Body mass index (BMI) and dental caries in 5-year-old children from southern Sweden

Dental caries and associated factors among preschool children in Southwest Ethiopia: a cross-sectional study

BACKGROUND

Dental caries is a global public health problem, especially for young children. This study aimed to assess the prevalence of dental caries and its associated factors among preschool children in Mizan Aman town, Southwest Ethiopia.

METHODS

A school-based cross-sectional study was conducted from 1 October to 1 December 2022. A total of 354 children and their parents participated using simple random sampling techniques. Data were collected through an oral clinical examination, interviewing the parents and measuring the anthropometry of the children.

RESULTS

The prevalence of dental caries was 36.4% (95% CI 31.2% to 41.8%). Night feeding (adjusted OR (AOR)=3.98, 95% CI 1.56 to 10.15), children who did not brush their teeth under parental supervision (AOR=2.98, 95% CI 1.60 to 5.57), body mass index (AOR=3.48, 95% CI 1.30 to 9.41) and history of dental visits (AOR=3.05, 95% CI 1.61 to 5.81) were significantly associated with dental caries.

CONCLUSION

The prevalence of dental caries in preschool children was found to be high. Children who did not brush their teeth under parental supervision, who had experience of night feeding, who had a high body mass index and who had a history of dental visits were at risk for dental caries. Prevention of those identified modifiable risk factors should be considered to reduce dental caries.

The influence of body mass index on physical activity engagement following anterior cruciate ligament reconstruction: A systematic literature review

Background

The objective of this study was to summarize available literature that explored the impact of body mass index (BMI) on physical activity participation among individuals who were subjected to the anterior cruciate ligament reconstruction (ACLR).

Methods

A total of three electronic databases, including Web of Science, Scopus, and PubMed, were comprehensively searched to identify relevant investigations. The following inclusion criteria were applied: (1) study design was observational; (2) participants underwent the ACLR; (3) BMI was estimated as a predictor variable; and (4) outcomes evaluated referred to physical activity. The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results

After a database search, 787 studies were found, and only 10 of them met each of the eligibility criteria and were included in the qualitative analysis. Regarding respondents' characteristics, 7171 individuals underwent ACLR, 4080 males and 3091 females, with a mean age of 25.5 years. Most importantly, the average BMI of the examined population was 24.9 kg/m2. In all studies, physical activity was evaluated subjectively using the Tegner activity scale and the Marx activity scale. The main findings unambiguously demonstrated that a negative relationship between BMI and physical activity engagement was observed. More specifically, there is convincing evidence that BMI over 25 kg/m2 harmfully affected subjectively assessed physical activity in individuals with a history of ACLR.

Conclusion

The results obtained in the presented research indicated that increased values of BMI were a factor that correlated with reduced physical activity levels in the ACLR population. Hence, taking into account the clinical and health implications of reduced physical activity participation, stimulation of a healthy lifestyle, such as a combination of adequately designed physical exercise and nutrition, seems necessary for the analyzed population.

Economic inequalities in decayed, missing, and filled first permanent molars among 8-12 years old Iranian schoolchildren

BACKGROUND

First permanent molars (FPM) play an important role in the masticatory function and oral health. This study aimed to assess the economic inequalities of FPM health indices among schoolchildren in the northeast of Iran.

METHODS

A total of 4051 children aged 8-12 years old were included in the analyses of this cross-sectional study in 2015. Economic status was measured using the principal component analysis on home assets. Concentration index (C) was used to measure economic inequality in FPM health indices, and its contributing factors determined by Wagstaff decomposition technique.

RESULTS

The prevalence of having decayed, missing, and filled FPMs among children was 40.9% (95% CI: 38.8-43.0), 1.2% (95% CI: 0.8-1.6%), and 7.8% (95% CI: 6.7-8.9%), respectively. Missing FPM was generally more concentrated among low-economic children (C=-0.158), whereas, filled FPM was more concentrated on high-economic children (C = 0.223). Economic status, mother education, having a housekeeper mother, and overweight/obesity, contributed to the measured inequality in missing FPM by 98.7%, 97.5%, 64.4%, and 11.2%, respectively. Furthermore, 88.9%, 24.1%, 14.5%, and 13.2% of filled FPM inequality was attributable to children's economic status, father education, residence in rural areas, and age, respectively.

CONCLUSION

There is a significant economic inequality in both missing and filled FPM. This inequality can be attributed to the economic status of individuals. To reduce FPM extraction, it is important to target low-income and rural children and provide them with FPM restoration services. Additionally, it is necessary to provide training to less-educated parents and housekeeper mothers to address the observed inequalities.

To Assess the Prevalence of Dental Caries and Its Association with Body Mass Index, Socioeconomic Status, Dietary Habits, and Oral Hygiene among 6-12-year-old Children in Faridabad

Aim

The aim of our study was to assess the prevalence of dental caries and the body mass index (BMI) in included school-going children. Moreover, to examine the relationship between the prevalence of dental caries, BMI, and socioeconomic (SES) status and to evaluate sugar consumption and other dietary habits as risk factors for dental caries.

Materials and methods

The present cross-sectional study was performed among 400 school-going children aged 6-12 years from Faridabad city, Haryana. Parents filled out questionnaires for their respective children. The clinical examination of dental caries was performed according to World Health Organization (WHO) 1997. The BMI calculation was done by measuring height and weight.

Statistical analysis

The collected data were analyzed statistically using parametric and nonparametric tests.

Results

The prevalence of dental caries in deciduous teeth was 95.5% and in permanent teeth was 47.3%, respectively.

Conclusion

This study displayed the positive correlation of dental caries to BMI, oral hygiene practices, beverages, aerated drinks, chips, candy, and tea/coffee. Whereas the SES status and dietary habits Jam group variable had no significance in relation to dental caries.

