Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: Dr Green and Dr Neiburger suggest
confounding of environmental lead exposure with poverty and race is problematic.
We have attempted to control for relevant factors that were measured in NHANES-III;
however, as we stated in our article, residual confounding is likely to be
present. The origin of dental caries is complex, requiring the interaction
of key acidogenic bacteria with fermentable carbohydrates in the diet. If
these cofactors are not present, even a highly susceptible tooth will not
suffer decay. Experimental animal data,1
showing an association between lead exposure and dental caries, provide a
basis for investigating this association in humans. The NHANES-III data presented
in our article support the need for further research.
Moss ME, Lanphear BP. Blood Lead Level and Dental Caries—Reply. JAMA. 2000;283(4):476-477. doi:10.1001/jama.283.4.475