Nutritional status, dental caries and tooth eruption in children: a longitudinal study in Cambodia, Indonesia and Lao PDR

Abstract

BackgroundUntreated dental caries is reported to affect children’s nutritional status and growth, yet evidence on this relationship is conflicting. The aim of this study was to assess the association between dental caries in both the primary and permanent dentition and nutritional status (including underweight, normal weight, overweight and stunting) in children from Cambodia, Indonesia and Lao PDR over a period of 2 years. A second objective was to assess whether nutritional status affects the eruption of permanent teeth.MethodsData were used from the Fit for School - Health Outcome Study: a cohort study with a follow-up period of 2 years, consisting of children from 82 elementary schools in Cambodia, Indonesia and Lao PDR. From each school, a random sample of six to seven-year-old children was selected. Dental caries and odontogenic infections were assessed using the World Health Organization (WHO) criteria and the pufa-index. Weight and height measurements were converted to BMI-for-age and height-for-age z-scores and categorized into weight status and stunting following WHO standardised procedures. Cross-sectional and longitudinal associations were analysed using the Kruskal Wallis test, Mann Whitney U-test and multivariate logistic and linear regression.ResultsData of 1499 children (mean age at baseline = 6.7 years) were analyzed. Levels of dental caries and odontogenic infections in the primary dentition were significantly highest in underweight children, as well as in stunted children, and lowest in overweight children. Dental caries in six to seven-year old children was also significantly associated with increased odds of being underweight and stunted 2 years later. These associations were not consistently found for dental caries and odontogenic infections in the permanent dentition. Underweight and stunting was significantly associated with a lower number of erupted permanent teeth in children at the age of six to seven-years-old and 2 years later.ConclusionsUnderweight and stunted growth are associated with untreated dental caries and a delayed eruption of permanent teeth in children from Cambodia, Indonesia and Lao PDR. Findings suggest that oral health may play an important role in children’s growth and general development.Trial registrationThe study was restrospectively registered with the German Clinical Trials Register, University of Freiburg (trial registration number: DRKS00004485; date of registration: 26th of February, 2013).

Analysis of salivary level Lactobacillus spp. and associated factors as determinants of dental caries amongst primary school children in Harar town, eastern Ethiopia

“…It has been known throughout history but started to become a significant health problem in industrialized countries in the latter part of the nineteenth century, when new technologies allowed the production of large amounts of refined sugars. Globally prevalence indicates about 60-90% of children and nearly 100% of the adult world population is suffering from dental caries [2,3]. While WHO reports that untreated caries accounts for 44% dental problems in 2010 [4], lack of oral hygiene practices is common problem in many developing and developed countries [5,6].…”

“…in the major progression of dental caries [8]. In addition, risk factors such as host susceptibility [9], age [10], dietary habits [11], socioeconomic and oral hygiene status [12] have been associated with increased incidence of dental caries [3,13,14] in human population.…”

Tooth-Level Analysis of Dental Caries in Primary Dentition in Myanmar Children

“…Accumulated evidence and advanced prevention techniques of dental caries have contributed to the reduction in the prevalence of dental caries [ 1 , 2 , 3 , 4 , 5 ]; however, in developing countries, the prevalence of dental caries in children remains high and is one of the major public health concerns [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. In these countries, dental treatment is still insufficient [ 15 ].…”

Nutritional status and dietary diversity of school-age children living with HIV: a cross sectional study in Phnom Penh, Cambodia

“…Also, the WHO recommends that nutritional assessment and support should be an integral part of the care plan for children living with HIV [11]. Such support needs to include interventions to improve oral health as untreated dental caries and a delayed eruption of permanent teeth are associated with underweight and stunting among children in Cambodia, Indonesia and Lao PDR [34]. The timing of such nutritional interventions is also important: a recent study suggested that the first year on ART could be the best period to conduct nutritional interventions for children living with HIV to optimize their growth in the long term [35].…”