The two-year follow up study on the association between new caries risk in school aged children and multi dimensional sleep indicators

LU Xiuzhen, HUANG Chuanlong, LI Yang, ZUO Min, SUN Ying, CHEN Xin

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The two-year follow up study on the association between new caries risk in school aged children and multi dimensional sleep indicators

VernacularTitle:学龄儿童睡眠状况与龋病新发风险关联的2年随访研究
Author: LU Xiuzhen, HUANG Chuanlong, LI Yang, ZUO Min, SUN Ying, CHEN Xin ^{1
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Author Information

1. College &
2. Hospital of Stomatology, Anhui Medical University/Key Lab. of Oral Diseases Research of Anhui Province, Hefei (230032) , Anhui Province, China
Publication Type:Journal Article
Keywords: Dental caries; Sleep; Follow up studies; Risk; Child
From: Chinese Journal of School Health 2025;46(4):579-583
CountryChina
Language:Chinese
Abstract: Objective:To explore the prospective association between multidimensional sleep indicators and the risk of newlyonset dental caries, providing a reference for childrens oral healthrelated sleep intervention.
Methods:In October 2021, 1 417 students in grades 1 to 4 (aged 6 to 11) from two elementary schools in Bengbu, Anhui Province, were selected by cluster sampling method. Surveys and followup visits were conducted at baseline (T1), November 2022 (T2), May 2023 (T3), and November 2023 (T4), respectively, including parental questionnaires, oral health and physical examination. Bedtime, sleep duration, sleep midpoint, social jet lag, weekend catchup sleep, and sleep habits were collected and calculated. A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newlyonset caries in schoolaged children after 2 years.
Results:The prevalence of dental caries in children was 65.1% at baseline, and the prevalence was 59.0% at the end of the 2year followup. Cox proportional risk regression model showed that for every 1point increase in the childrens bedtime resistance, nocturnal awakenings, parasomnias, and daytime sleepiness scores, the risk of newlyonset caries increased by 12% (HR=1.12, 95%CI=1.08-1.15), 22% (HR=1.22, 95%CI=1.15-1.29), 12% (HR=1.12, 95%CI=1.08-1.17), and 15% (HR=1.15, 95%CI=1.12-1.19), respectively; the risk of newlyonset caries increased by 23% for each 1 h increase in the length of weekend catchup sleep (HR=1.23, 95%CI=1.14 -1.33); compared with children who went to bed before 21:00 on school days, those who went to bed later than 22:00 had a 57% higher risk of newlyonset caries (HR=1.57, 95%CI=1.22-2.03). Compared to children who slept adequately (≥9 h/d), those with insufficient sleep had a 67% higher risk of new caries (HR=1.67, 95%CI=1.43-1.95) (P<0.01).
Conclusions:These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries. Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance childrens oral health outcomes.