Browsing by Author "Téllez-Rojo, Martha M."

Now showing 1 - 6 of 6
  • Thumbnail Image
    Item
    Blood levels of lead and dental caries in permanent teeth
    (Wiley, 2020) Yepes, Juan F.; McCormick-Norris, Jayme; Vinson, LaQuia A.; Eckert, George J.; Hu, Howard; Wu, Yue; Jansen, Erica C.; Peterson, Karen E.; Téllez-Rojo, Martha M.; Martinez Mier, Esperanza Angeles; Pediatric Dentistry, School of Dentistry
    Objectives: The purpose of this study was to determine whether there is an association between lead exposure within the ages of 1-4 years and dental caries in the permanent dentition between ages 9-17 among Mexican youth. Methods: Data were collected for the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort from a group of 490 children born and reared in Mexico City. Among ages 1-4 years, blood lead levels were measured in micrograms of lead per deciliter of blood (μg/dL) and the presence of caries in adolescence was determined using the International Caries and Detection and Assessment System (ICDAS). The relationship between blood levels of lead and decayed, missing, or filled surfaces (DMFS) was examined using negative binomial regression. Covariates were selected based on previous studies and included age, gender, socioeconomic status, oral hygiene, body mass index, and diet. The nonlinear relationship between lead and DMFS was examined using smoothing splines. Results: The mean overall blood lead level (BLL) was 4.83 μg/dL (S.D. of 2.2). The mean overall caries level (DMFS) was 4.1. No statistically significant association was found between early childhood blood lead levels and dental caries in adolescence. Conclusion: This study shows a lack of association between exposure to lead between the ages of 1-4 years of age and dental caries in permanent dentition later in life. Other covariates, such as age and sugar consumption, appeared to play a more prominent role in caries development.
  • Thumbnail Image
    Item
    Dietary Fluoride Intake during Pregnancy and Neurodevelopment in Toddlers: A Prospective Study in the PROGRESS Cohort
    (Elsevier, 2021) Cantoral, Alejandra; Téllez-Rojo, Martha M.; Malin, Ashley J.; Schnaas, Lourdes; Osorio-Valencia, Erika; Mercado, Adriana; Martínez-Mier, E. Ángeles; Wright, Robert O.; Till, Christine; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Foods and beverages provide a source of fluoride exposure in Mexico. While high fluoride concentrations are neurotoxic, recent research suggests that exposures within the optimal range may also pose a risk to the developing brain. This prospective study examined whether dietary fluoride intake during pregnancy is associated with toddlers' neurodevelopment in 103 mother-child pairs from the PROGRESS cohort in Mexico City. Food and beverage fluoride intake was assessed in trimesters 2 and 3 using a food frequency questionnaire and Mexican tables of fluoride content. We used the Bayley-III to evaluate cognitive, motor, and language outcomes at 12 and 24 months of age. Adjusted linear regression models were generated for each neurodevelopment assessment time point (12 and 24 months). Mixed-effects models were used to consider a repeated measurement approach. Interactions between maternal fluoride intake and child sex on neurodevelopmental outcomes were tested. Median (IQR) dietary fluoride intake during pregnancy was 1.01 mg/d (0.73, 1.32). Maternal fluoride intake was not associated with cognitive, language, or motor outcomes collapsing across boys and girls. However, child sex modified the association between maternal fluoride intake and cognitive outcome (p interaction term = 0.06). A 0.5 mg/day increase in overall dietary fluoride intake was associated with a 3.50-point lower cognitive outcome in 24-month old boys (95 % CI: -6.58, -0.42); there was no statistical association with girls (β = 0.07, 95 % CI: -2.37, 2.51), nor on the cognitive outcome at 12-months of age. Averaging across the 12- and 24-month cognitive outcomes using mixed-effects models revealed a similar association: a 0.5 mg/day increase in overall dietary fluoride intake was associated with a 3.46-point lower cognitive outcome in boys (95 % CI: -6.23, -0.70). These findings suggest that the development of nonverbal abilities in males may be more vulnerable to prenatal fluoride exposure than language or motor abilities, even at levels within the recommended intake range.
