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Background The relationship between body dissatisfaction (BD) and health-related quality of life (HRQoL) has been well documented in adolescents and adults but is less clear in children, particularly in China. The aims of this study were to describe body image perception and dissatisfaction and to examine their effects on HRQoL among primary school students in Guangzhou, China. Methods A total of 5734 children aged 8–12 years from 29 schools completed self-report questionnaires, which included the Paediatric Quality of Life Inventory 4.0 for measuring HRQoL and Ma figural stimuli for measuring BD. Based on their level of BD, the children were divided into three groups: no dissatisfaction, mild dissatisfaction and moderate or high dissatisfaction. Based on the children’s perceptions of their own body image, the groups were also categorized into just right, too fat and too thin groups. Height and weight were objectively measured using standardized methods, and a BMI z-score was derived using the age- and sex-specific WHO references from 2007 for children aged 5–19 years. Weight status was classified as underweight, healthy weight, overweight or obese. Results A total of 78.10% of children aged 8–12 years in Guangzhou had different levels of BD; boys had slightly higher levels BD than girls ( p < 0.01), and obese children demonstrated the highest degree of BD ( p < 0.01). However, BD levels did not differ significantly according to age ( p = 0.194). Gender differences in body image perceptions were only found in children with a healthy weight ( p < 0.01), but age differences in body image perception were present in both children with a healthy weight ( p < 0.05) and underweight children ( p < 0.05). Of the children with a healthy weight who were dissatisfied with their body image, 65.54% of the boys wanted to be heavier, whereas 52.95% of the girls wanted to be thinner ( p < 0.01), and older children were more inclined to perceive themselves as too fat ( p < 0.01). After controlling for the influence of confounding factors, significant trends for lower HRQoL scores with increasing BD levels persisted in all domains ( p < 0.01). Conclusions BD is as common in children as in adolescents and adults and might be independently associated with HRQoL impairment. The present findings suggest that the current epidemic of BD is a threat to the health of primary school children in China, and prevention programmes for this population should be implemented in the future.

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Background Analyses of the effects of pit and fissure sealant have been based on small samples and lack large-scale field evaluation data in China. The aim of this study was to understand the effect of pit and fissure sealant in preventing caries in the first permanent molars (FPMs) of children in Guangzhou. Methods We conducted a population-based cohort study using the database of the pit and fissure sealant program of Guangzhou. The carious status and sealant retention of the FPMs were assessed in 4,822 school children who received pit and fissure sealant 3 years prior to the study. The control group included 4,396 children who had indications for receiving pit and fissure sealant but were not treated and were matched according to sex, age and school. Results In the sealant group, the rate of sealant retention in the FPMs was 72.2%. Children in the sealant group had a 37% decreased risk of dental caries compared with the control group (adjusted HR = 0.63 [95% confidence interval (CI), 0.57–0.69], P < 0.001). Compared to no sealant use, the use of pit and fissure sealants reduced the risk of developing dental caries by 44% after 3 years in the FPMs of children from rural areas, reflecting a greater reduction than that among urban children (35%) during the same period (urban: adjusted hazard ratio (HR) = 0.65 [95% CI, 0.58–0.72]; rural: adjusted HR = 0.56 [95% CI, 0.45–0.70], P < 0.001). The mean number of decayed, missing, or filled permanent teeth (DMFT) in the control group was higher than that in the sealant group, and the difference was statistically significant regardless of sex. Conclusions Pit and fissure sealant has a significant preventive effect against dental caries in the FPMs, especially for children in rural areas; thus, this sealant represents an effective technique for preventing and controlling dental caries.