Epidemiology of Oral Diseases

The Relationship Between Poor Oral Health and Cognitive Impairment in Children and Adolescents Using a Twin Model

Protocol Description

This study uses dental examinations and magnetic resonance imaging (MRI) among other methods to examine the relationship between prematurity, inflammation, oral health and neurocognitive development. Previous research has shown that certain types of infections increase the risk for preterm birth, often because they result in inflammation of the fetal membranes or an increase in circulating inflammatory cells. Additionally, risk for preterm birth and susceptibility to infection may be at least partially heritable traits, meaning that there is a high likelihood that certain genes increase the risk for one or both of these conditions. Finally, prematurity and certain types of infection/inflammation have been linked to poorer neurocognitive abilities.

Note: While the participant base of this study is exclusively from the region of Montes Claros, Brazil, the Pediatric Imaging Research Center at Children’s Hospital of Pittsburgh of UPMC plays a vital role in analyzing MRI images collected, working collaboratively on study design, training and data analysis with an international research team that includes New York University, the University of Southern California and the Twins Institute for Genetics Research, Brazil.

Eligibility Criteria

This study is only open to identical (monozygotic) and fraternal (dizygotic) twin pairs in the Montes Claros region of Brazil. Subject to certain exclusion criteria, this study is enrolling participants of both genders ages 7 through 17 and up who are in good general health.
Females: Ages 7 through 17
Males: Ages 7 through 17


At the study onset, participants will receive an oral examination, and samples of saliva, blood and dental plaque will be collected. Additionally, investigators will test for difficulties in perceiving, thinking and remembering. Participants will be scheduled for MRI of the head and neck to be performed in Montes Claros within 6 months of the study visit. Visits and MRI imaging will be repeated 3 times at 12-month intervals.
Visits: 9
Duration: 3 years

Status: Enrollment open to Brazil-based participants only

Source(s) of Support

Children’s Hospital of Pittsburgh of UPMC
New York University School of Medicine
Twins Institute for Genetics Research
University of Southern California

Primary Investigator

Ashok Panigrahy, MD
Patricia Corby, DDS, MS

Contact Information

For information, please contact:
Fern Wasco