Underweight in low socioeconomic status preschool children with severe early childhood caries

Impact of oral intervention on the oral and overall health of children living with HIV in Cambodia: a randomized controlled trial

BACKGROUND

Maintaining oral health is essential for improving overall health of children living with HIV. Therefore, we evaluated the effectiveness of an oral health intervention for improving their oral and overall health. In addition, we examined their longitudinal association between changes in oral and overall health.

METHODS

We conducted a 2-year randomized controlled trial involving children living with HIV in Cambodia. Children aged 3-15 years and their caregivers were randomly allocated either to the intervention (group A) or control (group B) arm. A second control arm (group C) included children without HIV. The group A children received oral health education sessions and practiced home-based daily care.

RESULTS

In the baseline survey, 482 children participated (group A: n = 160, group B: n = 168, group C: n = 154), and 350 completed the endline survey. An interaction effect in teeth brushing duration was observed in children in group A relative to group B (AOR = 2.69, 95% CI: 1.37-5.31) and group C (AOR = 3.78, 95% CI: 1.70-8.40). Longitudinal associations were observed between changes in oral hygiene and overall health, as presented by alterations in dental caries in permanent teeth with viral load detection (adjusted odds ratio = 3.58, 95% CI: 1.10 - 11.73), in salivary flow quantity with the overall quality of life (β = 0.07, 95% CI: < 0.01 - 0.13), as well as in dental caries, salivary pH, debris index with body mass index for age among group A children.

CONCLUSIONS

Oral health intervention may improve oral care behaviors and potentially enhance overall health among children living with HIV in antiretroviral therapy in a resource-constrained setting.

TRIAL REGISTRATION

ISRCTN 15177479.

Association of Early Childhood Caries and Multiple Variable Factors in 3-6-year-old Children

Introduction

Dental caries is a globally prevailing condition. It is a common finding in all age-groups, whether it is young children or adults. Caries not only affects the oral health of an individual, but also the overall health of the individual.

Aims and Objectives

This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in age group of 3 to 6 year old children.

Material and methods

The study was planned and conducted in the Department of Pedodontics and Preventive Dentistry, Government College of Dentistry, Indore, Madhya Pradesh, India. The study consisted of 200 samples, including both groups. Group I included 100 patients with ECC and group II included 100 patients caries free. Children of age 3-6 years were randomly selected and evaluated for ECC and parameters like weight, height, number of siblings, birth order, SES status, and mothers' education.

Results

Body mass index (BMI) had no significant association with the occurrence of ECC. Statistical significant association was observed between the number of siblings and ECC. The "no caries" was significantly associated with "no sibling" or "one sibling". A significant association between SES status and ECC was observed. The upper and upper middle class had more number of caries free children, whereas the number of participants with ECC was significantly more in the upper lower class. There was a pronounced association between ECC and maternal education.

Conclusion

Researches like these help us to broaden our aspects of understanding that caries is not caused by only one factor but a magnitude of factors. It's prevention should take into consideration not only the dietary habits but also on increasing awareness about importance of oral hygiene and how it can be affected by other social varients.This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in 3-6-year-old children.

How to cite this article

Sahu P, Agrawal A, Jain D, et al. Association of Early Childhood Caries and Multiple Variable Factors in 3-6-year-old Children. Int J Clin Pediatr Dent 2023;16(1):42-47.

The role of oral health-related quality of life in the association between dental caries and height, weight and BMI among children in Bangladesh

OBJECTIVES

To examine whether oral health-related quality of life (OHRQoL) explained the negative associations between dental caries and anthropometric measures of child growth among a sample of 5- to 9-year-old children in Dhaka, Bangladesh, while taking potential confounding factors (maternal education, family income, study setting, child's birth weight and childhood diseases) into account. In addition, to test whether specific oral impacts had a role in explaining these associations.

