Document Type


Date of Degree

Spring 2013

Degree Name

MS (Master of Science)

Degree In

Dental Public Health

First Advisor

Warren, John J

First Committee Member

Levy, Steven M

Second Committee Member

Marshall, Teresa A

Third Committee Member

Weber-Gasparoni, Karin


Associations Between Dietary Factors and Malocclusion. Blackwelder AC*, Warren JJ, Levy SM, Marshall TA, Bishara SE (University of Iowa, Iowa City, IA)

Purpose: Malocclusions, including crowding, have a multifactorial etiology, but it has been suggested that dietary factors may be a risk factor for malocclusion. Thus, the objective was to assess associations between dietary factors and dental crowding in a sample of Iowa Fluoride Study participants.

Methods: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 102 months using questionnaires and diet diaries periodically to gather information on dietary intake. Subjects were also examined clinically around age 5 (n=168) and 9 (n=125) with dental casts made to gather information on malocclusion such as Tooth Size Arch Length Discrepancy (TSALD) and Canine Arch Width (CAW), as well as body mass index (BMI). Relationships between dietary factors and malocclusion were assessed.

Results: The maxillary and mandibular TSALD values for the age 5 and age 9 exams were correlated with the dietary data. The age 5 maxillary TSALD (1.74 mm) was statistically significant when correlated with kilocalories (P=.031) before and after adjusting for BMI. Further examination of the extreme TSALD values with dietary data was completed using Student's t-test. The age 9 mandibular extreme TSALD value and kilocalories was also statistically significant (P=.028). The age 5 CAW was correlated with the dietary data and kilocalories was also statistically significant (P=.012). Other dietary factors were found to approach statistical significance but were not significant at the alpha=0.05 level.

Conclusions: The findings from this study suggest that dietary factors may be associated with crowding of the dentition as measured by TSALD and CAW; however, further research is needed.


crowding, diet, dietary factors, Malocclusion, mastication


viii, 79 pages


Includes bibliographical references (pages 76-79).


Copyright 2013 Aaron Blackwelder