How to cite this article

Kapil D, Saraf BG, Sheoran N, et al. To Assess the Prevalence of Dental Caries and Its Association with Body Mass Index, Socioeconomic Status, Dietary Habits, and Oral Hygiene among 6-12-year-old Children in Faridabad. Int J Clin Pediatr Dent 2023;16(4):626-632.

Association of Early Childhood Caries and Multiple Variable Factors in 3-6-year-old Children

Introduction

Dental caries is a globally prevailing condition. It is a common finding in all age-groups, whether it is young children or adults. Caries not only affects the oral health of an individual, but also the overall health of the individual.

Aims and Objectives

This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in age group of 3 to 6 year old children.

Material and methods

The study was planned and conducted in the Department of Pedodontics and Preventive Dentistry, Government College of Dentistry, Indore, Madhya Pradesh, India. The study consisted of 200 samples, including both groups. Group I included 100 patients with ECC and group II included 100 patients caries free. Children of age 3-6 years were randomly selected and evaluated for ECC and parameters like weight, height, number of siblings, birth order, SES status, and mothers' education.

Results

Body mass index (BMI) had no significant association with the occurrence of ECC. Statistical significant association was observed between the number of siblings and ECC. The "no caries" was significantly associated with "no sibling" or "one sibling". A significant association between SES status and ECC was observed. The upper and upper middle class had more number of caries free children, whereas the number of participants with ECC was significantly more in the upper lower class. There was a pronounced association between ECC and maternal education.

Conclusion

Researches like these help us to broaden our aspects of understanding that caries is not caused by only one factor but a magnitude of factors. It's prevention should take into consideration not only the dietary habits but also on increasing awareness about importance of oral hygiene and how it can be affected by other social varients.This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in 3-6-year-old children.

How to cite this article

Sahu P, Agrawal A, Jain D, et al. Association of Early Childhood Caries and Multiple Variable Factors in 3-6-year-old Children. Int J Clin Pediatr Dent 2023;16(1):42-47.

Does Dental Caries Increase Risk of Undernutrition in Children?

INTRODUCTION

A systematic review of the evidence on the impact of dental caries on malnutrition risk in children was conducted.

OBJECTIVES

To systematically review published evidence pertaining to the effect of dental caries severity and prevalence on risk of wasting or stunting in children.

METHODS

Four questions relating to caries of the permanent dentition, primary dentition, early childhood caries (ECC), and severe ECC as a risk factor for undernutrition were set. The target population was children aged 0 to 18 y from any country. Data sources included MEDLINE and Embase. All human epidemiological studies were included. Quality assessment excluded lowest-quality studies. Evidence synthesis by vote counting was depicted using harvest plots. A best available evidence approach was applied to narrative synthesis. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

RESULTS

Of the 2,690 studies identified, 447 were screened in duplicate; of these, 117 underwent quality assessment, resulting in 46 included studies, of which 38 were included in vote counting (3 quasi-experimental, 1 cohort, 1 case control, and 33 cross-sectional studies). For the permanent dentition, findings were mixed; the balance of data showed no association between caries prevalence (7/11 studies) or severity (8/17 studies) with wasting. For the primary dentition, the balance of data showed a positive association between caries prevalence (10/15 studies) and severity (12/15 studies) with wasting, as well as between-caries prevalence (4/5 studies) and severity (6/6 studies) with stunting. Considering ECC only did not alter this pattern of findings.

CONCLUSION

The balance of evidence suggests that dental caries in the primary dentition is associated with undernutrition. There is a need for well-designed trials on the impact of caries rehabilitation on growth trajectories of children from low- and middle-income countries and for prospective studies of the impact of caries severity on both stunting and wasting to confirm causality.

KNOWLEDGE TRANSFER STATEMENT

The results of this study can be used by policy makers when considering the importance of oral health in addressing the United Nations Sustainable Development Goal to end all forms of malnutrition. The findings suggest that dental caries in the primary dentition may impair children's healthy weight gain. The findings indicate that higher-quality data are required to confirm a causal relationship and thus inform funding bodies of the need for research, especially in low- and middle-income countries, to substantiate the current knowledge and inform clear and accurate policy statements.

Clinical outcomes of dental treatment under general anesthesia and its effects on the caries activity and body growth of children: a 2-year retrospective study

OBJECTIVES

To analyze clinical outcomes of dental treatment under general anesthesia (DGA) and its effects on children's caries activity status and body growth within 2 years after the treatment.

MATERIALS AND METHODS

The case data and 2-year follow-up records of children who underwent DGA from February 2017 to February 2018 were collected and analyzed. The general characteristics of the sample, the success rates of treatment procedures, the caries recurrence rate, the caries activity test scores, and the BMI of all the children were described. The caries activity levels between children with and without caries recurrence at 24 months after DGA were compared before and after DGA to explore the relationship between caries activity level and caries recurrence. The correlation between BMI level and caries recurrence was explored using Cox regression analysis.

RESULTS

A total of 94 children consisting of 46 boys and 48 girls were included in this study. The average dmft score before DGA was 13.90. Within 2 years after the treatment, composite fillings and strip crowns of the anterior teeth achieved similar success rates, around 90%; SSCs showed a similar success rate to composite fillings of posterior teeth (P = 1.000); the clinical success rate of pulpectomy was 90.43%. All the children showed no caries relapse at 1 month after DGA. The number of children with caries relapse at 6-, 12-, and 24-month post-treatment was 24 (25.53%), 35 (37.23%), and 53 (56.38%), respectively. The caries activity scores at each follow-up were significantly lower than those before the treatment (P < 0.0001). Children with caries relapse within 2 years after DGA showed no significantly different caries activity scores than children without caries relapse before and after the treatment. The proportion of children with normal BMI at 12 months after DGA was significantly higher than that before DGA (P = 0.007), and the difference was still very significant at 24 months after DGA (P < 0.0001). Statistical results showed a correlation between BMI level before DGA and caries recurrence (P < 0.001).

