# Exploring the Triangle Between Oxidative Stress, Advanced Glycation End Products and Dental Caries in the Context of Diet and Lifestyle

## TL;DR

This study explores how diet, lifestyle, oxidative stress, and AGEs are linked to dental caries in adults, finding that sugar and smoking are major contributors.

## Contribution

The study identifies novel associations between oxidative stress, AGEs, and caries indices in the context of diet and lifestyle.

## Key findings

- Higher sugar consumption and smoking were strongly linked to increased caries indices.
- Salivary AGE-related biomarkers showed inverse associations with decay.
- Smoking was independently associated with higher DMFT scores.

## Abstract

Background/Aim: Dental caries is a multifactorial disease influenced by dietary habits, lifestyle factors, and host biochemical processes. Oxidative stress and advanced glycation end products (AGEs) have been implicated in oral and systemic pathophysiology, but their combined association with caries experience remains unclear. This study aimed to evaluate the relationships between caries indices, diet, smoking, oxidative stress markers, and AGEs in adults. Materials and Methods: A cross-sectional study was conducted on adults enrolled in the SALIVAGES project (2018–2020). Dental status was assessed using the DMFT index. Dietary habits and smoking status were recorded using a validated questionnaire. Oxidative stress parameters (TAC, TOS, OSI, NO, MDA, total thiols) and AGEs (FruLys, MG-H1, CML, CEL, Pyr, Arg, Lys) were quantified in saliva and plasma. Associations were analyzed using correlation tests and multivariable regression models (α = 0.05). Results: The mean DMFT was 21.89 ± 7.13, with missing teeth predominating. Caries experience was significantly associated with oxidative stress, AGEs, diet, and lifestyle. Higher decay scores were associated with increased NO and total thiols and reduced antioxidant capacity. Several salivary AGE-related biomarkers (FruLys, MG-H1, CML, and CEL) were negatively associated with the decay index. Sugary beverages, refined carbohydrates, pastries, and donuts were strongly positively associated with the decay index, whereas wholemeal bread showed an inverse association with caries indices. Smoking was independently associated with higher decay and DMFT values, corresponding to an approximately three-unit higher DMFT score. Conclusions: Caries experience in adults is associated with dietary, lifestyle, and biochemical factors. Sugar intake and smoking showed the strongest associations with caries indices, while oxidative stress parameters and selected salivary AGE-related biomarkers showed weaker but significant inverse associations with decay. These findings support preventive strategies targeting diet quality, smoking cessation, and redox balance to reduce oral disease burden.