Dental caries—something to sink your teeth into

In this volume of The Journal, Chen et al present some intriguing observations from the Kobe Offspring Study, comprising 71 069 children. The authors present analyses which may demonstrate an association between bedtime at 18 months and incidence of dental caries at 3 years, with increasing adjusted odds ratios for later bedtimes. This may have some biologic plausibility, since sleep and circadian rhythm may influence salivary flow, immune function, salivary amylase, and oral flora. On balance, though, this study raises as many questions as it seeks to answer.

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