METHODS

Data collection was conducted via a cross-sectional survey among children and their parents from both hospital and school settings in Dhaka. Dental caries and severe consequences of dental caries (defined here as dental sepsis) were the exposure variables, and age- and sex-adjusted height-z-scores (HAZ), weight-z-scores (WAZ) and BMI-z-scores (BAZ) were the outcome variables. OHRQoL was measured using the Bengali version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). First, associations between oral impacts (prevalence of overall impacts and specific items of the SOHO-5) and outcome measures were assessed. Multiple linear regression was used to assess associations between caries and anthropometric measures, adjusted for potential confounders. Oral impacts were then added to test whether their inclusion attenuated the associations between exposures and outcomes. To further investigate potential mediating role of oral impacts, structural equation modelling (SEM) was used to test the hypothesis that dental caries and sepsis were associated with the outcomes directly and also indirectly via oral impacts in general. A similar approach was used to investigate mediation by specific SOHO-5 items.

RESULTS

The sample consisted of 715 children, 73.1% of whom had dental caries, 37.5% presented with sepsis, and 57.3% reported at least one oral impact (SOHO-5 score ≥1). Prevalence of overall oral impacts and also the impact on 'eating difficulty' (a specific item of SOHO-5) were negatively associated with all three outcomes. Dental caries and sepsis was associated with lower HAZ, WAZ and BAZ, and adjustment for overall oral impacts considerably attenuated the associations between 'severe dental caries' and outcomes, and dental sepsis and outcomes. Using SEM, we found significant indirect associations between caries and sepsis and anthropometric measures via oral impacts (except for dental caries and HAZ). Considering specific oral impacts, eating difficulties explained about 44% and 65% of the associations between caries and anthropometric outcomes, and dental sepsis and anthropometric outcomes, respectively.

CONCLUSIONS

Oral impacts, in particular eating difficulties, appear to mediate associations between caries and markers of child growth among this population.

Prevalence of Dental Caries in Children in Mymensingh and Its Associated Risk Factors: A Cross-Sectional Study

Background: Children suffer from various oral and periodontal diseases. Dental caries is one of the most prevalent oral diseases among children in the world. This study was conducted to identify the prevalence and risk factors of dental caries in children in Mymensingh, Bangladesh. Methods: A cross-sectional study was conducted on 362 pediatric patients who attended the Dental Unit of Mymensingh Medical College from March to September 2019. The sample size was calculated using a statistical formula and the children were selected using a systematic random sampling technique. Children and their guardians were interviewed and data were recorded using a structured questionnaire. Risk factors were analyzed using multivariate logistic regression. Results: The overall prevalence of dental caries was 82.7%. The prevalence of caries was significantly higher in aged children (8–10 years) and also in rural, low-income, and illiterate families. Seven significant risk factors were identified that included residence in the rural area (OR: 7.31 [1.73–30.83]), a parental income of BDT ≤ 20,000 per month (OR: 4.75 [1.49–15.05]), reduced duration (≤1 min) of teeth cleaning (OR: 18.54 [2.05–168.17]), teeth cleaning before breakfast (OR: 93.30 [10.95–795.32]), the spoon-feeding method (OR: 12.57 [2.09–75.61]), long-term (37–48 months) breastfeeding (OR: 212.53 [8.69–5195.25]), and family oral problem (OR: 8.20 [2.57–26.16]). Conclusions: The prevalence of dental caries among the children in Mymensingh is very high and was associated with residence in rural areas, parental income, reduced duration of teeth cleaning, teeth cleaning before breakfast, the spoon-feeding method, long-term breastfeeding, and family oral problems.

Iron deficiency anemia associated factors and early childhood caries in Qingdao

Background

Iron deficiency anemia (IDA) has been shown to be related to early childhood caries (ECC). However, data on the relationship, if any, between IDA-associated factors and ECC remain scant. This study aimed to explore the interplay between IDA-associated factors and ECC.

Methods

This study randomly sampled a total of 1598 children in Qingdao city, and analyzed the severity of ECC using decayed-missing-filled teeth index, while the rate of caries was analyzed following the WHO recommendations. The correlation between IDA and ECC was analyzed by both the chi-square test and Mann–Whitney U test. In addition, we designed an electronic questionnaire and employed the disordered multi-classification logistic regression to interrogate the relationship between the IDA-associated factors and ECC.

