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January 26, 2000

Blood Lead Level and Dental Caries

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(4):476-477. doi:10.1001/jama.283.4.475

To the Editor: Dr Moss and colleagues1 implicated high blood lead level (BLL) as a risk factor for dental caries. This conclusion may have resulted instead from the confounding of lead toxicity and tooth decay with socioeconomic status.

Children with high BLL (>10 µg/dL) are about 4 times as likely to be living in poverty and 4 times as likely to be black as children with lower levels of lead.2 Being poor or being black is also strongly associated with tooth decay. For example, among children aged 2 to 5 years, those living in poverty are 7 times as likely to have decayed primary teeth as those from more affluent families.3 Blacks aged 6 to 18 years are twice as likely as whites to have decayed teeth.3

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