CONCLUSIONS

Dental treatment under general anesthesia achieves acceptable clinical outcomes in this study. Children's caries activity scores decrease significantly. Low or high BMI levels before DGA drift towards normal after the treatment.

CLINICAL RELEVANCE

Acceptable outcomes are achieved within 2 years after dental treatment under general anesthesia. However, children with abnormal BMI before the treatment tend to have caries relapse.

Evaluation of Serum and Salivary Iron and Ferritin Levels in Children with Dental Caries: A Meta-Analysis and Trial Sequential Analysis

Background and objective: Dental caries appears to be related to iron deficiency anemia and to low ferritin levels. In the present meta-analysis, we report salivary and serum iron and ferritin levels in children with dental caries, compared to healthy controls. Materials and methods: We searched in Web of Science, Cochrane Library, Scopus, and PubMed/Medline databases to extract studies published until 25 July 2021. We calculated mean differences (MD) and 95% confidence intervals (CI) of salivary and serum iron and ferritin levels in children with dental caries, always compared to healthy controls. In addition, we applied a trial sequential analysis (TSA). Results: A total of twelve articles covering thirteen studies were included in the meta-analysis. The pooled MD for salivary iron level was −5.76 µg/dL (p = 0.57), and −27.70 µg/dL (p < 0.00001) for serum iron level: compared to healthy controls, children with dental caries did not show different salivary iron levels, while children with caries had significantly lower serum iron levels. The pooled MD of salivary ferritin level was 34.84 µg/dL (p = 0.28), and the pooled MD of serum ferritin level was −8.95 µg/L (p = 0.04): compared to healthy controls, children with dental caries did not have different salivary iron levels, but significantly lower serum ferritin levels. Conclusions: The findings of the present meta-analysis showed that salivary levels of iron and ferritin did not differ between children with and without caries, though compared to healthy controls, children with caries had significantly lower salivary and serum iron and ferritin levels. The results are of practical and clinical importance: Possibly, iron and ferritin supplementation might prevent or attenuate dental caries in children at risk. Further, children with caries might suffer from further iron- and ferritin-related health issues. Lastly, serum blood samples, but not saliva samples inform accurately about the current iron and ferritin concentrations in children with or without caries.

The Association between Nutritional Alterations and Oral Lesions in a Pediatric Population: An Epidemiological Study

The oral conditions of an individual are the result of different factors, including the subject's genotype, oral hygiene habits, the type of diet, and lifestyle, such as smoking. Nutrition in the first years of life can affect dental health for a long time. To prevent mouth diseases, it is also important to eliminate unfavorable eating behaviour and to amplify protective ones. Eating habits, especially in pediatric age, are an easily modifiable and controllable factor, and diet, in addition to influencing the health of the oral cavity, plays a fundamental role in systemic health. Indeed, a sugar-rich diet can lead to conditions, such as diabetes, being overweight, and obesity. The present research was an epidemiological study, with the aim of highlighting some of the associations between nutrition and oral health. In particular, we studied those lesions of hard and soft tissues that are diagnosed most frequently by dentists: caries, enamel hypoplasia, periodontal disease, and aphotoxic lesions and their associations with nutritional deficiencies and excesses including proteins, vitamin A, vitamin D, B vitamins, and iron and calcium minerals. To perform this study, we recruited 70 patients from the pediatric and orthodontic clinics, aged between 3 and 15 years (y), with mean age of 10.4 y.o. The study was conducted by providing a questionnaire to pediatric patients' (supported from their parents or guardians) on individual eating habits, followed by an accurate oral cavity specialistic examination. The nutritional data were processed by using Grana Padano Observatory (OGP) software, freely provided online by the OPG. The statistical tests performed were the chi-square (χ²) for independence, and Cramér's V test was used to evaluate the associations between eating habits and oral pathologies. The results showed that certain nutritional vitamin deficiencies and nutritional excesses were associated with definite oral pathologies.

Dental Caries Severity and Nutritional Status of Nigerian Preschool Children

INTRODUCTION

Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child's nutrition and growth.

AIM

This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria.

STUDY DESIGN

This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used.

RESULTS

A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<-3 = severely wasted, -2 to -3 = wasted, -2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft (r = -0.181, P < 0.05 and r = -0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant (r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively).

CONCLUSION

Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight.

KNOWLEDGE TRANSFER STATEMENT

The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.

Undernutrition is associated with change in severe dental caries

OBJECTIVES

To examine the association of baseline prevalence of thinness or stunting and the incidence of dental caries among preschool children in Liaoning Province, China.

METHODS

Children were recruited from 15 kindergartens in Liaoning Province. A total of 772 children were assessed at baseline and follow-up. The mean age of children at baseline was 50.82 months, and the median follow-up time was 10.12 months. Anthropometric measurement, dental caries, and questionnaire were assessed overtime, whereas only baseline questionnaire was used in the data analysis. z-Score for body mass index (BMI)-for-age, weight-for-age, and height-for-age were calculated using World Health Organisation (WHO) Child Growth Standards. Dental caries was assessed according to the fifth WHO Basic Methods for Oral Health Surveys. The presence of pulpal involvement, ulceration, fistula, and abscess (pufa) were used to indicate severe dental caries in deciduous teeth. A structured questionnaire mainly based on the fifth WHO Oral Health Surveys was used to collect sociodemographic and behavior data. Logistic regression was constructed to assess the association between change in severe dental caries and prevalence of thinness and stunting.

RESULTS

There was a positive association between prevalence of stunting and incidence of severe caries in the fully adjusted model [odds ratios 2.88; 95 percent confidence interval (CI): 1.01, 8.27]. Prevalence of thinness showed insignificant positive association with incidence of severe caries.

CONCLUSIONS

While undernutrition indicated by stunting appeared to be a risk factor for severe dental caries, it could also be a marker for other determinants of progress of dental caries including socioeconomic factors and lack of use of dental services.