Results

Children with IDA had higher rates and severe ECC than those without IDA (p < 0.001). Children who were breastfed until 2 years old had a higher risk of IDA and ECC, compared to those who were not {OR 3.453 (1.681–7.094)}. Compared with children who had no history of IDA at the age of 2 years or below, those with IDA history had a higher risk of IDA and ECC {OR 8.762 (3.648–21.041)}. In addition, children who had a maternal history of IDA at pregnancy were at a higher risk of IDA and ECC compared to those who had no IDA history at pregnancy {OR 4.913 (2.934–8.226)}. Our data showed that children from a family with an annual income lower than 50,000 Renminbi (RMB) had a higher risk of IDA and ECC compared to those with an annual family income higher than 200,000 RMB {OR 3.421 (1.505–7.775)}. On the other hand, compared with children taking iron supplements, children who did not were at a higher risk of ECC and IDA {OR 5.602 (1.858–16.896)}.

Conclusion

Factors such as low family income, history of IDA in children aged 2 years or younger, IDA history during pregnancy, children breastfed until 2 years old, and those not taking iron supplements were significantly associated with the occurrence of ECC and IDA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02127-z.

Association between Serum Ferritin, Hemoglobin, Vitamin D3, Serum Albumin, Calcium, Thyrotropin-releasing Hormone with Early Childhood Caries: A Case–Control Study

Aim and objective

This study aimed to contrast and compare serum ferritin, hemoglobin, Vitamin D₃, Ca⁺⁺, thyrotropin-releasing hormone (TRH), and serum albumin levels between preschoolers with severe caries (SC) and measures taken for caries control.

Materials and methods

A sample size of 300 children was selected but only 266 participated; 54.14% with SC and 45.86% caries-free. Blood samples for serum ferritin, hemoglobin, Vitamin D₃, Ca⁺⁺, TRH, and serum albumin levels were taken.

Results

The mean age was estimated to be 40.82 + 14.09 months. The serum ferritin level estimated mean value for sample pedodontic subjects came to be 29.58 ± 17.87 μg/L whereas their hemoglobin level with mean value 115.13 ± 10.12 g/L was measured. Logistic regression analysis (LRA) suggested that children with SC were nearly two times as likely to have ferritin level depreciation and likely six times more chance of FeDA (iron deficiency anemia) than in children with caries control. Children with SC had significantly lower mean Vitamin D₃ value (p < 0.001), Ca⁺⁺ (p < 0.001), and serum albumin (p < 0.001) levels, and significantly higher thyrotropin-releasing factor (p < 0.001) levels than those subjects without caries.

Conclusion

Analysis of children with SC at a very young age significantly showed an increased chance of low ferritin levels than children with a caries-free mouth. The level of hemoglobin was deficient in children with SC at a very young age. Children with SC at a very young age appeared to be malnourished when compared with children without dental caries. Other contrasting parameters like FeDA, Vitamin D₃, Ca⁺⁺, and serum albumin concentrations were significantly deficient in children with SC at a very young age, in contrast, to a sample of children with a caries-free mouth. The analysis also suggested an increased level of TRH.

Clinical significance

The following research study sets a benchmark for the dental fraternity and other health specialists to analyze serum ferritin, hemoglobin, Vitamin D₃, Ca⁺⁺, TRH, and serum albumin levels while generally treating pediatric patients. Accordingly, supplements should be prescribed rationally even in dental caries.

How to cite this article

Jha A, Jha S, Shree R, et al. Association between Serum Ferritin, Hemoglobin, Vitamin D₃, Serum Albumin, Calcium, Thyrotropin-releasing Hormone with Early Childhood Caries: A Case–Control Study. Int J Clin Pediatr Dent 2021;14(5):648–651.

Iron deficiency and early childhood caries: a systematic review and meta-analysis

BACKGROUNDS

Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC.

METHODS

The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software.

RESULTS

After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P < 0.001). There was no statistically significant association found between the level of serum ferritin and ECC (weighted mean difference (WMD) = -5.80, 95% CI: [-11.97, 0.37], P = 0.07). Children with ECC were more likely to have iron-deficiency anemia (OR = 2.74, 95% CI: [2.41,3.11], P < 0.001). The hemoglobin (HGB) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -9.96, 95% CI: [-15.45, -4.46], P = 0.0004). The mean corpuscular volume (MCV) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -3.72, 95% CI: [-6.65, -0.79], P = 0.01).

CONCLUSIONS

ID was more prevalent in children with ECC, and the markers of iron status in the ECC group, such as serum ferritin, HGB, and MCV, were relatively lower than the ECC-free group.

