Obesity and caries in four-to-six year old English children: a cross-sectional study

Measuring disadvantage in the early years in the UK: A systematic scoping review

Background

The relationship between disadvantage and child health in the early years is well established. For this evidence base to most helpfully inform services, we need to better understand how disadvantage is conceptualised and measured in the literature. We aimed to conceptualise disadvantage measured in child health literature and explore the associations between disadvantage and child health using these measures.

Method

We conducted a scoping review using systematic methods to identify key concepts of disadvantage used in empirical child health literature. We searched MEDLINE, Scopus, and grey literature for studies exploring the association between disadvantage and child health outcomes for children aged 0–5 in the United Kingdom. We extracted and analysed data from 86 studies.

Results

We developed a framework describing two domains, each with two attributes conceptualising disadvantage: level of disadvantage indicator (individual and area) and content of disadvantage indicator (social and economic). Individual-level measures of disadvantage tended to identify stronger associations between disadvantage and child health compared with area-level measures.

Conclusion

The choice of disadvantage indicators, particularly whether individual- or area-level, can affect the inferences made about the relationship between disadvantage and child health. Better access to individual-level disadvantage indicators in administrative data could support development and implementation of interventions aimed at reducing child health inequalities in the early years.

•

Measurement of disadvantage in child health is wide-ranging and multi-dimensional.

•

Social, economic, individual, and area-level are key concepts of disadvantage.

•

Area-level measures underestimate the association between disadvantage and child health.

•

Individual-level disadvantage indicators are needed in administrative data.

•

Policymakers planning child health interventions should measure disadvantage carefully.

The relationship between tooth decay with stress and BMI among elementary students in Iran

Background

Tooth decay is one of the most common chronic diseases among children worldwide. Stress and body mass index are also amongst the arguable risk factors which will affect people considerably. They include biological (hormones and blood sugar), socio-economic, and environmental factors and also lifestyle. In the present study, the relationship between tooth decay with stress and BMI in children was therefore investigated.

Materials and methods

This was a cross-sectional study of a descriptive-analytical type. A total of 350 students who were referred to the clinic of the faculty of dentistry at Qazvin University of Medical Sciences during 2021-2022 were selected through convenience sampling method to participate in the study. First, the students underwent a dental examination after being measured on their height and weight. Then, two questionnaires; namely, demographic information and Children's Stress Symptom Scale (CSSS) of Scherer and Ryan-Wenger were completed by the children's parents through self-reporting. The collected data were analyzed using SPSS software version 23 and then descriptive statistics and logistic regression were applied.

Results

The mean BMI of the participating students was in the normal range. The prevalence of tooth decay among participants was 76.9% (269 people). The mean and standard deviation of stress scores was 6.85 ± 4.01 out of 26, which was at a low level. Also, the mean and standard deviation of the BMI were 22.78 ± 5.28, which was within the normal range. The results of the logistic regression showed that the variables of "father's level of education," "family's economic status," "the experience of the toothache during the past year," "the oral health status," "the frequency of tooth brushing," "flossing," "stress," and "BMI" were influential factors in tooth decay (P <0.05).

Conclusion

Students who had improper BMI, more stress, less educated fathers, families with poor economic status, the experience of toothache within the past year, poor oral health status, and those who used toothbrushes and floss to a minimal degree suffered more tooth decay. Therefore, it is necessary that we pay more attention to these students in designing and implementing educational programs to prevent tooth decay.

Association of Body Mass Index and Waist Circumference With Dental Caries and Consequences of Untreated Dental Caries Among 12- to 14-Year-old Boys: A Cross-Sectional Study

OBJECTIVE

To evaluate the association between body mass index (BMI) and waist circumference (WC) and dental caries (DC), and the clinical consequences of untreated dental caries (U-DC) among 12- to 14-year-old male public-school adolescents in the Northern Province, Saudi Arabia.

