Association of Hormonal Fingerprints and Body Mass Index with Dental Caries and Malocclusion: A Cross-Sectional Study

Abstract: Background: The second-to-fourth digit ratio (2D:4D) is a marker of prenatal hormonal exposure and has been studied as a potential biomarker for various health conditions, including oral diseases. Dental caries and malocclusion are common multifactorial oral health issues possibly influenced by hormonal factors and anthropometric measures such as body mass index (BMI). Aim: This study aimed to evaluate the association of hormonal fingerprints (2D:4D ratio) and BMI with dental caries and malocclusion among dental students. Materials and Methods: A cross-sectional study was conducted involving 200 dental students (158 females, 42 males; mean age approximately 20 years). BMI was calculated using standard anthropometry and classified according to WHO criteria. The 2D:4D ratio was measured using Vernier calipers. Dental caries experience was recorded using the DMFT index following ADA Type III clinical examination protocols. Malocclusion was classified clinically using standard orthodontic criteria. Statistical analysis included chi-square tests for categorical variables and Pearson’s correlation for associations between BMI, 2D:4D ratio, DMFT scores, and malocclusion, with a significance level set at p < 0.05. Results: No significant association was found between gender and BMI categories (p = 0.327). BMI showed a significant positive correlation with DMFT scores (r = 0.440, p = 0.032) but not with malocclusion (r = –0.163, p = 0.54). The 2D:4D ratio correlated positively with DMFT scores (r = 0.642, p = 0.032), indicating higher ratios were linked to greater caries experience. No significant correlations existed between the 2D:4D ratio and malocclusion (r = –0.005, p = 0.949) or BMI (r = –0.080, p = 0.257). Conclusion: Higher BMI and increased 2D:4D ratios were significantly associated with higher dental caries experience, suggesting their potential as non-invasive markers for caries risk. Neither BMI nor 2D:4D ratio showed significant relationships with malocclusion. Further studies with larger, more diverse samples are recommended. Keywords: 2D:4D ratio, Hormonal fingerprints, Body mass index, Dental caries, Malocclusion, Biomarkers, Dental students.