Associations of early childhood caries with salivary beta defensin-3 and childhood anemia: a case-control study

Background

Human beta defensin-3 (HβD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HβD-3 levels and observe the association of HβD-3 levels with childhood anemia.

Methods

A total of 80 children admitted in a pediatric medical ward, age 48–71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HβD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05.

Results

The mean Salivary HβD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HβD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HβD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HβD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HβD-3 level and anemia (r = -0.479, p = 0.002).

Conclusion

Anemia may affect the innate immunity of children, and may result in a decreased level of salivary HβD3, thus increasing vulnerability to decay.

An ecological study on the association between universal health service coverage index, health expenditures, and early childhood caries

Background

Universal health care (UHC) may assist families whose children are most prone to early childhood caries (ECC) in accessing dental treatment and prevention. The purpose of this study was to determine the association between UHC, health expenditure and the global prevalence of ECC.

Methods

Health expenditure as percentage of gross domestic product, UHC service coverage index, and the percentage of 3–5-year-old children with ECC were compared among countries with various income levels using one-way analysis of variance (ANOVA). Three linear regression models were developed, and each was adjusted for the country income level with the prevalence of ECC in 3–5-year-old children being the dependent variable. In model 1, UHC service coverage index was the independent variable whereas in model 2, the independent variable was the health expenditure as percentage of GDP. Model 3 included both independent variables together. Regression coefficients (B), 95% confidence intervals (CIs), P values, and partial eta squared (ƞ²) as measure of effect size were calculated.

Results

Linear regression including both independent factors revealed that health expenditure as percentage of GDP (P < 0.0001) was significantly associated with the percentage of ECC in 3–5-year-old children while UHC service coverage index was not significantly associated with the prevalence of ECC (P = 0.05). Every 1% increase in GDP allocated to health expenditure was associated with a 3.7% lower percentage of children with ECC (B = − 3.71, 95% CI: − 5.51, − 1.91). UHC service coverage index was not associated with the percentage of children with ECC (B = 0.61, 95% CI: − 0.01, 1.23). The impact of health expenditure on the prevalence of ECC was stronger than that of UHC coverage on the prevalence of ECC (ƞ² = 0.18 vs. 0.05).

Conclusions

Higher expenditure on health care may be associated with lower prevalence of ECC and may be a more viable approach to reducing early childhood oral health disparities than UHC alone. The findings suggest that currently, UHC is weakly associated with lower global prevalence of ECC.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01500-8.

Prevalence and Correlation of Dental Caries with its Specific Risk Factors in 5-15-year-old School-going Children in Urban Population of Ghaziabad

Dental caries is a rapidly emerging oral health problem amid the children with differing prevalence rate in different states of India. The data available from Ghaziabad city regarding dental caries are scarce; therefore, the study was conducted in 5–15-year school-going children in urban population of Ghaziabad.

Dental Caries, Body Mass Index, and Socioeconomic Status among Preschoolers in Private Preschools and Anganwadi Centers in Bengaluru City: A Comparative Study

Aim

Preschool is the time when deleterious oral habits, caries pattern, and risk factor are established and is the time to intervene and establish healthy trends which can have a lifelong influence. Individuals living in various socioeconomic conditions have an assortment of hazard factors that impact oral well-being. This work was conducted to study the prevalence of dental caries, body mass index (BMI), and socioeconomic status (SES) among preschoolers in private preschools and Anganwadi centers within Bengaluru.

Materials and methods

This cross-sectional study was conducted in Anganwadis and preschools in Bengaluru city. About 800 students were selected by stratified cluster sampling technique. Written informed consent was obtained before the start of the study. Study proforma was used for the recording of sociodemographic details, anthropometric measurements, decayed, missing and filled teeth (dmft), and decayed, missing and filled surfaces (dmfs) index scoring. Statistical analysis was done using SPSS version 22.0.

Results

The mean dmf (t) score in Anganwadi children was 1.60, whereas in private preschool children mean dmf (t) was 1.16. The mean dmf (s) score in Anganwadi children was 3.05, whereas in private preschool children mean dmf (s) was 1.76. There was a statistically significant difference between the two groups with respect to dmf (s) score (p = 0.01).

Conclusion

It was found that there is an association between dental caries, BMI, and SES among Anganwadi children when a linear correlation was done.