A twin study of body mass index and dental caries in childhood

Sub-optimal nutrition and dental caries are both common with significant short and long-term implications for child health and development. We applied twin statistical methods to explore the relationship between body mass index (BMI) and dental caries. We measured BMI at 18 months and six years of age and cumulative dental caries experience at six years in 344 twin children. Dental caries in primary teeth was categorised into ‘any’ or ‘advanced’ and BMI was analysed as both a continuous and categorical variable. Statistical analyses included multiple logistic regression using generalized estimating equations and within/between-pair analyses. There was no association between BMI and ‘any’ dental caries experience at either time-point, neither overall nor in within/between pair analyses. However, ‘advanced’ dental caries at six years was associated with a within-pair difference in BMI of −0.55 kg/m² (95% CI −1.00, −0.11, p = 0.015). A within-pair increase of 1 kg/m² in BMI was associated with a lower within-pair risk of advanced dental caries (OR 0.68, 95% CI 0.52, 0.90, p = 0.007). These findings reveal a possible causal relationship between lower BMI and dental caries. As dental outcomes were only measured at one time point, the direction of this potentially causal relationship is unclear.

Body Mass Index and Association With Caries in School-Aged Children With Orofacial Cleft: A Case-Control Study

OBJECTIVE

Data on the association between body mass index (BMI) and dental caries in children with orofacial clefts are sparse. Therefore, studies on the impact of BMI on caries frequency in children with cleft lip and/or palate (CL/P) are of importance. The aim of the current study was to investigate the association between BMI and frequency of dental caries in children with and without CL/P. Height, weight, and BMI in children with CL/P were also compared to controls.

DESIGN

This study used a cross-sectional case-control design.

PARTICIPANTS

One hundred and thirty-nine 5- and 10-year-old children with CL/P and 299 age-matched controls.

MAIN OUTCOME MEASURES

Caries was recorded according to the International Caries Detection and Assessment System. Height and weight were recorded, and BMI was calculated as weight/height².

RESULTS

There was no correlation between BMI and caries frequency. Weight, height, and BMI were significantly lower in all children with CL/P compared to controls. After adjustment for international adoption, only BMI was significantly lower in CL/P children compared to controls. Non-adopted children with CL/P were significantly heavier and longer than adopted children with CL/P.

CONCLUSIONS

Five- and 10-year-old children with corrected CL/P seemed to have a lower BMI than controls, but there was no association between BMI and caries frequency. Internationally adopted children with CL/P were lighter and shorter than non-adopted CL/P children and controls.

Childhood obesity in relation to sweet taste perception and dental caries - a cross-sectional multicenter study

Background

Obesity is a multifactorial disease that is increasing worldwide and is caused by different environmental and genetic factors, with an increase in the consumption of high-energy–containing food and a decrease in physical activity constituting two of the main reasons. Sweet taste perception may have an effect on the subject’s dietary choices and affect his or her predisposition to obesity.

Objectives

The aim was to study the sweet taste perception and dental caries in relation to body mass index (BMI) in 13–15-year-old schoolchildren from three different countries and to compare the BMI among the countries.

Design

The sweet taste perception level, determined as the sweet taste threshold and preference, was assessed in a total of 669 schoolchildren from Italy, Mexico and Saudi Arabia, examined in school settings. Height and weight were collected and BMI was calculated, after which the children were grouped as underweight, normal, overweight, and obese. For caries registration, the International Caries Detection and Assessment System and Decayed Missing Filled Surfaces indices were used.

Results

A statistically significant difference was found for BMI among the children from the three countries (p < 0.001), with the highest mean found among Saudi children, followed by Mexican and Italian children. A statistically significant difference regarding sweet taste threshold when comparing the BMI groups was only found for Saudi Arabia (p < 0.01). No significant correlation was found between BMI and sweet taste threshold or preference and dental caries variables, respectively.

Conclusions

BMI was found to differ between countries, with a further significant difference among the groups among the Saudi Arabia schoolchildren.

Association between Dental Caries and Body Mass Index-for-Age among 10-12-Year-Old Female Students in Tehran

Introduction:

Dental caries and obesity are multifactorial diseases with diet being a common contributory factor. Many studies have reported varied outcomes about the association between dental caries and body mass index. But, there is no published study that investigates this association among female students in Tehran. The main aim of this study was to examine the relationship between dental caries and body mass index (BMI) in a sample of female students in Tehran.

Methods:

In this cross-sectional study, 416 students aged between 10 to 12 years was examined for dental caries using WHO standard diagnostic criteria. The Decayed, missing and filled of permanent teeth (DMFT) were recorded. The student's weight and height were measured by two trained examiner and their BMI were calculated. BMI-for-age and dental caries categories were analyzed with Pearson correlation coefficient, Chi-square, and t-tests using SPSS computer software.

Results:

The mean DMFT score and BMI of the study population was 1.03 ± 1.41 and 18.11 ± 3.33 respectively. The findings showed that 58.9% of the children had a normal weight, 27.9% were overweight, 10.3% were obese, and only 2.9% of the students were thin when they were compared with WHO standard of BMI for children with the same age. The respective mean DMFT values for BMI groups (thin, normal, overweight and obese) were 1.25, 0.73, 1.42, and 1.65, respectively. There was a significant association (P < 0.05) between dental caries and high BMI.

Conclusions:

This study demonstrated a significant association between caries frequency with high body mass index. For these reasons, the evaluation of nutritional status in students should be implemented in control programs for dental caries both on the community, schools, and individual levels.

Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey

BACKGROUND

Dental caries in preschool children is prevalent worldwide, but data regarding its magnitude and associated factors were not available for preschool children in Zhejiang Province, China. This study examines the dental caries situation and its associated factors in Zhejiang Province.

