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. 2025 Mar 19.
doi: 10.1007/s12011-025-04579-0. Online ahead of print.

Correlation Between Urinary Heavy Metals and Early Childhood Caries in a Typical Industrial and Mining Area

Mingkun Sun #  1 , Ting Yu #  2   3 , Yufan Zhu  1 , Xuandi Zhang  1 , Ya Chen  1 , Yuhui Dang  1 , Xiaowen Zhang  1 , Shiwei Ai  4
Affiliations

Correlation Between Urinary Heavy Metals and Early Childhood Caries in a Typical Industrial and Mining Area

Mingkun Sun et al. Biol Trace Elem Res. .

Abstract

In order to assess the association between urinary heavy metals and early childhood caries (ECC), a survey of deciduous tooth decay and urinary heavy metal concentrations of 408 children was conducted in a typical industrial and mining area. The results indicated that urinary heavy metal concentrations were ranked as Zn > Fe > Cu > Pb > Ni > Cd > As > Cr > Mn > Hg. The zero-inflated negative binomial model identified Hg as a significant risk factor for ECC (P25 ~ P75, OR = 3.499; > P75, OR = 3.184). Bayesian kernel machine regression further revealed that Pb, Cd, and Hg were positively correlated with ECC. Additional analysis using the Wilcoxon rank sum test and restricted cubic splines confirmed a positive correlation between the urinary concentrations of Pb, Cd, As, and Hg and the number of ECC (p < 0.05). Moreover, Bayesian kernel function regression and weighted quantile sum regression indicated that combined exposure to heavy metals was positively associated with ECC, with Hg (0.420) being the most dominant contributor, followed by As, Pb, and Cd. In conclusion, this study demonstrated a significant positive correlation between urinary heavy metals and both the occurrence and severity of ECC, with Hg identified as the most influential factor. It was recommended to minimize children's exposure to heavy metals to protect their dental health.

Keywords: Combined exposure; Early childhood caries; Preschool children; Urine heavy metals.

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Conflict of interest statement

Declarations. Ethical review: The study was approved by the Ethics Committee of the School of Public Health, Lanzhou University (Ethical Approval Number: IRB 22030205). Consent to participate: All guardians of the participants in this study signed the informed consent. Competing Interests: The authors declare no competing interests.

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