Association between Dental Caries and BMI in Children: A Systematic Review and Meta-Analysis

Abstract

Research on the association between dental caries and body mass index (BMI) in children has shown contradictory results; thus we aimed to examine the association between dental caries and the full range of BMI classes among children. We comprehensively searched PubMed, Embase, and the Cochrane Library for studies published prior to March 2017. Articles comparing dental caries among the full range of BMI classes for children below 18 years of both genders were included. Fourteen studies were eligible for this study. Basic information - i.e., first author, published year, study design, country, sample size, age, type of dental caries index and BMI, main results and conclusions, and means and standard deviations of the dental caries indexes used - was pooled. The weighted mean differences and corresponding 95% confidence intervals for dental caries between children with abnormal weight and those with normal weight were analyzed. Generally, no significant differences in caries were found between any abnormal-weight group and the normal-weight group for both primary and permanent teeth. Sensitivity analyses showed that the obese group had more caries than the normal-weight group in their primary teeth. Significantly more caries was found among the overweight and obese children in both primary and permanent teeth in high-income countries, but not in low- and middle-income countries. We recommend that further studies use suitable sample sizes, unify the criteria for BMI categorization and the dental caries index, and investigate the confounding factors that might influence dental caries and BMI.

Overweight/obese children are associated with lower caries experience than normal‐weight children/adolescents

“…A recent systematic literature review demonstrated a lack of significant differences in dental caries prevalence between abnormal‐ and normal‐weight children and adolescents, in both dentitions. The authors, however, suggest the importance of investigating the confounding factors associated between dental caries and body mass index (BMI) …”

“…Up to date, most studies of the relationship between caries experience and overweight/obese children used the DMF index (decayed, missing, and filled), proposed by the World Health Organization (WHO) . This index, however, does not evaluate the level of severity of dental caries, thereby providing inaccurate results . Yet, the use of validated criteria seems to improve the accuracy of visual inspection .…”

Body mass index and dental caries experience in Nepalese schoolchildren

“…Hooley et al concluded in their systematic review that both high and low BMI are associated with children's dental caries. Similarly, the association was also inconclusive in another systematic review, particularly concerning low‐ and middle‐income countries as well as primary and permanent dentitions . Both dental caries and obesity are multifactorial and share common risk factors, such as dietary habits, lifestyle and socioeconomic conditions .…”

Social inequalities in body weight and dental caries experience among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort.

“…A systematic review and meta-analysis found a significant relationship between obesity and dental caries in children from industrialized countries, but the authors concluded that future analyses should focus on common risk factors as confounders in this association [10]. Another recent systematic review and meta-analysis confirmed that, in high-income countries, overweight and obese children had more dental caries when compared to normal-weight children [11]. The authors called for future studies to address confounding factors, including possible common risk factors.…”