Supplementary Material for: Asthma, medication use and dental caries in adolescents: a population-based study

Introduction
Asthma and dental caries may be linked through frequent mouth breathing and the use of inhaled asthma medication. However, the current literature is inconclusive on whether asthma or asthma medications increase the risk of dental caries in permanent dentition. This study aimed to investigate whether asthma, the age of asthma onset, and the use of asthma medications are associated with the caries experience of 13-year-old adolescents.
Methods
This study was embedded in the Generation R Study, a population-based prospective cohort. Data on asthma, asthma medication use, and potential confounders were collected through parental questionnaires. Dental caries in the permanent dentition was defined by the Decayed, Missing, and Filled Teeth (DMFT) index. Hurdle negative binomial regression models were used to examine the associations between asthma variables and dental caries.
Results
In the study population (n=3356, 13.6 ± 0.34 years, 48.8% male) the prevalence of dental caries was 35.2% and the prevalence of ever diagnosed with asthma 15.3%. The results showed no associations between (current) asthma, age at asthma onset or asthma medication use at 13 years and risk of dental caries (OR (95% CI) ranging from 0.64 (0.41-1.02) to 1.27 (0.79-2.05)).
Conclusion
As the largest study conducted to date in adolescents, no associations were found between asthma or asthma medication and dental caries, consistent with findings across multiple large, population-based cohort studies, underscoring the strength of these findings.