Clinical significance

Dental caries can cause serious physical and mental problems in children which affects their quality of life. These problems have their root cause from childhood and are related to their BMI and SES. This can be prevented by giving proper health education and dietary advice to parents.

How to cite this article

Sukumaran N, Sharma V, Bhat PK. Dental Caries, Body Mass Index, and Socioeconomic Status among Preschoolers in Private Preschools and Anganwadi Centers in Bengaluru City: A Comparative Study. Int J Clin Pediatr Dent 2020;13(6):630–634.

Health and oral health-related quality of life of children and adolescents with chronic kidney disease: a cross-sectional study

PURPOSE

The aim of this study was to evaluate if health and oral health status of children and adolescents with different stages of CKD are associated with their health-related quality of life (HRQoL), oral health-related quality of life (OHRQoL) and socioeconomic and demographic conditions.

METHODS

One hundred children and adolescents with CKD were age and gender matched to 100 individuals without CKD (mean age ± SD = 13.04 ± 2.57). Oral health was characterised by means of gingival bleeding index (GBI), plaque index (PI), the decayed, missing, and filled teeth (DMFT) index and the developmental enamel defect (DED) index. All children and adolescents answered two Peds QL^® instruments (general and oral health scales).

RESULTS

Comparing the mean scores of HRQoL and OHRQoL between groups, we observed that CKD group demonstrated worse perceptions when compared to non-CKD group. Multiple linear regression analysis with bootstrap estimation of variance (1000 replications) showed association between dental caries experience (p < 0.001), gingival inflammation (p < 0.001) and diagnosis of CKD (p = 0.027) with the OHRQoL and between physical and the emotional domain of HRQoL, when moderate/severe gingival inflammation and hypoplasia were present.

CONCLUSION

The implementation of public policies that contemplate the early dental preventive intervention in CKD children and adolescents should occur aiming to improve their oral health, once oral manifestations can directly affect the aspects of the HRQoL and OHRQoL of these individuals.

The bidirectional relationship between weight, height and dental caries among preschool children in China

There is evidence of a bidirectional association between dental caries and anthropometric measures among children. This dual relationship has not been examined in the same population. The objectives of this study are (1) to examine the relationship between baseline caries and changes in weight and height; and (2) to assess whether baseline weight and height are associated with changes in dental caries in a sample of preschool Chinese children. Children were recruited from 15 kindergarten in Liaoning Province at baseline (8 in rural area and 7 in urban area), a total of 1,111 of children were included at baseline. The mean age of children at baseline was 50.82 months. Data were collected through clinical oral examination, assessment of anthropometric measures and structured questionnaire. Dental caries was assessed according World Health Organization (WHO) methods by one dentist. Sociodemographic and behaviour data were also collected. At follow-up, 772 children were included (attrition rate: 30%), dental caries and anthropometric measures were assessed again. Z-score for weight-for-age and height-for-age were calculated using the 2006 and 2007 WHO Child Growth Standards. The sum of decayed, missing and filled primary teeth (dmft) were used in the analysis. Multilevel analysis for longitudinal data was conducted to explore the relationship between z-score for weight-for-age and height-for-age, and dental caries among children. The median follow-up time was 10.12 months. There was a significant negative association between dmft at baseline and change in height-for-age. On the other hand, weight-for-age at baseline was negatively associated with change in dmft at follow-up. The findings suggest that dental caries impedes children's growth indicated by height for age. Low weight children appear to be more susceptible to dental caries in the same population.

Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India

INTRODUCTION

Dental caries is one of the major widespread health issues that continue to negatively affect the oral health of children globally.

AIM

To estimate the prevalence of dental caries and its risk factors among preschool children of Bhubaneswar, Odisha, India.

MATERIALS AND METHODS

The study was a community-based cross-sectional one among preschool children with (N = 425) participants recruited from the Anganwadi centers (AWCs) of Bhubaneswar, Odisha, India. By using a cross-sectional study design, dental caries was assessed using the World Health Organization (WHO) guidelines, and other socioeconomic and risk factors data were collected through parental interview using questionnaires. Caries was identified at both tooth and surface levels through visual dental examinations by trained and calibrated dentists. Logistic regression analyses were used to identify associations among variables and caries.