METHODS

A total of 1591 children aged 3-5 years and their parents or caregivers were enrolled in this study. The condition of their teeth was assessed by three dental technicians qualified to WHO 2013 criteria. A structured questionnaire was completed by the children's parents or caregivers. A logistic regression analysis was used to analyze the risk factors that may be associated with dental caries occurring among preschool children.

RESULTS

Caries prevalence (dmft> 0) of 3-5 year old children in Zhejiang Province was 70.4%. The mean decayed, missing and filled teeth (dmft) scores of the 3, 4 or 5 year old children surveyed were 2.96 ± 4.07, 4.42 ± 4.66, and 5.75 ± 5.19 respectively. The negative binomial regression model found that higher dental caries prevalence was found in children as age increased, with lower body mass index (BMI), with longer breastfeeding duration and with fewer hours of sleep.

CONCLUSIONS

The dental caries prevalence and dmft score of 3-5-year-old children in Zhejiang Province was high, and it was associated with age, BMI, breastfeeding duration and hours slept.

Obesity, salivary glands and oral pathology

Obesity has reached pandemic proportions in recent years. Not only adults suffer from the disease, but increasingly children and young people. One of the main causes of overweight and obesity is excessive food intake, in particular heavily processed carbohydrates. Obesity alters multiple organs, including the salivary glands, bringing functional alterations with it. Among researchers, the relation between obesity and tooth decay, periodontal disease and xerostomia is being debated. More and more scientific reports are drawing attention to the changes in the microflora of the oral cavity during obesity. All changes are closely related to the morphological and functional alterations of the salivary glands. This article review presents the current points of view regarding the impact of obesity on the health of the salivary glands, and how changes their functions influence other structures in the oral cavity.

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

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.

Association between Dental Caries and Delayed Growth in Korean Children

The purpose of this study was to assess the relationship of dental caries with anthropometric outcomes in 4- to 6-year-old children participating in the Korean National Health and Nutrition Examination Survey (KNHANES). The sample size was 1,910 children from the 4th and 5th KNHANES. The caries status was assessed with the decayed and filled teeth index in primary dentition (dft score). We employed height for age, body weight for age, and body mass index for age as outcome variables. Age, gender, region, and income were confounders. Nutritional deficiency as a mediator in the association between dental caries and delayed growth was also examined. A series of logistic regression analyses estimated the magnitude of association between dental caries and unfavorable growth after adjustment of the confounders and the mediator. Those with a high dft score were more likely to be deficient in nutrition (OR 1.77, 95% CI 1.14-2.74). After adjusting for sociodemographic factors and nutritional deficiency, we also found that a high dft score was associated with low weight (OR 1.70, 95% CI 1.15-2.51). The influence of dental caries on delayed growth was found in Korean representative children.

Overweight, obese, underweight, and frequency of sugar consumption as risk indicators for early childhood caries in Brazilian preschool children

BACKGROUND

A possible association between being overweight or obese and early childhood caries (ECC) remains controversial.

AIM

To investigated this association in a developing country testing the confounding effects of socioeconomic factors and frequency of sugar consumption.

METHODS

Historical cohort study, 388 children (aged 24-71 months) living in São Luís, Brazil. A theoretical model adjusted according to income, birthweight, and nutritional status at twelve months and frequency of sugar consumption was generated with directed acyclic graphs to analyze this association. Caries were considered a discrete variable in the Poisson regression models; incidence density ratios (IRs) and 95% confidence intervals (95% CIs) were estimated.

RESULTS

Being overweight or obese (IR = 1.52; 95% CI: 1.03-2.22) was independently associated with ECC. Being thin or very thin (IR = 1.97; 95% CI: 1.52-2.54), a high frequency of sugar consumption (IR = 1.83; 95% CI: 1.42-2.38), and age (IR = 3.62; 95% CI: 2.58-5.08) were associated with ECC.

CONCLUSIONS

Children overweight or obese, as well as children exhibiting being thin/very thin, were associated with ECC independent of socioeconomic variables and a high frequency of sugar consumption.

Identification of Caries Risk Determinants in Toddlers: Results of the GUSTO Birth Cohort Study

The aim of this study was to identify risk determinants leading to early childhood caries (ECC) and visible plaque (VP) in toddlers. Data for mother-child pairs participating in the Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort were collected from pregnancy to toddlerhood. Oral examinations were performed in 543 children during their clinic visit at 24 months to detect ECC and VP. Following logistic regression, ECC and VP were jointly regressed as primary and secondary outcomes, respectively, using the bivariate probit model. The ECC prevalence was 17.8% at 2 years of age, with 7.3% of children having a VP score >1. ECC was associated with nighttime breastfeeding (3 weeks) and biological factors, including Indian ethnicity (lower ECC rate), higher maternal childbearing age and existing health conditions, maternal plasma folate <6 ng/mL, child BMI, and the plaque index, while VP was associated with psychobehavioral factors, including the frequency of dental visits, brushing frequency, lower parental perceived importance of baby teeth, and weaning onto solids. Interestingly, although a higher frequency of dental visits and toothbrushing were associated with lower plaque accumulation, they were associated with increased ECC risk, suggesting that these established caries-risk factors may be a consequence rather than the cause of ECC. In conclusion, Indian toddlers may be less susceptible to ECC, compared to Chinese and Malay toddlers. The study also highlights a problem-driven utilization pattern of dental services (care sought for treatment) in Singapore, in contrast to the prevention-driven approach (care sought to prevent disease) in Western countries.

Influence of masticatory function, dental caries and socioeconomic status on the body mass index of preschool children

OBJECTIVE

The objective of this study was to determine the influence of masticatory function, dental caries and socioeconomic status on the body mass index (BMI) of preschool children.

