Wich factors influencing the number of teeth at 12 months of age: a birth cohort study

Silveira, Ethieli Rodrigues da; Cademartori, Mariana Gonzalez; Ardenghi, Thiago Machado; Silveira, Mariangela Freitas; Barros, Fernando Celso; Azevedo, Marina Sousa; Demarco, Flávio Fernando

doi:10.1590/1807-3107bor-2021.vol35.0059

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Original Research, Pediatric Dentistry • Braz. oral. res. 35 • 2021 • https://doi.org/10.1590/1807-3107bor-2021.vol35.0059 linkcopy

Wich factors influencing the number of teeth at 12 months of age: a birth cohort study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

This study aimed to verify, through a longitudinal follow-up, the pre-, peri- and postnatal factors associated with the eruption of deciduous teeth. The study was nested in a Birth Cohort Study conducted in Pelotas, a Southern Brazilian city. Mothers were followed prenatally and their children were followed-up perinatally, at 3 and 12 months of age. The outcome was the number of teeth at 12 months, and exploratory variables included maternal habits and characteristics, anthropometric measures of children and mothers, and socioeconomic and demographic information. Data were collected through interviews with the mother and children’s clinical exam. Poisson regression models were used for the analysis. Participants included 4,014 children with a mean number of erupted teeth at 12 months of 5.50. After adjustments, a lower mean number of teeth was observed in children from non-white mothers, early preterm children, and shorter children at birth and at 12 months. A higher number of teeth was observed for mothers with excessive weight gain during pregnancy, mothers who smoked during pregnancy, weightier children at birth and at 12 months, and for children with larger heads at birth and at 12 months. Our findings suggest that maternal and children characteristics influenced primary tooth eruption.

