urine cadmium concentrations ranged from 0.01 to 3.38 ng/mL. Approximately 56% of children had experienced caries in their deciduous teeth, and almost 30% had been affected by caries in their permanent dentition. An interquartile range (IQR) increase in creatinine-corrected cadmium concentrations (0.21 μg/g creatinine) corresponded to a 16% increase in the odds of having experienced caries in deciduous teeth [prevalence odds ratio (OR) = 1.16, 95% confidence interval (CI), 0.96-1.40]. This association was statistically significant in children with low ETS exposure (prevalence OR = 1.30,-95% CI, 1.01-1.67). The results from the ZINB regression indicated that, among children with any caries history in their deciduous teeth, an IQR increase in cadmium was associated with 17% increase in the number of decayed or filled surfaces. We observed no association between cadmium and caries experience in permanent teeth. Conclusions: Environmental cadmium exposure may be associated with increased risk of dental caries in deciduous teeth of children.

Original languageEnglish
Pages (from-to)821-825
Number of pages5
JournalEnvironmental Health Perspectives
Issue number6
StatePublished - Jun 2008
Externally publishedYes


  • Children
  • Dental caries
  • Environmental tobacco smoke
  • Urine cadium


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