METHODS

A cross-sectional study was conducted with a sample of 285 children aged three to five years allocated to three groups based on the BMI: underweight, ideal weight and overweight/obesity. Socioeconomic status was determined based on the responses of parents/caregivers to a specific form. Cavitated lesions were diagnosed using the criteria of the International Caries Detection and Assessment System. Masticatory function was assessed based on masticatory performance (MP) and the swallowing threshold (ST), which were evaluated based on the results of a test food. Data analysis involved the employment of the Kruskal-Wallis, Mann-Whitney and chi-square tests as well as simple and multiple linear regression analyses.

RESULTS

In the final multiple regression model, BMI was influenced by monthly household income (β=0.234; 95%CI: 1.014 to 1.647), number of cavitated teeth (β=-0.180; 95%CI: -0.293 to -0.054) and X50 of the ST (β=0.304; 95%CI: 0.213-0.498).

CONCLUSION

Children whose food test resulted in large particles and those from families with a higher monthly income had a higher BMI. Children with a greater number of teeth with cavitated dental caries had a lower BMI.

Exploring the association between body mass index and dental caries in 3–7-year-old children, living in Łódź, Poland

Dental caries and childhood obesity are major problems affecting the health of children and preventing these conditions in children have been recognized as public health priorities (Hong et al. 2008; Odgien et al. 2010). The aim of the present study was to analyze the association between age-specific body mass index (BMI-for age) and dental caries in 3- to 7-year-olds. A cross-sectional study was conducted on 729 children from randomly chosen kindergartens and elementary schools in the urban area of Lodz, Poland. Anthropometric measurements were taken and the BMI-for-age was calculated for each child. Dental examinations were performed according to the WHO criteria. The sum of decayed, missing, filled primary/ permanent teeth and surfaces - dmft/DMFT and dmft/DMFTS, and caries prevalence were computed. The percentage distribution of the BMI categories in the study group was: 72.7% normal weight, 8.92% underweight, 12.89% overweight and 5.49% obese. Caries prevalence in the primary dentition was significantly lower in underweight children than in those who were of normal weight (p=0.004) or were overweight (p=0.039). However, controlling for age and gender, no significant association was noted between BMI and caries prevalence in either dentition group. The Kruskal-Wallis test failed to reveal any significant differences in mean dmft across the four BMI groups in the whole population, nor within particular age groups, nor in DMFT in 5- to 7-year-olds. There was no association between BMI and dental caries either in the primary dentition or permanent teeth in the early period after eruption.

A Polymorphism in the MTRR Gene Is Associated with Early Childhood Caries and Underweight

Polymorphisms in genes encoding the enzymes involved in the metabolism of homocysteine, such as methionine synthase (MTR) and methionine synthase reductase (MTRR), play an important function in the metabolism of folic acid and vitamin B12. The present study aimed to evaluate the association of polymorphisms in genes MTR (rs1805087) and MTRR (rs1801394) with susceptibility of early childhood caries (ECC) and with body mass index alterations. A cross-sectional study was performed in 488 children aged from 2 to 6 years from 25 public day care centers in Rio de Janeiro, Brazil. Demographic data and oral health habits were obtained through a questionnaire. Anthropometric measurements and caries experience data were collected by 2 examiners (κ = 0.80). Genotyping of the selected polymorphisms was carried out by TaqMan real-time PCR using genomic DNA extracted from buccal cells. Allele and genotype frequencies were compared between groups with and without disease. The t test, χ2 test, odds ratio, Pearson correlation tests, and logistic regression analysis were used (p ≤ 0.05). The mean white spot lesion score was 1.18 (±2.57) in normal weight children and 2.50 (±3.87) in underweight children (p = 0.05). For MTRR polymorphisms, significant differences were observed for allele and genotype frequency distributions between caries-free and caries-affected children (p = 0.03 and 0.04 for allele and genotype frequencies, respectively) and in the genotype frequencies between normal weight and underweight children (p = 0.04). Our results suggest an association between underweight and ECC; in addition it is suggested that MTRR is a common genetic risk factor for ECC and underweight.

Relationship between caries, body mass index and social class in Spanish children

OBJECTIVE

To determine the association between caries, body mass index (BMI) and social class in child population of the Valencia region (Spain) at 6, 12 and 15 years, and study.

METHODS

In a cross sectional study of 1326 children aged 6 (n=488), 12 (n=409) and 15 years (n=433) who took part in the 2010 Oral Health Survey of the Valencia region, the ICDAS II criteria were employed for diagnosing and coding all the teeth examined. The quantitative BMI values on a continuous scale were grouped into 3 categories (normal weight, overweight, obese) based on a table adjusted for age and gender. The highest-ranking occupation of the parents was taken to indicate the social class of the child.

RESULTS

The mean BMI was 17.21 at 6 years, 21.39 at 12 years and 22.38 at 15 years. No significant differences in caries indexes (DMFT or dft) by degree of obesity stratified by social class were found in any of the age groups studied. There was no significant correlation between BMI and DMFT-dft in any of the age groups.

CONCLUSIONS

Obesity is not associated with dental caries in schoolchildren of this population.

[Is the severity of caries associated with malnutrition in preschool children?]

An analysis was conducted to evaluate if the severity of caries is associated with protein-calorie malnutrition in preschool children. The cross-sectional study was performed on a retrospective cohort of 625 children aged 24-71 months attending daycare centers in São Luís, Maranhão. A hierarchical model was evaluated at five levels: 1.) Socio-economic variables (economic group, mother's educational level and skin color); 2) Access variables; 3) Low birth weight (LBW) and exclusive breastfeeding; 4) Weight per height at 12 months; and 5) Severity of caries and albumin (Alb) levels. The outcome was protein-calorie malnourishment (weight per height z score < -2). The prevalence of outcome was 5.0% and the prevalence of caries was 32%. At the first level, the variables were not associated with the outcome, but the economic group was maintained until the final model. The variables in the second and third levels were not significant. At the fourth level, weight for height at 12 months was not significant, but was maintained until the final model. In the last level, severity of caries was positively associated with malnourishment. The association between severity of caries and malnourishment suggest that oral health should be integrated with public health care policies for children.

