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A N N A L E S A C A D E M I A E M E D I C A E S T E T I N E N S I S

R O C Z N I K I P O M O R S K I E J A K A D E M I I M E D Y C Z N E J W S Z C Z E C I N I E

2009, 55, 3, 20–22

MARIA USTIANOWSKA, DAMIAN CZEPITA, KRYSTYNA LISIECKA

DOES A CORRELATION EXIST BETWEEN MYOPIA AND DENTAL CARIES?

CZY ISTNIEJE ZALEŻNOŚĆ POMIĘDZY WYSTĘPOWANIEM

KRÓTKOWZROCZNOŚCI I PRÓCHNICY ZĘBÓW?

Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie

al. Powstańców Wlkp. 72, 70-111 Szczecin

Kierownik: prof. dr hab. n. med. Danuta Karczewicz

Zakład Stomatologii Dziecięcej Pomorskiej Akademii Medycznej w Szczecinie

al. Powstańców Wlkp. 72, 70-111 Szczecin

Kierownik: dr hab. n. med. Krystyna Lisiecka

Streszczenie

Wstęp: Celem pracy było przeprowadzenie oceny za-

leżności pomiędzy występowaniem krótkowzroczności
i próchnicy zębów.

Materiał i metody: Przebadano 900 dzieci ze Szko-

ły Podstawowej nr 3 w Szczecinie (443 chłopców i 457

dziewcząt w wieku 7

−13 lat, średni wiek 10 lat, SD = 2).

Badani uczniowie należeli do rasy kaukaskiej, mieszkali

w Szczecinie i jego okolicach. Wykonywano skiaskopię

po cykloplegii. Wyniki wad refrakcji wyrażono w formie
ekwiwalentu sferycznego (SE). Przyjęto, że w krótkowzrocz-
ności SE < −0,5 D. Stan zdrowia jamy ustnej oceniano

według ujednoliconych kryteriów WHO. Stopień zaawan-

sowania próchnicy określano na podstawie średniej liczby
puw i analizie jej składowych dla zębów mlecznych oraz

średniej liczby PUW i analizie jej składowych dla zębów

stałych. Analizę danych przeprowadzono testem χ

Pearsona

i testem U Manna–Whitneya. Przyjęto poziom istotności

p < 0,05.

Wyniki: Stwierdzono wysoką częstość występowania

próchnicy zębów u uczniów z (91,6%) i bez (93,8%) krótko-

wzroczności. Różnice pomiędzy tymi dwoma grupami nie

były istotne statystycznie (p > 0,05) – tabela 1. Poza tym
u uczniów z krótkowzrocznością zaobserwowano niższe

wartości p (p < 0,01), puw (p < 0,001) dla zębów mlecznych

oraz wyższe wartości W dla zębów stałych – tabela 2.

Wniosek: Brak jest dodatniej zależności pomiędzy wy-

stępowaniem krótkowzroczności i próchnicy zębów.

H a s ł a: krótkowzroczność

− próchnica zębów.

Summary

Introduction: The aim of this study was to analyze the

coexistence of myopia and dental caries.

Material and methods: 900 children from Elementary

School № 3 in Szczecin, Poland were examined (443 boys
and 457 girls, aged 7

−13 years, mean age 10, SD = 2). The

pupils were Caucasian and resided in or near Szczecin.

The examination included retinoscopy under cycloplegia.

Refractive error readings were expressed as the spheri-

cal equivalent (SE). Myopia was defi ned as SE of at least

−0.5 D. Unifi ed WHO criteria were used to evaluate the

state of health of the oral cavity. The advancement of car-

ies was assessed basing on the mean value of dmf and its

components for deciduous teeth, as well as on the mean

value of DMF and its components for permanent teeth.
The data was analyzed using Pearson’s χ

test and Mann–

Whitney U test. P values of < 0.05 were considered sta-

tistically signifi cant.

Results: A high prevalence of dental carries with myopia

(91.6%) and without myopia (93.8%) was found. Differences
between these two groups were not statistically signifi cant
(p > 0.05, table 1). Furthermore, lower values of d (p < 0.01)

and dmf (p < 0.001) in deciduous teeth and higher values of

F (p < 0.05) in permanent teeth were observed in associa-
tion with myopia (table 2).

DOES A CORRELATION EXIST BETWEEN MYOPIA AND DENTAL CARIES?

Conclusion: No positive correlation between myopia

and dental caries was ascertained.

K e y w o r d s: myopia

− dental caries.

Introduction

Recent clinical studies on the occurrence of myopia have

focused on the possible role of many factors [1, 2], among

them dental caries [3, 4, 5, 6]. In 1971, Goldstein et al. [4]
examined 100 students from the College of Medicine at the
State University of New York, New York, NY and found
that dental caries occured more frequently in subjects with
myopia (p < 0.05). However, the number of carious teeth

was not related to the severity of myopia. These fi ndings
were criticized by Cohen et al. [3] who questioned their
validity and the hypothesis on the link between myopia and

caries. In 1973, Hirsch and Levin [5] decided to repeat the
study of Goldstein et al. [4] in a group of 99 students from
the University of California, Berkeley, CA, and found that
dental caries occured more frequently in subjects with myo-
pia (p < 0.05) and that myopia

≤ −5 D predisposes to dental

caries (p < 0.01). Further research was done by Keller [6]

in 1978 who examined 196 children attending John Carroll
High School in Birmingham, AL. No proof of a correlation
between myopia and caries was found.

