Association between bisphenol A exposure and dental caries in U.S. population: insights from the NHANES survey

Human exposure to bisphenol A (BPA) primarily occurs through diet, but its impact on oral health, especially dental caries, remains underexplored. Data from a nationally representative sample of 5,566 participants aged 12-65 years were analyzed. Dental caries were assessed using the Decayed, Missing, and Filled Teeth (DMFT) and Decayed, Missing, and Filled Surfaces (DMFS) indices, while BPA exposure was measured via urine concentrations adjusted for creatinine. Statistical methods including zero-inflated negative binomial and logistic regressions, and restricted cubic spline models were employed to evaluated dose-response relationships. No significant association was found in the 12-19 age group. However, in the fully adjusted models for the 20-65 age group, participants in the highest BPA exposure quartile showed significantly higher Incidence Rate Ratios (IRR) for DMFT (1.13, 95%CI: 1.07, 1.19) and DMFS (1.21, 95%CI: 1.12, 1.30) compared to the lowest quartile. Subgroup analysis highlighted a significant gender heterogeneity, with men in the highest BPA quartile showing significantly higher adjusted IRRs for DMFT (1.20, 95%CI: 1.10, 1.31) and DMFS (1.29, 95%CI: 1.15, 1.45) compared to the lowest quartile. Our study underscores the association of BPA exposure with dental caries in adults, particularly in males, warranting further research to confirm these findings.