Keywords: Tooth Eruption; Epidemiology; Cohort Studies; Tooth; Deciduous

Variables			n (%) [95%CI]
Pre-pregnancy period
Block 1 – Maternal characteristics
	Mother’s age		3,068
		< 20 years	433 (14.1) [12.89-15.39]
		20–34 years	2,216 (72.2) [70.60-73.80]
		35–46 years	419 (13.7) [12.46-14.92]
	Skin color (self-reported)		3,065
		White	2,169 (70.8) [69.12-72.37]
		Non-white	896 (29.2) [27.62-30.87]
	Maternal schooling		4,013
		≤ 8 years	1,379 (34.4) [32.89-35.85]
		≥ 9 years	2,634 (65.6) [64.14-67.10]
Block 2 – Pre-pregnancy morbidities
	Anemia		3,044
		No	2,021 (66.4) [64.68-68.07]
		Yes	1,023 (33.6) [31.92-35.31]
	Diabetes mellitus		3,063
		No	2,990 (97.6) [97.01-98.12]
		Yes	73 (2.4) [1.87-2.98]
	Arterial hypertension		3,064
		No	2,536 (82.8) [81.38-84.08]
		Yes	528 (17.2) [15.91-18.61]
	Asthma		3,066
		No	2,582 (84.2) [82.87-85.48]
		Yes	484 (15.8) [14.51-17.12]
Pregnancy period
Block 3 – Health behaviors
	Smoking habit during pregnancy		4,011
		No	3,365 (83.9) [82.71-85.02]
		Yes	646 (16.1) [14.98-17.28]
	Alcohol use		4,011
		No	3,716 (92.7) [91.79-93.43]
		Yes	295 (7.3) [6.56-8.21]
	Illicit drugs use		3,014
		No	2,980 (98.9) [98.42-99.21]
		Yes	34 (1.1) [0.78-1.57]
	Weight gain during pregnancy		3,863
		Adequate weight gain	1,314 (34.0) [32.5-35.5]
		Insufficient weight gain	1,169 (30.3) [28.8-31.7]
		Excessive weight gain	1,380 (35.7) ]34.2-37.2]
Perinatal period
Block 4 – Birth children characteristics
	Gestational age		4,014
		Early preterm	148 (3.7) [3.1–4.3]
		Late preterm	440 (11) [10.0–11.9]
		Early term	1,499 (37.3) [35.8–38.8]
		Full term	1,611 (40.1) [38.6–41.6]
		Late term	287 (7.2) [6.3–7.9]
		Post-term	29 (0.7) [0.4–1.0]
	Apgar 1° minute		4,001
		0–3	112 (2.8) [2.31–3.35]
		4–6	240 (6) [5.28–6.77]
		≥ 7	3,649 (91.2) [90.28–92.06]
	Apgar 5° minute		4,003
		0–6	35 (0.9) [0.60–1.21]
		≥ 7	3,968 (99.1) [98.78–99.39]
	Gender		4,014
		Male	2,040 (50.8) [49.26–52.38]
		Female	1,974 (49.2) [47.61–50.73]
	Birth weight/gestational age (score-z)		4,011
		Adequate	3,788 (94.6) [93.8–95.2]
		Low	62 (1.5) [0.1–1.9]
		High	156 (3,9) [3.3–4.5]
	Birth lenght/gestational age (score-z)		4.001
		Adequate	3806 (95.1) [94.4–95.7]
		Low	195 (4.9) [4.2–5.6]
	Birth head circumference/gestational age (score-z)		4.001
		Adequate	2.574 (64.4) [62.8–65.8]
		Low	393 (9.8) [8.9–10.7]
		High	1034 (25,8) [24.4–27.2]
Block 5 – Children characteristics from 3 to 12 months of age
	Start time of pacifier use		4.014
		Never used	1.509 (37.6)[36.1– 39.1]
		0–6 months of age	2.409 (60.0)[58.4– 61.5]
		7–12 months of age	96 (2.4)[1.9–2.9]
	Exclusive breastfeeding up to 6 months of age		3,964
		No	819 (20.7) [19.41–21.95]
		Yes	3,145 (79.3) [78.04–80.59]
	Start of meat consumption (at 12-month follow up)		4,009
		Do not consume	319 (8) [7.13–8.83]
		0–5 months of age	472 (11.8) [10.79–12.81]
		6 months of age	1,291 (32.2) [30.75–33.67]
		7–12 months of age	1,927 (48.2) [46.51–49.62]
	Weight-for-age z-score at 12 months		3,957
		Adequate	3,523 (90.0) [89.1–90.9]
		Low weight	60 (1.5) [1.1–1.9]
		High weight	334 (8.5) [7.59–9.35]
	Length/height-for-age z-score at 12 months		3,958
		Low length	156 (3.9) [3.35–4.59]
		Adequate length	3,802 (96.1) [95.40–96.64]
	Head circumference at 12 months		3,949
		Mean (continuous)/ in centimeters (cm)	45.8cm (40 to 57.1)