Due to the divergent data, we decided to reconsider the

association between myopia and dental caries.

Material and methods

900 children from Elementary School № 3 in Szczecin,

Poland were examined (443 boys and 457 girls, aged 7

−13

years, mean age 10, SD = 2). The pupils were Caucasian and

resided in or near Szczecin. The examinations were carried
out between February 1

and December 1

, 2005. Participa-

tion was voluntary. Informed consent was obtained in each
case from the child, parents or legal guardians, and school
principal. The study protocol adhered to the provisions of
the Declaration of Helsinki for research involving human

subjects and was approved by the Bioethics Committee of

the Pomeranian Medical University in Szczecin.

The children were examined in the school’s medical

room. The examination included retinoscopy under cyclople-

gia induced with two drops of 1% tropicamide administered

5 minutes apart. Thirty minutes after the last drop, pupillary

dilation and the presence of light refl ex was ascertained and
retinoscopy was performed.

Refractive error readings were expressed as the spherical

equivalent (SE)

− sphere power plus half negative cylinder

power. Myopia was defi ned as SE of at least −0.5 D. Both
eyes were examined, but only data from the right eye were
analyzed. Myopia in the examined pupils did not exceed

−5.0 D (mean refractive error −1.2, SD = 0.7).

Routine dental examinations were conducted in the

school’s dentist room. Unifi ed WHO criteria were used

to evaluate the state of health of the oral cavity. The advance-
ment of caries was assessed basing on the mean value of dmf
(number of decayed, missing, and fi lled teeth) and its compo-
nents for deciduous teeth, as well as on the mean value of DMF
and its components for permanent teeth. Retinoscopy and
dental examination were performed by the same doctor (MU).

The data was analyzed using Pearson’s χ

test and

Mann–Whitney U test. P values of < 0.05 were considered

statistically signifi cant.

Results

A high prevalence of dental carries among schoolchil-

dren with myopia (91.6%) and without myopia (93.8%) was

found. Differences between these two groups were not sta-

tistically signifi cant (p > 0.05, table 1). Furthermore, lower

values of d (p < 0.01) and dmf (p < 0.001) in deciduous teeth

and higher values of F (p < 0.05) in permanent teeth were
observed in myopia (table 2).

T a b l e 2. Average dmf/DMF and its components in schoolchildren with and without myopia

T a b e l a 2. Wartości średniej liczby puw/PUW i jej składowych u uczniów z krótkowzrocznością i bez krótkowzroczności

Parameters

Parametry

d / p

m / u

f / w

dmf / puw

D / P

M / U

F / W

DMF
PUW

With myopia
Z krótkowzrocznością

155

1.67

0.02

0.77

2.46

1.14

0.01

0.87

2.02

Without myopia
Bez krótkowzroczności

745

2.29

0.09

1.14

3.52

1.28

0.01

0.56

1.85

–

< 0.01

> 0.05

< 0.001

> 0.05

< 0.05

> 0.05

T a b l e 1. Prevalence of dental caries in schoolchildren with

and without myopia

T a b e l a 1. Występowanie próchnicy zębów u uczniów

z i bez krótkowzroczności

Parameters

Parametry

Number of schoolchildren

Liczba przebadanych uczniów

with caries

z próchnicą

without caries
bez próchnicy

total

razem

With myopia
Z krótkowzrocznością

142

155

Without myopia
Bez krótkowzroczności

699

745

Total / Razem

841

900

MARIA USTIANOWSKA, DAMIAN CZEPITA, KRYSTYNA LISIECKA

Discussion

Previous studies on the association between myopia

and dental caries were carried out in relatively small groups

(Goldstein et al. [4] – 100, Hirsch and Levin [5] – 99, Keller
[6] – 196). To increase the credibility of the fi ndings, we

decided to examine a total of 900 schoolchildren. However,

we found no positive correlation between myopia and den-

tal caries. This fi nding is in accordance with the study of

Keller [6], but not with of Goldstein et al. [4] and Hirsch

and Levin [5]. The discrepancy may be due to different age
and degree of myopia in the study groups.

As suggested by Goldstein et al. [4] and Hirsch and

Levin [5], an association between myopia and dental caries

may be due to changes in the metabolism of collagen which
occur in the sclera during progression of myopia [7, 8] and
in dentin during formation of carious lesions [9, 10, 11].
Our study did not rule out the possibility that myopia is
due to some form of collagen defi ciency. It is possible that
a mechanism could be operating to produce defective scleral
tissue in the eye independently of a similar mechanism
responsible for dental carries.

We have shown that the prevalence of dental carries in

pupils with myopia is high and comparable with the group

without myopia. The intensity of dental caries in deciduous

teeth was lower in children with myopia than in children

without myopia, refl ecting fewer teeth affected by caries.

However, the intensity of dental caries in permanent teeth

was comparable in both groups. The larger number of fi lled

teeth in children with myopia suggests that this group de-

voted more attention to hygiene of the oral cavity.

Conclusion

There is no positive correlation between myopia and

dental caries.

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