Weighing in on pediatric obesity: Weight screening at the dental visit

Exploring Barriers and Facilitators to Dietary Assessment and Advice in the Paediatric Population Attending Dental Clinics: A Scoping Review

OBJECTIVES

This scoping review aimed to identify barriers and facilitators, from both dental clinic staff and caregivers, to effectively providing and implementing dietary assessment and advice (for both oral and/or systemic health) in dental clinics managing paediatric patients.

METHODS

A protocol was developed a priori (Open Science Framework- https://osf.io/bp4ts.) and followed the PRISMA-ScR guidelines. Studies published in English from 1990 to December 2024 in MEDLINE, Cochrane Library, Embase and CINAHL databases were searched. Additional journal searches targeted articles on dietary assessment or advice in dental clinics treating paediatric patients (aged ≤ 18 years), exploring barriers and facilitators for caregivers and dental clinic staff.

RESULTS

Of 4736 studies identified, 32 were included, with 5 additional studies included from manual searching. Sixteen studies were quantitative, 13 were qualitative, and 8 mixed methods. Across studies, 77 barriers and 45 facilitators were identified in providing and implementing dietary assessment and advice in the paediatric population attending dental clinics. Results were mapped to the Theoretical Domains Framework. Common barriers for dental staff included time constraints and financial compensation, while caregivers cited controlling children's dietary habits as a major barrier.

CONCLUSIONS

Understanding the main barriers and facilitators in providing and implementing dietary assessment and advice in dental clinics treating paediatric patients is crucial to improving preventive healthcare.

Paediatric dentists' identification and management of underweight and overweight children

Introduction

Dental caries and obesity are growing challenges for the NHS. Dentists are in the unique position of being able to identify both conditions and intervene, following UK government strategy of 'making every contact count'.

Aims

Identify specialists in paediatric dentistry's (SPD) current practice regarding diagnosis and management of underweight or overweight/obese children presenting to dental services.

Materials and methods

An online survey was emailed to the UK SPD group. Questions investigated whether height, weight or body mass index (BMI) were measured, actions taken, and dentists' feelings regarding their role.

Results

49/118 (42%) SPDs responded. All felt they had a responsibility to identify underweight or overweight/obese children. Around a quarter (26%) measured BMI 'always' or 'often', while 37% did not measure BMI. Only 41% of SPDs who measured BMI took action more than twice in a year. Most commonly (90%) the child's GP was informed.

Conclusions

SPDs were supportive of the identification of underweight or overweight/obese children. However, many felt uncertain about BMI interpretation. Thus, few routinely measured BMI or acted on abnormal results. SPDs would benefit from training, alongside development of a local protocol, regarding BMI calculation and interpretation.

The role of dental practitioners in addressing overweight and obesity among children: A scoping review of current interventions and strategies

INTRODUCTION

With the growing prevalence of childhood obesity worldwide, there is a need for interventions to identify and address overweight and obesity in childhood. Although guidelines recommend general practitioners routinely screen for overweight and obesity among children, research suggests this is often not done. To address this, dental practitioners may be able to play a role in identifying and addressing overweight and obesity among children.

METHODS

This review aimed to explore the evidence and efficacy of existing obesity and overweight interventions targeting children in the dental setting. A systematic search of nine electronic databases was conducted to identify relevant published and grey literature. This was expanded to also include strategies for promoting oral health in the dental setting.

RESULTS

A total of 11 records were included in this review, which focussed on the current role and effectiveness of dental practitioners in addressing obesity among children, and the available strategies and resources. Although there was a paucity of research on the training of dental practitioners in this area and their efficacy in identifying and addressing obesity among children, evidence suggests that parents found it acceptable for dental practitioners to promote healthy practices to children who experience overweight or obesity. This review also identified screening tools and strategies for identifying and addressing overweight and obesity among children in dental practice.

CONCLUSION

There is a clear role for dental practitioners in addressing overweight and obesity among children, however further research is required to identify the most effective interventions to implement in dental practice.

Are dentists involved in the treatment of obesity?

The morbidity and mortality associated with being overweight or obese have been known to the medical profession to be related with an increased risk of associated diseases. This article provides an overview of obesity and addresses possible strategies for the management of this important public health concern. This narrative review sheds light on the problem of obesity and the necessity of professional oral health care to work in partnership with the medical team for managing obesity. In this regard, general dental practitioners should at least reinforce their knowledge regarding obesity and understand their potential role in the treatment and management of obese patients.