Associations of activity, sedentary and sleep behaviors with oral health indictors in children and adolescents: a cross-sectional analysis

Abstract

Background: The purpose of this study was to examine the associations of physical activity (PA), recreational screen time, and sleep with indicators of poor oral health in youth. Methods: Participants were children and adolescents whose parents completed the 2022 National Survey of Children’s Health (N = 34,342; 49% female; Mean age = 11.9 +/- 3.5 years). The dependent variables were three binary response items that indicated the presence of toothaches, bleeding gums, and cavities within the previous 12 months. Independent variables were three items indicating the weekly frequency of 60 min of PA, hours of recreational screen time, and hours of weeknight sleep. Relationships between variables were examined using double-selection logistic regression with demographic, dietary, oral hygiene, and dental service covariates selected using the plug-in method of the least absolute shrinkage and selection operator. Results: Compared to zero days of PA, 4–6 days of PA per week was associated with 30% lower odds of bleeding gums (p = 0.021). Compared to less than 1 h of recreational screen time, 2 h or more hours of recreational screen time were associated with a 1.26 to 1.62 times higher odds of cavities (p < 0.01). Compared to 5 h or less of sleep, 7 to 10 h of sleep was associated with 47–61% lower odds of bleeding gums and 31–47% lower odds of cavities (p < 0.01). Secondary analyses indicated that at least 2 of the movement behavior recommendations had to have been adhered to for positive associations with indicators of oral health to be observed. For toothaches, bleeding gums, and cavities, meeting 2 or 3 recommendations was associated with lower odds of poor oral health; whereas adhering to only one recommendation was not. Conclusion: Children with higher PA and sleep durations had improved oral health indicators and children with longer periods of screen time exposure had poorer oral health indicators. Our findings recommend adhering to multiple movement behavior recommendations to achieve improvements in oral health indicators.