Nutritional Status and its Relationship with Dental Caries among 3–6-year-old  Anganwadi  Children

The children of India are malnourished because of factors attributed to overpopulation, poverty, large family size, poor maternal health, adverse cultural practices, destruction of the environment, and lack of education, gender inequality, and inaccessible medical care. Growing malnourished children exhibit behavioral changes, including irritability, apathy, decreased social responsiveness, anxiety, attention deficits, impaired growth, poor school performance, and decreased intellectual achievement. However, malnutrition is also known to produce high morbidity and mortality and considering its effect on oral cavity, malnutrition is shown to have preeruptive and posteruptive effects. Oral health conditions, dietary practices, nutritional status, and general health status are all interrelated factors. Malnutrition adversely affects the oral structures. Studies have shown that early malnutrition affects tooth structure, delay in tooth eruption, and results in increased dental caries. It is also associated with enhanced susceptibility to caries because of impaired saliva secretion due to salivary glandular hypofunction and saliva compositional changes. Malnutrition appears to have multiple effects on the oral tissues and subsequent development of oral disease. It results in altered tissue homeostasis, reduced resistance to microbial biofilms, and tissue repair capacity.

ABSTRACT

Aim

The purpose of this study is to determine dental caries status in 3–6-year-old malnourished children.

Materials and methods

A total of 500 children aged 3–6 years enrolled in anganwadi were selected for this study. The nutritional status was evaluated by anthropometric measurements such as body weight and height [body mass index (BMI)-for-age]. Dental caries status was recorded according to WHO criteria. The obtained data were subjected to statistical analysis.

Results

The prevalence of underweight was 41% and prevalence of dental caries was 61%.

Conclusion

Low BMI-for-age is a risk factor for dental caries.

Clinical significance

Inclusion of BMI-for-age calculation in routine case history pro forma helps in timely diagnosis, prevention, and treatment of children suffering from malnutrition.

How to cite this article

Madhusudhan KS, Khargekar N. Nutritional Status and its Relationship with Dental Caries among 3–6-year-old Anganwadi Children. Int J Clin Pediatr Dent 2020;13(1):6–10.

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Most cited references 23

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The Immune System in Children with Malnutrition—A Systematic Review

Maren Rytter, Lilian Kolte, André Briend … (2014)

Background Malnourished children have increased risk of dying, with most deaths caused by infectious diseases. One mechanism behind this may be impaired immune function. However, this immune deficiency of malnutrition has not previously been systematically reviewed. Objectives To review the scientific literature about immune function in children with malnutrition. Methods A systematic literature search was done in PubMed, and additional articles identified in reference lists and by correspondence with experts in the field. The inclusion criteria were studies investigating immune parameters in children aged 1–60 months, in relation to malnutrition, defined as wasting, underweight, stunting, or oedematous malnutrition. Results The literature search yielded 3402 articles, of which 245 met the inclusion criteria. Most were published between 1970 and 1990, and only 33 after 2003. Malnutrition is associated with impaired gut-barrier function, reduced exocrine secretion of protective substances, and low levels of plasma complement. Lymphatic tissue, particularly the thymus, undergoes atrophy, and delayed-type hypersensitivity responses are reduced. Levels of antibodies produced after vaccination are reduced in severely malnourished children, but intact in moderate malnutrition. Cytokine patterns are skewed towards a Th2-response. Other immune parameters seem intact or elevated: leukocyte and lymphocyte counts are unaffected, and levels of immunoglobulins, particularly immunoglobulin A, are high. The acute phase response appears intact, and sometimes present in the absence of clinical infection. Limitations to the studies include their observational and often cross-sectional design and frequent confounding by infections in the children studied. Conclusion The immunological alterations associated with malnutrition in children may contribute to increased mortality. However, the underlying mechanisms are still inadequately understood, as well as why different types of malnutrition are associated with different immunological alterations. Better designed prospective studies are needed, based on current understanding of immunology and with state-of-the-art methods.

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Exploring the association between overweight and dental caries among US children.