Caries in adolescents in relation to their skeletal status

OBJECTIVE

Despite well-known evidence of association of caries with bone metabolic diseases, there are only a small number of studies about caries and bone mineral density (BMD) on pediatric population. We evaluated the possibility of bone mineralization and metabolism disturbances in children with caries and compared them with healthy individuals.

MATERIALS AND METHODS

A total of 123 patients with caries (63 boys and 60 girls), aged 12-15 years, were included. The children were divided according caries stage: the decayed, missing, and filled tooth (DMFT) group (n=73) and the initial caries (IC) group (n=50), which have clinically active initial caries lesions on the enamel ("white spots"). Caries-free (CF) children (n=42) were the healthy controls. Bone mineralization was measured in all children with caries and healthy controls by dual-energy X-ray absorptiometry of the lumbar spine (L1-L4). For the assessment of bone metabolism, osteocalcin, carboxy terminal telopeptide of type I collagen (CTX), parathyroid hormone, Ca²⁺, inorganic phosphate, and total alkaline phosphatase were used.

RESULTS

Children with DMFT have low BMD and BMD Z score in association with low osteocalcin and high CTX levels, compared with IC (p=0.008 and p=0.0001, respectively) and CF children (p<0.0000 and p=0.0001, respectively). In DMFT, Ca²⁺ was significantly higher compared with IC (p=0.01) and CF (p=0.003). Caries stages negatively correlated with BMD (r=-0.86, p<0.001). A differently directed correlation between CTX and osteocalcin was detected: CTX was negatively related to osteocalcin in the DMFT group (r=-0.22, p=0.043) and positively related in the IC (r=0.42, p=0.002) and CF children (r=0.58, p=0.0000).

CONCLUSIONS

Children with any caries stage have decreased BMD accompanied with increased bone resorption. We consider that caries could be a marker of impact bone mineralization and metabolism.

Prevalence of obesity was related to HLA-DQ in 2-4-year-old children at genetic risk for type 1 diabetes

OBJECTIVES

Body size is postulated to modulate type 1 diabetes as either a trigger of islet autoimmunity or an accelerator to clinical onset after seroconversion. As overweight and obesity continue to rise among children, the aim of this study was to determine whether human leukocyte antigen DQ (HLA-DQ) genotypes may be related to body size among children genetically at risk for type 1 diabetes.

METHODS

Repeated measures of weight and height were collected from 5969 children 2-4 years of age enrolled in The Environmental Determinants of Diabetes in the Young prospective study. Overweight and obesity was determined by the International Obesity Task Force cutoff values that correspond to body mass index (BMI) of 25 and 30 kg m(-)(2) at age 18.

RESULTS

The average BMI was comparable across specific HLA genotypes at every age point. The proportion of overweight was not different by HL A, but percent obesity varied by age with a decreasing trend among DQ2/8 carriers (P for trend=0.0315). A multivariable regression model suggested DQ2/2 was associated with higher obesity risk at age 4 (odds ratio, 2.41; 95% confidence interval, 1.21-4.80) after adjusting for the development of islet autoantibody and/or type 1 diabetes.

CONCLUSIONS

The HLA-DQ2/2 genotype may predispose to obesity among 2-4-year-old children with genetic risk for type 1 diabetes.

Early childhood caries and its relationship with perinatal, socioeconomic and nutritional risks: a cross-sectional study

Background

Socioeconomic, perinatal and other life cycle events can be important determinants of the health status of the individual and populations. This study aimed to assess the prevalence of early childhood caries (ECC), perinatal factors (gestational age, teenage pregnancy and birth weight), family income and nutritional risk in children.

Methods

A cross-sectional study in which 320 children were examined according to the criteria established by the World Health Organization. A previously validated questionnaire was used to obtain information from parents and guardians about family income, gestational age and birth weight. To check the nutritional risk, we used the criteria provided by the CDC (Center for Disease Control). For Statistics, Pearson’s, chi-square and the multivariate Poisson analyses were used to determine the association among variables.

Results

Approximately 20% of children had ECC, and the Poisson multivariate analyses indicated that family income (p = 0.009), birth weight (p < 0.001) and infant obesity (p < 0.001) were related to the increase of ECC, and gestational age was not significantly associated with ECC (p = 0.149). Pregnancy in adolescence was not included in the regression analyses model because it was not statistically significant in the chi-square test (p > 0.05).

Conclusion

The prevalence of ECC was related to low family income, premature birth and infant obesity.

Impact of low birthweight on early childhood caries in 6-36 months old infants in Uganda: A cross-sectional study

OBJECTIVE

Focusing on 6-36 months old infants, this study assessed (1) whether socio-economic status, current anthropometric status, presence of enamel hypoplasia, number of erupted teeth, oral hygiene and consumption of sugared snacks varied between children with normal birthweight (NBW) and low birthweight (LBW) and (2) the association between ECC and birthweight whilst adjusting for covariates of ECC, such as current anthropometric status.

METHOD

A cross-sectional study was conducted in Kampala in 2007, involving 816 child/caretaker pairs. All caretakers completed face-to-face interviews. Children were examined for ECC and enamel defects using WHO (1997) criteria and the developmental defects of enamel (DDE) index. Weight at birth was obtained from hospital records and current anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ).

RESULTS

Prevalence of LBW (< 2500 g) and ECC were estimated to 11.5% and 18.1%, respectively. Children with LBW and those with ECC presented with more visible plaque, higher sugar consumption and more current underweight (WAZ < -2) than children with normal birth weight (NBW) and no caries; 26.7% of LBW vs 17.3% (p < 0.001) of NBW children presented with ECC. Enamel defects (OR = 2.8, 95% CI = 1.6-4.8) and presence of visible plaque (OR = 2.4, 95% CI = 1.3-4.1), but not LBW, were associated with ECC in multiple variable logistic regression analyses.

