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Association between exposure to environmental pollutants and increased oral health risks, a comprehensive review

Li Zhu, Mengchen Tang, Yinyin Cai, Panpan Wang

Frontiers in Public Health, 2025

18 citations

Abstract

The burden of disease and death attributable to environmental pollution is a growing public health challenge worldwide, particularly in developing countries. While the adverse effects of environmental pollution on oral health have garnered increasing attention, a comprehensive and systematic assessment remains lacking. This article delves into the intricate relationship between environmental pollution and oral health, highlighting significant impacts on various aspects such as dental caries, periodontal diseases, oral facial clefts, cancer, as well as other oral diseases. Our results suggested that secondhand smoke, particulate matters (PM) and heavy metals are the most important risk factors affecting oral health. Additional contributors, such as radiation pollutants, electronic cigarette, phthalates, gaseous air pollutants, pesticides, solvents, wood dust, formaldehyde and excessive fluoride were investigated, though evidence for their impacts remains limited and often inconclusive. The review also explores potential mechanisms underlying these impacts, including microorganism, inflammation, oxidative stress, genetic influences, and toxicant exposures from heavy metals and other pollutants. For instance, PM2.5 may contribute to dental caries by disrupting oral pH balance and absorbing heavy metals such as lead and cadmium which have been considered as caries promoting elements. It is also associated with adverse inflammatory responses and tissue damage in periodontal…

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