METHODS

The demographic and anthropometric measurements of 302 boys 12 to 14 years of age (mean: 12.5 years) were recorded. BMI and central obesity (based on WC) were measured. The decayed-missing-filled teeth (DMFT) index was used to record DC. The pulp involvement, ulceration, fistula, abscess (PUFA) index was used to quantify the clinical consequences of U-DC. Multiple logistic regression analysis was performed to evaluate the risk factors related to DC and clinical consequences of U-DC.

RESULTS

A high prevalence of DC was found in adolescents who were underweight according to BMI and nonobese based on WC (46.7% vs 34.5%). The association between underweight (BMI) and obese (WC) with DC (odds ratio [95% CI]) was 1.91 (0.87, 4.18) and 0.34 (0.18, 0.63), respectively, while with PUFA (adjusted odds ratio [AOR]; 95%CI), it was 1.76 (0.76, 4.09) and 0.19 (0.06, 0.63) respectively. The logistic regression model showed that consuming sugar more than once a day led to a 2.87-fold greater likelihood of DC (AOR [95% CI] = 2.87 [1.68, 4.88]) and a 3.91-fold greater likelihood of mean PUFA score (AOR [95% CI] = 3.91 [2.05, 7.44].

CONCLUSION

High risks for DC and clinical consequences of U-DC were observed among underweight and nonobese adolescent males. The frequency of sugar consumption was significantly associated with both conditions.

Is there an association between body weight and early childhood caries experience?

Data sources PubMed, Cochrane Library, and Google Scholar. Study selection Papers reporting a primary study in non-syndromatic preschool children aged 0-6 years, reporting body weight and dental caries experience as outcomes.Data extraction and synthesis Two reviewers independently screened the titles and abstracts of the identified citations for relevance. The full text articles were subsequently assessed for eligibility for both qualitative and quantitative review. Body weight outcomes were standardised into four groups; 'underweight' (BMI-for-age percentile less than five), 'normal weight' (BMI-for-age percentile between five and 85), 'overweight' (BMI-for-age percentile between 85 and 95), and 'obese' (BMI-for-age percentile greater than 95). Dental caries outcomes were based on decayed, missing, and filled teeth/surfaces (dmft/dmfs) index. The risk of bias in individual studies were assessed based on the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The GRADE system was used to perform quality assessment for each outcome reported.Results Following screening of 293 articles, a total of 32 studies qualified for qualitative review and 12 of them reported data that was used to conduct a meta-analysis. All included studies were cross-sectional in nature and presented a high risk of bias. Findings from meta-analysis showed that children who are overweight have a significantly higher dmft index (95% CI -0.64 to -0.14, P = 0.002, I2 equals 62 percent). The quality of evidence was found to be moderate.Conclusions Overweight and obese preschool children are at a greater risk of developing caries. Public health prevention programmes must target both conditions together to reduce their burden and effectiveness of prevention strategies.

Excessive Weight Gain and Dental Caries Experience among Children Affected by ADHD

In recent years, attention has been paid to the co-occurrence of attention deficit hyperactivity disorder (ADHD) and obesity, but results in relation to dental caries outcomes differ. The study was conducted to determine obesity/overweight and dental caries in children suffering from ADHD and to draw comparisons with non-ADHD children. A total of 119 children under 11 years old (8.2 ± 1.2) were enrolled into a cross-sectional study: those with confirmed ADHD (n = 39), and healthy controls (n = 80). The behavioral evaluation included a parent interview directed at sweetened food/drink habits. The clinical evaluation included physical measurements (height, waist, hip circumference, body weight, body mass index (BMI), and dental examination (International Caries Detection and Assessment System—ICDAS). Results showed a higher prevalence of abnormal body weight, hip circumference, and BMI, and a higher frequency of caries (84.6%) in the ADHD group. Significant caries differences for primary (ICDAS 0, 1, 2, 5, 6 scores) and permanent teeth (ICDAS 1, 3 scores) were recorded. The questionnaire pinpointed interplays between sugar consumption and tooth decay, especially for primary dentition. It can be concluded that the consumption of sweetened foods/drinks among ADHD children may lead to an increased rate of overweight, but may also affect oral health. Limiting sugar consumption might be one of the important elements in prevention programmes against dental caries and overweight/obesity.

