Associations Of Movement Behaviors With Oral Health In Children And Adolescents

PURPOSE: Previous research showed evidence of a relationship between movement behaviors and oral health in adults; however, these associations have remained largely unexamined in youth. The purpose of this study was to examine the associations of physical activity (PA), screen time, and sleep with indicators of poor oral health in a sample of children and adolescents. METHODS: Participants were children and adolescents whose parents completed the 2022 National Survey of Children’s Health (N = 34,342; 49% female). Randomly selected parent respondents completed a paper or online screener and topical questionnaire for one household child or adolescent. The dependent variables consisted of three binary response items that indicated the presence of toothaches, cavities, and bleeding gums within the previous 12 months. Independent variables were three items indicating the weekly frequency of 60 minutes of PA, the average number of hours per day of recreational screen use, and the average hours of sleep per night. Relationships between the movement behaviors and oral health outcomes were examined using double-selection logistic regression with demographic, dietary, dental service, and parental health covariates selected using the plug-in method of the least absolute shrinkage and selection operator. RESULTS: Compared to zero days of PA, 4-6 days of PA per week was associated with 30% lower odds of bleeding gums (OR = 0.70, p = 0.021). Compared to less than 1 hour of screen time, 2 hours or more hours of screen time was associated with a 1.26 to 1.62 times higher odds of cavities (OR range = 1.26-1.62, p < 0.01). Compared to 5 hours or less of sleep, 7 to 10 hours of sleep was associated with 31% to 47% lower odds of cavities (OR range = 0.53-0.69, p < 0.01) and 47% to 61% lower odds of bleeding gums (OR range = 0.39-0.53, p < 0.01). CONCLUSIONS: PA and sleep duration were negatively associated with indicators of poor oral health and screen time positively associated with indicators of poor oral health. Although associations were robust and adjusted for covariates selected using a machine learning algorithm, causal inferences cannot be established. More rigorous studies are needed to understand the relationship between physical activity, sleep, screen time and oral health in children and adolescents.