December 29, 2017
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Tap water leads to higher blood lead levels, less chance of dental caries

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Children and adolescents who do not consume tap water are more likely to experience dental caries but are slightly less likely to have elevated blood lead levels, according to a study published in the American Journal of Preventive Medicine.

“Elevated blood lead levels affect only a small minority of children, but the health consequences are profound and permanent,” Anne E. Sanders, PhD, from the department of dental ecology at the University of North Carolina at Chapel Hill, said in a press release. “On the other hand, tooth decay affects one in every two children, and its consequences, such as toothache, are immediate and costly to treat.”

To assess if drinking water from sources other than the tap is connected with reduced blood lead levels and a higher likelihood of dental caries, the researchers conducted a study using cross-sectional data collected from the National Health and Nutrition Examination Survey 2005-2014. This data included drinking water source (n = 15,604) and blood lead levels (n = 12,373) for all years as well as dental caries for the 2011-2014 participants (n = 5,677).

Sanders and Gary D. Slade, BDSc, PhD, also from the department of dental ecology at the University of North Carolina at Chapel Hill, set the threshold for blood lead levels at 3 µg/dL or more, and a binary outcome was used to demonstrate the prevalence of dental caries. The researchers also examined the adjusted prevalence ratios using multivariable generalized linear models.

Of the children included in the study, 15% did not consume tap water. A small percentage of children had elevated blood lead levels (3%), and 50% had previously had dental caries. Those who drank water from sources other than the tap were less likely to have elevated blood lead levels (adjusted prevalence ratios (PR) = 0.62; 95% CI, 0.42-0.90).

Although blood lead levels were lower in this cohort, children and adolescents who drank water from a source other than the tap were far more likely to experience dental caries (aPR = 1.13; 95% CI, 1.03-1.23). These correlations between blood lead levels, dental caries and drinking source remained the same when the researchers adjusted for other covariates.

“Our study draws attention to a critical trade-off for parents: Children who drink tap water are more likely to have elevated blood lead levels, yet children who avoid tap water are more likely to have tooth decay,” Slade said in the release. “Community water fluoridation benefits all people, irrespective of their income of ability to obtain routine dental care. Yet, we jeopardize this public good when people have any reason to believe their drinking water is unsafe.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.