CONCLUSION

Both LBW and ECC were associated with poor oral hygiene, high intake of sugars and current underweight. Enamel defects were associated with ECC. Adjusting for covariates there were no clear association between LBW and ECC. Studies using a prospective study design are needed for further investigation.

Dental caries and growth in school-age children

BACKGROUND AND OBJECTIVE

Dental caries in young children is commonly untreated and represents a public health problem. Dental caries in children is reported to affect their anthropometric outcomes, but the evidence is conflicting. Some studies found no association, whereas others found that caries was associated with underweight or overweight. The objective was to assess the relationship between dental caries status and height and weight in 6- to 8-year-old Saudi children with high caries prevalence.

METHODS

This study was a cross-sectional survey in schoolchildren aged 6 to 8 years attending military primary schools in Jeddah, Saudi Arabia. Caries status was assessed by using the dmft (decayed, missing, filled, teeth [primary teeth]) index. Height and weight were assessed by using z scores of height-for-age (HAZ), weight-for-age (WAZ), and BMI-for-age (BAZ) calculated by World Health Organization standardized procedures. Relationships between caries and HAZ, WAZ, and BAZ were assessed by using regression models.

RESULTS

A total of 417 of the 436 eligible schoolchildren with complete data were included, with a response rate of 95.6%. Their mean dmft index was 5.7 ± 4.2. There was an inverse linear relationship between caries status and children's HAZ, WAZ, and BAZ and significantly lower anthropometric outcomes for children at each consecutive group with higher levels of caries. The associations remained significant after adjusting for dental, social, and demographic variables.

CONCLUSIONS

The inverse linear association between dental caries and all anthropometric outcomes suggests that higher levels of untreated caries are associated with poorer growth in Saudi schoolchildren.

Association between health examination items and body mass index among school children in Hualien, Taiwan

Background

To assess the prevalence of obesity and major physical examination items including dental caries, myopia, pinworm, hematuria, and proteinuria among school children in Hualien, Taiwan. In addition, the health status differences between gender, grader, levels of residence urbanization, and body mass index (BMI) were examined.

Methods

Cross-sectional studies with a total of 11,080 students (age, 7–14 years) in grades 1, 4, and 7 were evaluated for weight, height, routine physical examination, and urine analysis during the 2010 Student Health Examination in Hualien. Frequencies, Chi-square test, and logistic regression were conducted using SPSS.

Results

Of the 11,080 students evaluated, 1357 (12.2%) were overweight, and 1421 (12.8%) were obese. There were significant differences in overweight/obese prevalence by gender, by grader, and by levels of residence urbanization. Dental caries, myopia, and obesity were the most prevalent health problems among these students (75.6%, 33.0%, and 12.8%, respectively). In crude and adjusted analyses, research results showed that there were significant differences in the prevalence of major physical examination items between different gender, grader, levels of residence urbanization, and BMI groups. Girls had a higher prevalence of dental caries, myopia, and hematuria than boys (all p < 0.01), whereas boys had a higher prevalence of pinworm than girls (p = 0.02). Students in higher grades had significantly higher prevalence of myopia, hematuria, and proteinuria (all p < 0.01), whereas students in lower grades had higher prevalence of dental caries and pinworm (p < 0.01). Students with abnormal BMI had lower prevalence of pinworm (p < 0.01). Students residing in suburban and rural areas had higher prevalence of dental caries, pinworm, and hematuria (all p < 0.01), and lower prevalence of myopia than students residing in urban areas (all p < 0.01).

Conclusion

Routine health examination provides an important way to detect students’ health problems. Our study elucidated major health problems among school children in Hualien, Taiwan. In addition, the results also indicated that the prevalence of health problems had a significant relationship with gender, grader, levels of residence urbanization, and BMI. It is suggested that school health interventions should consider students’ health profiles along with their risk factors status in planning.

Feeding practice among 6-36 months old in Tanzania and Uganda: reliability and relationship with early childhood caries, ECC

OBJECTIVE

To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC.

METHOD

Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child-caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding.

RESULTS

Cohen's kappa for intake of sugar items ranged from 0.40-1.0, with no differences observed between average intakes at test-re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC.

CONCLUSION

Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers.

Early childhood caries and body mass index in young children from low income families

The relationship between early childhood caries (ECC) and obesity is controversial. This cross-sectional survey investigated this association in children from low-income families in Goiania, Goias, Brazil and considered the role of several social determinants. A questionnaire examining the characteristics of the children and their families was administered to the primary caregiver during home visits. In addition, children (approximately 6 years of age) had their height, weight, and tooth condition assessed. The primary ECC outcome was categorized as one of the following: caries experience (decayed, missing, filled tooth: “dmft” index > 0), active ECC (decayed teeth > 0), or active severe ECC (decayed teeth ≥ 6). Descriptive, bivariate and logistic regression analyses were conducted. The participants in the current study consisted of 269 caregiver-child dyads, 88.5% of whom were included in the Family Health Program. Caregivers were mostly mothers (67.7%), were 35.3 ± 10.0 years old on average and had 9.8 ± 3.1 years of formal education. The mean family income was 2.3 ± 1.5 times greater than the Brazilian minimum wage. On average, the children in the current study were 68.7 ± 3.8 months old. Of these, 51.7% were boys, 23.4% were overweight or obese, 45.0% had active ECC, and 17.1% had severe ECC. The average body mass index (BMI) of the children was 15.9 ± 2.2, and their dmft index was 2.5 ± 3.2. BMI was not associated with any of the three categories of dental caries (p > 0.05). In contrast, higher family incomes were significantly associated with the lack of caries experience in children (OR 1.22, 95%CI 1.01–1.50), but the mother’s level of education was not significantly associated with ECC.