  • Thumbnail Image
    Item
    Dietary Fluoride Intake Over the Course of Pregnancy in Mexican Women
    (Cambridge, 2021-06) Castiblanco-Rubio, Gina A.; Muñoz-Rocha, Teresa V.; Cantoral, Alejandra; Téllez-Rojo, Martha M.; Ettinger, Adrienne S.; Téllez-Rojo, Adriana; Peterson, Karen E.; Hu, Howard; Martínez-Mier, E. Angeles; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Objective: To estimate dietary fluoride intake (F) over the course of pregnancy and the overall adjusted difference in dietary F intake by pregnancy stages and levels of compliance with dietary recommendations. Design: Secondary data analysis from a longitudinal pregnancy cohort study in a population exposed to fluoridated salt. Women were followed during the early, middle and late stages of their pregnancy (n 568). The dietary intake of recommended prenatal nutrients according to Mexican dietary guidelines and F intake (mg/d) was estimated with a validated FFQ. Data were summarised with descriptive statistics. Levels of F intake were compared with the USA’s Institute of Medicine adequate intake (AI) of 3 mg/d for pregnancy. Adjusted differences in F intake by pregnancy stages and levels of compliance with recommendations were estimated using random effects models. Setting: Mexico City. Participants: Women participating in the Early Life Exposures in Mexico to ENvironmental Toxicants (ELEMENT) project, from 2001 to 2003. Results: Median dietary F intake throughout pregnancy ranged from 0·64 (interquartile range (IQR) 0·38) in the early to 0·70 (IQR 0·42) in the middle, and 0·72 (IQR 0·44) mg/d in the late stage (0·01 mg F/kg per d). Corresponding adjusted intakes of F were 0·72 (95 % CI 0·70, 0·74), 0·76 (95 % CI 0·74, 0·77) and 0·80 (95 % CI 0·78, 0·82) mg/d. Women who were moderately and highly compliant with Mexican dietary recommendations ingested, on average, 0·04 and 0·14 mg F/d more than non-compliant women (P < 0·005). Conclusions: Dietary F intake was below current AI, was greater with the progression of pregnancy and in women who were moderately and highly compliant with dietary recommendations.
  • Thumbnail Image
    Item
    Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5, and 6–12 years in the ELEMENT cohort
    (Elsevier, 2022) Goodman, Carly V.; Bashash, Morteza; Green, Rivka; Song, Peter; Peterson, Karen E.; Schnaas, Lourdes; Mercado-García, Adriana; Martínez-Medina, Sandra; Hernández-Avila, Mauricio; Martinez-Mier, Angeles; Téllez-Rojo, Martha M.; Hu, Howard; Till, Christine; Dental Public Health and Dental Informatics, School of Dentistry
    Objective: Prenatal exposure to fluoride has been associated with adverse neurodevelopmental outcomes. However, the neuropsychological profile of fluoride's developmental neurotoxicity at low levels and the stability of this relationship across childhood has not been characterized. We investigated the longitudinal and domain specific effect of prenatal fluoride exposure on IQ among children ages 4, 5, and 6-12 years in the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort. Methods: We measured the average of maternal urinary fluoride at each trimester of pregnancy adjusted for creatinine (MUFCRE). Children were administered the McCarthy Scales of Children's Abilities at ages 4 (N = 386) and 5 (N = 308), and the Wechsler Abbreviated Scale of Intelligence at age 6-12 (N = 278). We used generalized estimating equation (GEE) models to estimate the population averaged effect of MUFCRE concentration on longitudinal General Cognitive Index (GCI)/Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ) scores (N = 348). We tested for possible interactions between MUFCRE and child sex as well as for MUFCRE and time point on children's IQ. All models controlled for relevant available covariates. Results: The mean/median MUFCRE concentration was 0.90/0.83 mg/L (SD = 0.39; IQR, 0.64-1.11 mg/L). A 0.5 mg/L increase in MUFCRE predicted an average 2.12-point decrease in GCI/FSIQ (95% CI: -3.49, -0.75) and 2.63-point decrease in PIQ (95% CI: -3.87, -1.40). MUFCRE was marginally associated with VIQ across time (B = -1.29, 95% CI: -2.60, 0.01). No interactions between MUFCRE and child sex or MUFCRE and time were observed. Conclusion: The negative association between prenatal fluoride exposure and longitudinal IQ was driven by decrements in non-verbal intelligence (i.e. PIQ), suggesting that visual-spatial and perceptual reasoning abilities may be more impacted by prenatal fluoride exposure as compared to verbal abilities.