RESULTS

The proportion of preschool children suffering from dental caries was found to be 47.29%. The multivariable-adjusted model depicted that longer duration of breastfeeding was a significant predictor as follows: Those who had breastfed for more than 36 months [adjusted odds ratio (AOR): 5.41; 95% confidence interval (CI): 2.97-9.85; p = 0.001], 12 to 24 months (AOR: 2.1; 95% CI: 1.04-4.36; p = 0.037), followed by increase in age 61 to 72 months (AOR: 5.39; 95% CI: 2.72-10.67; p = 0.001), 49 to 60 months (AOR: 2.53; 95% CI: 1.41-4.52; p = 0.002), more than two children in the family (AOR: 2.70; 95% CI: 1.55-4.69; p = 0.001), and children who did not brush the teeth under the parent's supervision (AOR: 2.70; 95% CI: 1.55-4.69; p = 0.001).

CONCLUSION

The study highlights the need to increase awareness about the oral health and hygiene among parents of preschool children in India.How to cite this article: Chugh VK, Sahu KK, Chugh A. Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India. Int J Clin Pediatr Dent 2018;11(3):238-243.

Association between underweight and tooth loss among Korean adults

There is growing interest in the relationship between body mass index and oral health. Previous study showed that being underweight was significantly associated with having lower masticatory performance. This study was performed to assess the relationship between an underweight body mass index lower than 18.5 and the number of natural teeth using nationally representative data. Initially, a total of 25,534 individuals were candidates in the Korean National Health and Nutrition Examination Survey. The analysis in this study was confined to 17,870 subjects who were 19 years or older and without missing values for outcome variables. Body mass index and number of natural teeth were evaluated. Multiple regression analysis was used to evaluate the risk of tooth loss in relation to body mass index. Adjusted odds ratios and their 95% confidence intervals for chewing discomfort in individuals who were underweight, normal, overweight, obese, and extremely obese were 1.712(1.156–2.535), 1.111(0.939–1.315), 1(reference), 0.949(0.798–1.128), and 1.172(0.807–1.700), respectively, after adjustment. The association between underweight and tooth loss was proven by multiple logistic regression analyses after adjusting for confounding factors. Underweight may be considered a potential risk indicator for tooth loss in Korean adults.

Early Childhood Caries: Prevalence, Risk Factors, and Prevention

Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC.

Higher body mass index associated with severe early childhood caries

BACKGROUND

Severe Early Childhood Caries (S-ECC) is an aggressive form of tooth decay in preschool children affecting quality of life and nutritional status. The purpose was to determine whether there is an association between Body Mass Index (BMI) and S-ECC.

METHODS

Children with S-ECC were recruited on the day of their slated dental surgery under general anesthesia. Age-matched, caries-free controls were recruited from the community. All children were participating in a larger study on nutrition and S-ECC. Analysis was restricted to children ≥ 24 months of age. Parents completed a questionnaire and heights and weights were recorded. BMI scores and age and gender adjusted BMI z-scores and percentiles were calculated. A p-value ≤ 0.05 was significant.

RESULTS

Two hundred thirty-five children were included (141 with S-ECC and 94 caries-free). The mean age was 43.3 ± 12.8 months and 50.2 % were male. Overall, 34.4 % of participants were overweight or obese. Significantly more children with S-ECC were classified as overweight or obese when compared to caries-free children (p = 0.038) and had significantly higher mean BMI z-scores than caries-free children (0.78 ± 1.26 vs. 0.22 ± 1.36, p = 0.002). Those with S-ECC also had significantly higher BMI percentiles (69.0 % ± 29.2 vs. 56.8 % ± 31.7, p = 0.003). Multiple linear regression analyses revealed that BMI z-scores were significantly and independently associated with S-ECC and annual household income as were BMI percentiles.

CONCLUSIONS

Children with S-ECC in our sample had significantly higher BMI z-scores than caries-free peers.

Effect of Comprehensive Dental Rehabilitation on Growth Parameters in Pediatric Patients with Severe Early Childhood Caries

BACKGROUND

Children who have severe early childhood caries (S-ECC) weigh significantly less than caries-free children. The association between S-ECC and weight suggests that its timely treatment at early stages may preserve general health, in addition to preventing pain and infection.