Early childhood caries and related risk factors: A cross-sectional study of children in Zhejiang Province, China

OBJECTIVES

This work aims to exploring the risk factors related to ECC by investigating oral health status, related behaviours and habits of children and their parent's knowledge regarding oral hygiene.

METHOD

A total of 2700 children aged 3-5 years and their parents from Zhejiang province were examined. Chi-square test or U test was used to analyse the difference of caries incidence among different groups. Logistic multiple factor stepwise regression model was used to analyse the risk factors influencing ECC prevalence.

RESULTS

ECC prevalence rate in these children was 70.7%. The mean decayed missing filled teeth(dmft) scores were 4.33. Through analysis of logistic multiple factor stepwise regression model, risk factors related to the prevalence of ECC in children include: older age, region (coastal or mountainous area), higher frequency of bedtime dessert consumption and poor care of children's oral health by parents. In the questionnaire, 5 of 14 questions showed parents' poor oral knowledge or awareness.

CONCLUSION

The prevalence rate of ECC in children aged 3-5 in this study was high and associated with older age, region (coastal or mountainous area), higher frequency of bedtime dessert consumption and poor care of children's oral health. Parents need to strengthen their understanding and action of dental caries.

Associations of nutritional status, sugar and second-hand smoke exposure with dental caries among 3- to 6-year old Malaysian pre-schoolers: a cross-sectional study

BACKGROUND

Dental caries in primary teeth is a serious oral health concern among children. It can lead to detrimental impacts on a child's growth, development, and quality of life. Therefore, this cross-sectional study aimed to examine the prevalence of dental caries and its associations with nutritional status, sugar and second-hand smoke exposure among pre-schoolers.

METHODS

A total of 26 pre-schools in Seremban, Malaysia were randomly selected using the probability proportional to size sampling. Dental examination was performed by a dentist to record the number of decayed teeth (dt). Weight and height of the pre-schoolers were measured. The mother-administered questionnaire was used to gather information pertaining to the sociodemographic characteristics and second-hand smoke exposure. Total sugar exposure was calculated from a 3-day food record.

RESULTS

Among the 396 participating pre-schoolers, 63.4% of them had at least one untreated caries, with a mean ± SD dt score of 3.56 ± 4.57. Negative binomial regression analysis revealed that being a boy (adjusted mean ratio = 1.42, 95% CI = 0.005-0.698, p = 0.047), exposed to second-hand smoke (adjusted mean ratio = 1.67, 95% CI = 0.168-0.857, p = 0.004) and those who had more than 6 times of daily total sugar exposure (adjusted mean ratio = 1.93, 95% CI = 0.138-0.857, p = 0.013) were significantly associated with dental caries among pre-schoolers.

CONCLUSION

A high prevalence of dental caries was reported in this study. This study highlights the need to reduce exposure to second-hand smoke and practice healthy eating behaviours in reducing the risk of dental caries among pre-schoolers.

Association between Dental Caries and Obesity in Children and Young People: A Narrative Review

OBJECTIVES

To explore the association between obesity and dental caries in children and adolescents. Furthermore, to consider the possible reasons behind this relationship.

METHODS

A database search for papers published between January 2015 and May 2018, inclusive, addressing the association between obesity and dental caries was conducted. A review and critical appraisal of all included studies was performed.

RESULTS

Twenty-six studies were included in this review from different populations worldwide. Eight studies assessed the primary dentition, nine studies were conducted on permanent dentition, and remaining nine studies on both dentitions. The results regarding the association between obesity and dental caries were conflicting and inconsistent. Nine studies concluded that there was no relationship between obesity and dental caries. A positive association was reported in five studies, while the inverse association was reported in eleven studies. Studies included in this review had significant variations in methodology and the investigated cofactors. Possible explanations of the controversial association between obesity and dental caries are discussed in this review.

CONCLUSION

Both obesity and dental caries are multifactorial diseases, and their association is far more complex that can be explained by a single common risk factor, presenting evidence for the complexity of this association.