Body mass index and dental caries experience in Nepalese schoolchildren

Abstract

Objectives:The aim was to investigate the severity of untreated dental caries among Nepalese schoolchildren and its association with their body mass index (BMI) using IOTF, WHO and Nepalese growth reference systems.Methods: This school-based clinical cross-sectional study was conducted with three WHO index age groups (5-to 6-, 12-and 15-year-olds) in 18 out of 75 districts of Nepal, selected using stratified random sampling. A total of 1135 schoolchildren were included in the study. A validated structured questionnaire was used to assess the children's oral hygiene practices and dietary habits. Clinical oral examinations investigated the status of untreated dental caries in primary and permanent teeth (dt/DT) along with its consequences (pufa/PUFA). Later, the grade of severity of untreated dental caries (GUDC) was determined using both dt/DT and pufa/PUFA. Height (cm), weight (kg), waist circumference (cm) and hip circumference (cm) were measured, and the body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. The findings were presented as proportions, and the chisquare test was performed to compare differences between groups. Generalized linear mixed models with random effects assessed the association between the severity of untreated dental caries and the BMI.Results: According to the IOTF, WHO and Nepalese growth reference systems, the overall proportions of children with a low BMI were 38.6%, 15.4% and 12.8%, and those with a high BMI were 7.9%, 4.6% and 8.4%, respectively. Untreated dental caries was common among the youngest age group and those with infrequent tooth brushing habits or frequent consumption of sweet bakery products, sweets or candy, or tea with sugar. Neither a low nor a high BMI was associated either with dt + DT or with pufa + PUFA, after adjusting for confounders. However, both a low and a high BMI (all three references) were associated with the severity of dental caries or GUDC. Conclusion:Regardless of the growth reference system used, children with either low or high BMI may be at risk of developing untreated dental caries lesions and related consequences. Both underweight and overweight/obese and dental caries share common risk factors, mostly dietary. Preventive and intervention approaches/ strategies such as behavioural and dietary modifications should be implemented to improve both children's oral health and their nutrition in Nepal. | 347KARKI et Al.

Associations between Child Snack and Beverage Consumption, Severe Dental Caries, and Malnutrition in Nepal

“…Across both age groups, severe caries by pufa+PUFA-an indication of deep dental infection, cavitation, and likelihood of dental pain-was associated with lower WAZ and BAZ, suggesting a risk for acute malnutrition, and in older children, severe caries by SiC was associated with lower HAZ, suggesting a risk for chronic malnutrition. This study adds to the growing literature from developing countries, demonstrating that severe dental caries may exacerbate the risk for childhood malnutrition, especially in early childhood [29,32,33,36]. The pathophysiologic mechanisms by which severe caries may contribute to malnutrition include chronic infection/inflammation and dental pain suppressing children's appetite and growth, loss of tooth structure inhibiting children's ability to chew nutritious foods, and increasing use of non-nutritious sweets to pacify children's chronic pain [32].…”

“…There have been mixed findings on the association between severe caries and nutritional status. Studies have demonstrated an association between severe caries and malnutrition in some low-income contexts, with caries contributing to mouth pain and chronic inflammation which disrupt normal eating, sleep, and growth [29][30][31][32][33]; associations with obesity in high-income contexts due to shared dietary risk factors [34,35]; and no associations in other studies [36]. There is limited research on these relationships in Nepali populations.…”

Dental caries among Finnish teenagers participating in physical activity and diet intervention: association with anthropometrics and behavioural factors

“…According to Hooley et al [ 13 ], both high and low BMI show association with caries. The association is different depending on the country’s developmental stage and socioeconomic situation [ 13 , 14 ]. Chen et al [ 35 ] in their systematic review found that obese children from high-income countries were more likely to have a higher caries prevalence than from low-income countries.…”

“…Caries and obesity are both multifactorial diseases sharing similar risk factors such as a harmful diet, socioeconomic conditions [ 11 ] and lifestyle [ 12 ]. Literature on the association between overweight and caries is contradictory; both high and low BMI showing an association with decaying teeth in children [ 13 , 14 ]. The association depends on the country’s stage of development as well as on socioeconomics [ 13 ].…”

Association between Sucrose Intake in Coke and Root or Coronal Caries among Teenagers

“…Intake of starch and its association with the risk of occurrence of dental caries was not found as a result of conducting a systemic review but it was recommended that higher intake of starch which has ability to quickly digestible may elevate the caries risk. 6 Sweet choices as well as consumption of sweet in the form of coffee and tea are associated with the experience of dental caries as reported in many studies 7,8,9,10,11,12 .…”