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Turton B, Sullivan S, Chher T, Hak S, Sokal-Gutierrez K, Wieringa F, Singh A. Caries Incidence Is Associated with Wasting among Cambodian Children. J Dent Res 2023; 102:157-163. [PMID: 36217721 DOI: 10.1177/00220345221126713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Evidence suggests that dental caries is associated with chronic and acute malnutrition, manifested as stunting and wasting in children. However, studies have not always appropriately accounted for confounding factors or for the temporal ordering between exposure and outcome. This study examined relationships between the development of caries lesions with subsequent stunting and wasting outcomes using data from a population-based cohort in Cambodia. Caries incidence was assessed based on the presence of a new cavitated carious lesion or a new pulpally involved lesion across a 6-mo observation period. Anthropometric measurements were taken at regular intervals. Effects of carious lesions on stunting and wasting were assessed using inverse probability treatment weighting, adjusting for potential confounders, using z scores for height-for-age (HAZ) and weight-for-height (WHZ) as outcomes. In total, 894 children (mean age 20 mo at baseline) were followed over 2 y. At baseline, 350 (39.1%) were identified as having stunting malnutrition. At follow-up, 58 (6.5%) had a new pulpally involved lesion. There was no association between incidence of cavitated or pulpally involved carious lesions at follow-up and stunting (relative risk [RR] = 1.06; 95% confidence interval [CI]: 0.75, 1.50). The incidence of pulpally involved carious lesions had an effect on wasting prevalence (WHZ <-2; RR = 1.35; 95% CI: 0.70, 2.62) and WHZ scores (average treatment effect = -0.294; 95% CI: -0.538, -0.050). This study offers evidence that the development of pulpally involved carious lesions has an effect on WHZ scores. Oral health promotion and clinical prevention and management of dental caries should be explored as interventions to promote normal growth and development among preschool children, particularly in low-income settings.
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Affiliation(s)
- B Turton
- University of Puthisastra and Boston University, Boston, MA, USA
| | - S Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - T Chher
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh, Cambodia
| | - S Hak
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh, Cambodia
| | | | - F Wieringa
- UMR QualiSud (Université Montpellier, Université Avignon, CIRAD, Institut Agro, IRD, Université de la Réunion), French National Research Institute for Sustainable Development (IRD), Montpellier, France
| | - A Singh
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
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Chowdhury N, Turton B, Chher T, Hak S, Hondru G, Sokal-Gutierrez K. Relationship between Early Childhood Caries and Prolonged Coughing Episodes in a Cohort of Cambodian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12842. [PMID: 36232141 PMCID: PMC9566348 DOI: 10.3390/ijerph191912842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Studies have shown an association between Early Childhood Caries (ECC) and respiratory infections; however, most have been cross-sectional, and all have been in high-income countries. Inverse probability treatment weighting (IPTW) was applied to longitudinal data from the Cambodia Health and Nutrition Monitoring Study. An analytical sample of 1703 Cambodian children between 1- and 4-years old was used to examine the effect of caries incidence (ECC Activity) on the odds of a child subsequently experiencing an episode of prolonged coughing (>14 days) over the subsequent 18 m. ECC activity occurred among 523 children (30.7%) while prolonged coughing was observed among 235 children (13.8%). ECC activity increased the risk of prolonged coughing (RR 1.23; 95% CI 0.95, 1.58; Average treatment effect = 3%). Follow-up investigations are justified in order to examine whether ECC may be a modifiable risk factor for prevention of respiratory illness among young children.
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Affiliation(s)
- Noureen Chowdhury
- Faculty of Dentistry, University of Puthisastra, Phnom Penh 120211, Cambodia
| | - Bathsheba Turton
- Faculty of Dentistry, University of Puthisastra, Phnom Penh 120211, Cambodia
- Office of Global and Population Health, Henry M. Goldman School of Dental Medicine, Boston University, Bostson, MA 02118, USA
| | - Tepirou Chher
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh 12151, Cambodia
| | - Sithan Hak
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh 12151, Cambodia
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Turton B, Chher T, Hak S, Sokal-Gutierrez K, Lopez Peralta D, Laillou A, Singh A. Associations between dental caries and ponderal growth in children: A Cambodian study. J Glob Health 2022; 12:04046. [PMID: 35713031 PMCID: PMC9204672 DOI: 10.7189/jogh.12.04046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background The evidence around the relationship between Early Childhood Caries (ECC) and undernutrition is sparse and mostly reported from cross-sectional data sets. This paper aimed to test the relationship between ECC and linear and ponderal growth trajectories. Methods This project involves secondary data analysis from the Cambodia Longitudinal Health and Nutrition Study. The analytical sample included a 2y-cohort of 894 children who were younger than 2 years of age at the time of first height and weight measurement. Statistical analysis used both logistic regression modelling and Latent Class Analysis to examine the effect of exposure to dental caries in the first 1000 days on weight for height Z-score (WHZ) and height for age Z-score (HAZ) trajectory class groups. The presence of any cavity and pulp involvement were examined using multinomial regression adjusting for gender, socioeconomic status, maternal age and education. Findings Within each class groupings (HAZ and WHZ groupings), there was a trend whereby those with one or more cavities had lower Z-scores across the three follow-up time points of observation. There was an association between exposure to caries and WHZ class membership whereby children with caries exposure were more likely belong to WHZ class groups with lower Z-scores over time. Conclusions The study offers evidence that ECC is correlated with less favourable ponderal growth categorized by WHZ trajectory class groups.
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Affiliation(s)
- Bathsheba Turton
- University of Puthisastra, Phnom Penh, Cambodia.,Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
| | - Tepirou Chher
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh, Cambodia
| | - Sithan Hak
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh, Cambodia
| | | | - Diego Lopez Peralta
- Centre for Epidemiology and Biostatistics and Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | | | - Ankur Singh
- Centre for Epidemiology and Biostatistics and Melbourne Dental School, University of Melbourne, Melbourne, Australia
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