Analysis of the Effect of Daily Water Intake on Oral Health: Result from Seven Waves of a Population-Based Panel Study

Round 1

Reviewer 1 Report

Dear Authors,

very interesting article. Corrections are not required.

Best regards

Author Response

Thank you very much for your review. We will do our best to do better research.

Author Response File: Author Response.docx

Reviewer 2 Report

The manuscript submitted to Water entitled “Analysis of the effect of daily water intake on oral health: Result from Seven Waves of a Population-Based Panel Study” is an original research article which aim to compare the relationship between dental caries and periodontal disease according to the amount of water drank per day.

The manuscript is interesting, well written, with good English. All the sections have been properly prepared. On my opinion the article may be suitable for publication.

Minor suggestions:

• Abstract: Please structure abstract to attract the reader's attention.
• Type of paper: specify “Article”.
• English language: minor spell check required

Thanks for the opportunity to review this manuscript.

Author Response

Minor suggestions:

• Abstract: Please structure abstract to attract the reader's attention.

--> We edited the abstract.

 

• Type of paper: specify “Article”.

--> Yes. thank you.

 

• English language: minor spell check required

--> We checked and corrected it in its entirety.

 

Thank you very much for your review. We will do our best to do better research.

Author Response File: Author Response.docx

Reviewer 3 Report

The authors aimed to compare the relationship between dental caries and periodontal disease according to the amount of water drank per day. I found the topic interesting and the study well conducted. Here my comments to improve the quality of the manuscript:

INTRODUCTION:

1. Lines 57-58. The authors, correctly, stated that a poor water intake may cause dry mouth which predisposes to oral diseases. In the following lines they talked about some important bacterial species involved in dental caries and periodontal diseases. I suggest to report a further consideration on dental caries which is one of the direct consequences of a reduced salivary flow (reduced mechanical cleansing, reduction of the buffering action of saliva from acid attacks, reduction of antibacterial enzymes) [with relative references].

MATERIALS AND METHODS

1. Lines 100-102. Given that the optimal daily water intake should be > 1.5 L, it would be interesting to distinguish individuals who consume > 8 cups (optimal amount). Why was this distinction not made? If possible, it would be interesting to distinguish this fourth category of individuals.
2. Paragraph 2.3.1-2.3.2. I suggest elaborating a table/figure to resume in detail the dependent and independent variables considered for the study protocol.
3. Lines 125-126 (“The periodontal disease was recorded as having periodontal disease if the periodontal pocket is more than 3mm deep using probe”). This parameter adopted is not correct and led to an overdiagnosis of “periodontal disease”, according to the new classification of periodontal and peri‐implant diseases.

[1. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018 Jun;89 Suppl 1:S159-S172.

2. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Mealey BL, Papapanou PN, Sanz M, Tonetti MS. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol. 2018 Jun;89 Suppl 1:S1-S8.]

RESULTS

1. The statistical analysis adopted and the presentation of the results is of good quality. However, my main concern is the lack of a 4th group (> 8 cups) [see comment 1 in “materials and methods”].

I think that the conclusions are in line with the results obtained.

Author Response

INTRODUCTION:

1. Lines 57-58. The authors, correctly, stated that a poor water intake may cause dry mouth which predisposes to oral diseases. In the following lines they talked about some important bacterial species involved in dental caries and periodontal diseases. I suggest to report a further consideration on dental caries which is one of the direct consequences of a reduced salivary flow (reduced mechanical cleansing, reduction of the buffering action of saliva from acid attacks, reduction of antibacterial enzymes) [with relative references].

--> I added a note about saliva based on your comments. Thank you.

MATERIALS AND METHODS

1. Lines 100-102. Given that the optimal daily water intake should be > 1.5 L, it would be interesting to distinguish individuals who consume > 8 cups (optimal amount). Why was this distinction not made? If possible, it would be interesting to distinguish this fourth category of individuals.

--> According to your opinion, the analysis was re-analyzed into 4 groups. Thank you.

 

1. Paragraph 2.3.1-2.3.2. I suggest elaborating a table/figure to resume in detail the dependent and independent variables considered for the study protocol.

--> Figure 1 has been modified.

 

1. Lines 125-126 (“The periodontal disease was recorded as having periodontal disease if the periodontal pocket is more than 3mm deep using probe”. This parameter adopted is not correct and led to an overdiagnosis of “periodontal disease”, according to the new classification of periodontal and peri‐implant diseases.

--> This content is presented as a limitation in the discussion section.

RESULTS

The statistical analysis adopted and the presentation of the results is of good quality. However, my main concern is the lack of a 4th group (> 8 cups) [see comment 1 in “materials and methods”]. [1. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018 Jun;89 Suppl 1:S159-S172.][2. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Mealey BL, Papapanou PN, Sanz M, Tonetti MS. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol. 2018 Jun;89 Suppl 1:S1-S8.]

--> I analyzed the 4 groups and corrected the results.

I think that the conclusions are in line with the results obtained.

--> Thank you very much for your review. I hope to do better research.

Author Response File: Author Response.docx