Variables			Number of teeth at 12 months of age
			Bivariate analysis	p-value^* * statistical significant p-value ≤ 0.05.	Multivariate analysis	p-value^* * statistical significant p-value ≤ 0.05.
			IRR (95%CI)	p-value^* * statistical significant p-value ≤ 0.05.	IRR (95%CI)	p-value^* * statistical significant p-value ≤ 0.05.
Pre-pregnancy period
Block 1 – Maternal characteristics
	Mother’s age (ref. <20 years)			0.231	—	--
		20–34 years	0.94 (0.89–0.98)
		35–46 years	0.96 (0.90–1.03)
	Skin color (self-reported) (ref. White)			0.059		0.007
		Non-white	0.96 (0.92–1.00)		0.94 (0.91–0.98)
	Maternal schooling (ref. ≥ 8 years)			0.004		0.113
		≤ 8 years	1.05 (1.01–1.08)		1.03 (0.99–1.08)
Block 2 - Pre-pregnancy morbidities
	Anemia (ref. No)			0.848
		Yes	0.99 (0.96–1.03)
	Diabetes mellitus (ref. No)			0.049	—	--
		Yes	1.05 (1.00–1.12)
	Arterial hypertension (ref. No)			0.333
		Yes	1.01 (0.98–1.05)
	Asthma (ref. No)			0.344
		Yes	1.02 (0.97–1.06)
Pregnancy period
Block 3 – Health behaviors
	Smoking habit during pregnancy period (ref. No)			<0.001		<0.001
		Yes	1.08 (1.03–1.12)		1.10 (1.05–1.16)
	Alcohol use (ref. No)			0.472
		Yes	1.01 (0.97–1.05)
	Illicit drugs use (ref. No)			0.010		0.196
		Yes	1.20 (1.04–1.38)		1.09 (0.95–1.26)
	Weight gain during pregnancy (ref. Adequate)			0.006		0.014
		Insufficient weight gain	0.97 (0.93–1.02)		0.98 (0.94–1.03)
		Excessive weight gain	1.05 (1.01–1.11)		1.05 (1.01–1.09)
Perinatal period
Block 4 – Birth children characteristics
	Gestational age (ref. early preterm)			<0.001		<0.001
		Late preterm	1.23 (1.10–1.39)		1.22 (1.06–1.39)
		Early term	1.22 (1.10–1.36)		1.23 (1.09–1.39)
		Full term	1.27 (1.14–1.41)		1.28 (1.13–1.45)
		Late term	1.39 (1.24–1.56)		1.38 (1.20–1.58)
		Post-term	1.18 (0.94–1.48)		1.32 (1.10–1.59)
	Apgar 1° minute (ref. ≥7)			0.623
		0–6	0.94 (0.86–1.03)
		0–3	1.02 (0.96–1.09)
	Apgar 5° minute (ref. ≥7)			0.990
		0–6	1.00 (0.86–1.16)
	Gender (ref. Male)			<0.001		<0.001
		Female	0.91 (0.87–0.93)		0.91 (0.87–0.94)
	Weight z-score (Intergrowth 21-reference adequate)			0.001		0.021
		Low	0.88 (0.77–1.01)		0.89 (0.76–1.04)
		High	1.15 (1.07–1.23)		1.13 (1.07–1.20)
	Length z-score (Intergrowth 21-reference adequate)			<0.001		0.003
		Low very low	0.85 (0.78–0.93)		0.86 (0.77–0.96)
	Head circumference z-score (Intergrowth 21-reference adequate -1 até 1)			<0.001		0.051
		Low	0.89 (0.84–0.95)		0.96 (0.89–1.03)
	High		1.09 (1.05–1.13)		1.05 (1.01–1.09)
Block 5 – Children characteristics from 3 to 12 months of age
	Start time of pacifier use (ref. Do not use)			0.058		0.079
		At birth to 6 months of age	0.95 (0.92–0.98)		0.94 (0.91 –0.97)
		7–12 months of age	1.08 (0.98–1.19)		1.12 (1.01–1.24)
	Exclusive breastfeeding up to 6 months of age (ref. No)			0.303
		Yes	1.02 (0.98–1.06)
	Consumption of meat (ref. Do not consume)			0.041		0.271
		0–5 months of age	1.15 (1.06–1.24)		1.13 ( 1.04–1.23)
		6 months of age	1.07 (1.00–1.14)		1.06 (0.98–1.15)
		7–12 months of age	1.11 (1.04–1.18)		1.09 (1.01–1.17)
	Weight-for-age z-score at 12 months (ref. Adequate/[-2 to +2])			<0.001		<0.001
		Low weight (SD > -3 to < -2)	0.89 (0.76–1.06)		0.98 (0.80–1.21)
		High weight (> +2)	1.17 (1.11 –1.22)		1.14 (1.07–1.20)
	Length/height-for-age z-score at 12 months (ref. Adequate length (SD ≤-2)			<0.001		0.008
		Low length [SD > -2 to < -2])	0.81 (0.74–0.89)		0.86 (0.77–0.96)
	Head circumference at 12 months (ref 0, continuous)			<0.001		<0.001
		Mean 45,8cm	1.04 (1.03–1.05)		1.04 (1.02–1.05)

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statistical significant p-value ≤ 0.05.