OBJECTIVE

This study was conducted to evaluate whether children with untreated S-ECC had lower weight and height as compared with children with low caries and to evaluate whether full mouth rehabilitation of children with S-ECC resulted in the phenomenon of catch-up growth.

MATERIALS AND METHODS

The weight and height of children with noncontributory medical histories and S-ECC (3-6 years) were compared with caries-free children, before and 6 months after full mouth dental rehabilitation.

RESULTS

Prior to dental rehabilitation, children with S-ECC had significantly less weight and height than their comparison counterparts (p < 0.001). Following therapeutic intervention, the test group children exhibited catch-up growth in relation to weight, as there was no significant difference in the body weight of the test and control groups (p = 0.171).

CONCLUSION

Comprehensive full mouth rehabilitation of children with S-ECC results in catch-up growth, thus improving the overall health of the child. How to cite this article: Sachdev J, Bansal K, Chopra R. Effect of Comprehensive Dental Rehabilitation on Growth Parameters in Pediatric Patients with Severe Early Childhood Caries. Int J Clin Pediatr Dent 2016;9(1):15-20.

Dental caries and social factors: impact on quality of life in Brazilian children

The objective of this study was to evaluate the impact of dental caries and social determinants in the Oral Health Related Quality of Life (OHRQoL) of children in Belo Horizonte, Brazil. This is a population-based cross-sectional study with a representative sample of 1,204 children aged 8 to 10 years randomly selected from 19 public and private schools. The children were clinically examined at school by two trained and calibrated examiners (Kappa = 0.78 - 1.00). The Decayed, Missing and Filled Teeth Index (DMF-T and dmf-t) was used for the diagnosis of dental caries. The social factors were determined by parents'/caregivers' schooling, household income, number of people in the household, type of school, and by the Social Vulnerability Index. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years was used to assess the impact on quality of life. A total of 278 (23.1%) out of 1,204 children had at least one cavitated carious lesion and 47.0% presented a negative impact on OHRQoL. In the final multivariate Poisson's regression model, household income and presence of untreated dental caries were statistically associated with a negative impact on OHRQoL (p < 0.001).Children with dental caries and from low-income families had a higher negative impact on OHRQoL.

Anthropometric measurements and dental caries in children: a systematic review of longitudinal studies

There is growing interest in the association between anthropometric measurements and dental caries in childhood over time (life-course studies). The aim of this review was to identify and systematically review the evidence of the association between anthropometric measurements and dental caries in childhood over time. PubMed, Institute for Scientific Information (ISI) Web of Knowledge, the Cochrane Library, and 6 other databases were searched to identify effective articles. A systematic approach involving critical appraisal was conducted to examine the relation between anthropometric measurements and dental caries in preschool- and school-aged populations from longitudinal studies. An initial search identified 1338 studies, with 59 potentially effective studies (κ = 0.82) and 17 effective studies (κ = 0.88). The quality of reporting among the studies ranged from 19.5 to 30.0 according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) criteria. Among the effective studies, 2 studies in which caries was used to predict anthropometric measurements consistently found an inverse association and 15 studies in which anthropometric measurements were used to predict caries were inconsistent, with results appearing to be influenced by nonuniformity of assessments, setting, and procedure of measurements; age and ethnicity of participants; and confounders of dental caries. In conclusion, among >1000 studies identified, 17 informed this systematic review. The quality of reporting of these studies varied considerably. Evidence of the association between anthropometric measurements and dental caries is conflicting and remains inconclusive.

Vitamin D status of children with severe early childhood caries: a case-control study

BACKGROUND

Severe Early Childhood Caries (S-ECC) affects the health and well-being of young children. There is limited research in this area, though evidence suggests that children with S-ECC are at an increased risk of malnutrition. The purpose of this study was to determine the association between vitamin D (25(OH)D) levels and S-ECC.

METHODS

This case-control study was conducted from 2009 to 2011 in the city of Winnipeg, Manitoba, Canada. 144 preschool children with S-ECC were recruited from a local health centre on the day of their slated dental surgery under general anesthetic. 122 caries-free controls were recruited from the community. Children underwent a blood draw for vitamin D (25(OH)D), calcium, parathyroid hormone, and albumin levels. Parents completed an interviewed questionnaire assessing the child's nutritional habits, oral health, and family demographics. Analyses included descriptive and bivariate statistics as well as multiple and logistic regression. A p value  ≤  0.05 was significant.