  • Thumbnail Image
    Item
    Fluoride Content in Foods and Beverages From Mexico City Markets and Supermarkets
    (Sage, 2019-12) Cantoral, Alejandra; Luna-Villa, Lynda Cristina; Mantilla-Rodriguez, Andres A.; Mercado, Adriana; Lippert, Frank; Liu, Yun; Peterson, Karen E.; Hu, Howard; Téllez-Rojo, Martha M.; Martinez-Mier, Esperanza A.; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Background: Sources of fluoride exposure for Mexicans include foods, beverages, fluoridated salt, and naturally fluoridated water. There are no available data describing fluoride content of foods and beverages consumed in Mexico. Objective: To measure the content of fluoride in foods and beverages typically consumed and to compare their content to that of those from the United States and the United Kingdom. Methods: Foods and beverages reported as part of the Mexican Health and Nutrition Survey (n = 182) were purchased in the largest supermarket chains and local markets in Mexico City. Samples were analyzed for fluoride, at least in duplicate, using a modification of the hexamethyldisiloxane microdiffusion method. Value contents were compared to those from the US Department of Agriculture and UK fluoride content tables. Results: The food groups with the lowest and highest fluoride content were eggs (2.32 µg/100 g) and seafood (371 µg/100 g), respectively. When estimating the amount of fluoride per portion size, the lowest content corresponded to eggs and the highest to fast foods. Meats and sausages, cereals, fast food, sweets and cakes, fruits, dairy products, legumes, and seafood from Mexico presented higher fluoride contents than similar foods from the United States or the United Kingdom. Drinks and eggs from the United States exhibited the highest contents, while this was the case for pasta, soups, and vegetables from the United Kingdom. Conclusion: The majority of items analyzed contained higher fluoride contents than their US and UK counterparts. Data generated provide the first and largest table on fluoride content, which will be useful for future comparisons and estimations.
  • Thumbnail Image
    Item
    The Association of Dietary Fluoride Intake and Diet Variables with Dental Caries in Adolescents from the ELEMENT Cohort Study
    (Karger, 2021) Cantoral, Alejandra; Muñoz-Rocha, Teresa V.; Luna-Villa, Lynda; Mantilla-Rodriguez, Andres; Ureña-Cirett, José L.; Castiblanco, Gina A.; Solano, Maritsa; Howard, Hu H.; Peterson, Karen E.; Téllez-Rojo, Martha M.; Martínez-Mier, Esperanza A.; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    To examine the association of dietary fluoride intake, total carbohydrate consumption and other key dietary variables with dental caries experience among adolescents, a cross-sectional analysis was conducted in a sample of 402 participants from the Early Life Exposures in Mexico to Environmental Toxicants cohort. The presence and severity of dental caries were assessed using the Caries Detection and Assessment System (ICDAS) to calculate the number of Decayed, Missing, and Filled Teeth or Surfaces (D1MFT/D4MFT). Dietary intake of fluoride, energy, carbohydrates and food groups was estimated using a validated Food Frequency Questionnaire (FFQ). Multivariate zero-inflated negative binomial regression models and negative binomial regression models were run to estimate the association of fluoride intake (mg/d) and total carbohydrate intake (g/d) with the D1MFT/D4MFT index. We found that 80% of adolescents experienced dental caries (D1MFT>0), with 30% presenting cavitated lesions (D4MFT>0). Mean scores for D1MFT and D4MFT were 6.2 (SD 5.3) and 0.67 (SD 1.3), respectively. The median intake of fluoride estimated by the FFQ was 0.015 mg/d, this intake was statistically higher in those participants with a D4MFT=0 than those with a D4MFT>0 (0.90 vs 0.82 mg/d; 0.016 mg/Kg/d vs 0.014 mg/Kg/d, p<0.05). For D1MFT, D1MFS, D4MFT and D4MFS scores, there was a statistically significant reduction in the number of lesions with higher fluoride consumption (mg/d) from foods and beverages. The reported frequency of consumption of sugary foods in a whole day was statistically higher in those with D1MFT>0 than those with D1MFT=0 (p<0.05). Total carbohydrate intake (g/d) was positively associated with dental caries experience. We conclude that higher fluoride intake through foods and beverages was associated with lower dental caries experience among adolescents; this effect was seen even when the dietary intake of fluoride was 0.015mg/kg/d, which is lower than the average intake recommendation. In contrast, a higher amount of total carbohydrate intake and the frequency of intake of sugary foods were associated with higher dental caries experience, with no apparent threshold for the effects.