Mark Macek, David J. Mitola (2016)

The purpose of this study was to examine the relationship between age-specific body mass index (BMI-for-age) and dental caries among US children. Body measures data and oral health data came from the 1999-2002 National Health and Nutrition Examination Survey. Outcome measures for primary and permanent dentitions were: (1) dental caries prevalence; and (2) severity (geometric mean dft and DMFT). Covariates included: (1) age; (2) gender; (3) race/ethnicity; and (4) poverty status. Analysis was limited to children 2 to 17 years old. Approximately 36% of overweight children 2 to 6 years old and 39% of overweight children 6 to 17 years old had dental caries. Geometric mean dental caries scores for overweight children were dft=3.3 and DMFT=2.5 for primary and permanent dentitions, respectively. Controlling for covariates, there was no significant association between BMI-for-age and dental caries prevalence in either dentition. In addition, among children with a positive history of dental caries, BMI-for-age was significantly associated with dental caries severity in the permanent dentition - overweight children had a lower geometric mean DMFT than did normal weight children. Although it was hypothesized that age-specific body mass index would be associated with increased dental caries prevalence and severity, these associations were not found. Rather, overweight was found to be associated with lower geometric mean DMFT. Future studies should address which factors specific to overweight in children might be protective against dental caries in the permanent dentition. Given the importance of overweight as a public health problem, however, clinicians are encouraged to continue providing health education and dietary counseling to their overweight child patients.

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Chronic malnutrition, dental caries, and tooth exfoliation in Peruvian children aged 3-9 years.

O Alvarez, J Navia, J M Izquierdo … (1988)

A cross-sectional evaluation of dental caries in primary teeth and nutritional status was conducted involving 285 Peruvian children from low socioeconomic conditions aged 3-9 y. Forty-nine percent of the children were found to be chronically malnourished (stunted) whereas acute malnutrition (wasting) was infrequent (2%). Stunted children showed a delayed exfoliation of primary teeth. The caries prevalence curve as a function of age (ie, a plot of decayed, extracted, and filled teeth vs age) was found to be shifted to the right by approximately 15 mo in stunted children as compared with well-nourished children. Children aged 7-9 y with stunted growth showed a significantly higher percentage of carious teeth than did well-nourished children of the same age (40 and 29%, respectively; p less than 0.005). Nutritional deficits that lead to chronic malnutrition not only may affect tooth exfoliation but also appear to render the primary teeth more susceptible to caries attack later in life.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Clin Pediatr Dent

Journal ID (iso-abbrev): Int J Clin Pediatr Dent

Journal ID (publisher-id): IJCPD

Title: International Journal of Clinical Pediatric Dentistry

Publisher: Jaypee Brothers Medical Publishers

ISSN (Print): 0974-7052

ISSN (Electronic): 0975-1904

Publication date (Print): Jan-Feb 2020

Volume: 13

Issue: 1

Pages: 6-10

Affiliations

[1 ]Department of Pedodontics and Preventive Dentistry, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India

[2 ]Department of Orthodontics, Sri Venkateshwara Dental College and Hospital, Bengaluru, Karnataka, India

Author notes

Kempaiah S Madhusudhan, Department of Pedodontics and Preventive Dentistry, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, Karnataka, India, Phone: +91 9886035137, e-mail: sudhannks@ 123456gmail.com

Article

DOI: 10.5005/jp-journals-10005-1706

PMC ID: 7299890

PubMed ID: 32581470

SO-VID: cf32ccbe-19b7-4f42-94b4-ce5e948f7de6

License:

© The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Nutritional Status and its Relationship with Dental Caries among 3–6-year-old Anganwadi Children

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Summary

ABSTRACT

Aim

Materials and methods

Results

Conclusion

Clinical significance

How to cite this article

Related collections

Biomarkers for Inflammatory Lung Disease

Most cited references 23

The Immune System in Children with Malnutrition—A Systematic Review

Exploring the association between overweight and dental caries among US children.

Chronic malnutrition, dental caries, and tooth exfoliation in Peruvian children aged 3-9 years.

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