RESULTS

The mean age of participants was 40.8 ± 14.1 months. Children with S-ECC had significantly lower mean 25(OH)D (68.9 ± 28.0 nmol/L vs. 82.9 ± 31.1, p < 0.001), calcium (p < 0.001), and albumin (p < 0.001) levels, and significantly higher parathyroid hormone (p < 0.001) levels than those caries-free. Children with S-ECC were significantly more likely to have vitamin D levels below recognized thresholds for optimal and adequate status (i.e. < 75 and < 50 nmol/L, respectively). Multiple regression analysis revealed that S-ECC, infrequent milk consumption, and winter season were significantly associated with lower 25(OH)D concentrations. Low 25(OH)D levels, low household income, and poorer ratings of the child's general health were significantly associated with S-ECC on logistic regression.

CONCLUSION

Children with S-ECC appear to have relatively poor nutritional health compared to caries-free controls, and were significantly more likely to have low vitamin D, calcium, and albumin concentrations and elevated PTH levels.

Early childhood caries and body mass index in young children from low income families

The relationship between early childhood caries (ECC) and obesity is controversial. This cross-sectional survey investigated this association in children from low-income families in Goiania, Goias, Brazil and considered the role of several social determinants. A questionnaire examining the characteristics of the children and their families was administered to the primary caregiver during home visits. In addition, children (approximately 6 years of age) had their height, weight, and tooth condition assessed. The primary ECC outcome was categorized as one of the following: caries experience (decayed, missing, filled tooth: “dmft” index > 0), active ECC (decayed teeth > 0), or active severe ECC (decayed teeth ≥ 6). Descriptive, bivariate and logistic regression analyses were conducted. The participants in the current study consisted of 269 caregiver-child dyads, 88.5% of whom were included in the Family Health Program. Caregivers were mostly mothers (67.7%), were 35.3 ± 10.0 years old on average and had 9.8 ± 3.1 years of formal education. The mean family income was 2.3 ± 1.5 times greater than the Brazilian minimum wage. On average, the children in the current study were 68.7 ± 3.8 months old. Of these, 51.7% were boys, 23.4% were overweight or obese, 45.0% had active ECC, and 17.1% had severe ECC. The average body mass index (BMI) of the children was 15.9 ± 2.2, and their dmft index was 2.5 ± 3.2. BMI was not associated with any of the three categories of dental caries (p > 0.05). In contrast, higher family incomes were significantly associated with the lack of caries experience in children (OR 1.22, 95%CI 1.01–1.50), but the mother’s level of education was not significantly associated with ECC.

Association between iron status, iron deficiency anaemia, and severe early childhood caries: a case-control study

Background

Severe tooth decay is known to affect the health and well-being of young children. However, little is known about the influence of Severe Early Childhood Caries (S-ECC) on childhood nutritional status. The purpose of this study was to contrast ferritin and haemoglobin levels between preschoolers with S-ECC and caries-free controls.

Methods

Children were recruited as part of a larger case–control study examining differences in nutritional status between those with and without S-ECC. Preschoolers with S-ECC were recruited on the day of their dental surgery, while caries-free controls were recruited from the community. Parents completed a questionnaire and the child underwent venipuncture. The study was approved by the University’s Health Research Ethics Board. Statistics included descriptive, bivariate and logistic regression analyses. A p value ≤ .05 was significant. A total of 266 children were recruited; 144 with S-ECC and 122 caries-free.

Results

The mean age was 40.8 ± 14.1 months. The mean ferritin concentration for all children was 29.6 ± 17.9 μg/L while the mean haemoglobin level was 115.1 ± 10.1 g/L. Children with S-ECC were significantly more likely to have low ferritin (p=.033) and low haemoglobin levels (p>.001). Logistic regression analyses revealed that children with S-ECC were nearly twice as likely to have low ferritin levels and were over six times more likely to have iron deficiency anaemia than caries-free controls.

Conclusions

Children with S-ECC appear to be at significantly greater odds of having low ferritin status compared with caries-free children and also appear to have significantly lower haemoglobin levels than the caries-free control group. Children with S-ECC also appear to be at significantly greater odds for iron deficiency anaemia than cavity-free children.