Impact of Mouth Breathing on Dental Caries in Children and Its High Medical Costs.

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.