Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India

Barriers to child nutrition in Bengaluru slums: Caregiver insights from the SCOPE strategy

Child undernutrition and protein insecurity remain a critical global issue, particularly in urban slums, driven by multiple socioeconomic and structural barriers. This study applies the Sustainable Community Partnership and Empowerment (SCOPE) strategy to assess challenges and inform the development of a culturally appropriate protein-feeding program for malnourished children in Indian slums. A qualitative approach using focus group discussions was conducted with twenty-one primary caregivers of twenty-four malnourished preschool children aged 3-6 years in Bengaluru, India, to evaluate perceptions of child nutrition, barriers to accessing protein-rich foods, economic constraints, and intervention preferences in slum settings. Data were analyzed using grounded theory and the Social-Ecological model (SEM) to categorize barriers at individual, household, organizational, community, and government levels. Key barriers included limited protein intake, picky eating, preference for junk food at the individual level, economic hardships, and lack of family support at the household level. Caregivers emphasized the need for sustainable solutions from organizational and community help, such as school meal programs and community partnerships, to improve access to affordable, protein-rich foods. Findings highlight the complex interplay of economic, cultural, and systemic factors influencing child nutrition. Results suggest a community-centered, collaborative program for sustainable interventions, prioritizing high-quality protein provision, child-friendly engagement strategies, and caregiver empowerment through education and partnerships with local stakeholders. This study underscores the necessity of integrated, context-specific, community-based programs to effectively address child undernutrition in urban slums and other resource-limited settings worldwide.

Examining the association between maternal junk food consumption and obesity among children: evidence from a cross-sectional survey in India

BACKGROUND

Childhood obesity is not only a concern for the immediate health of children but also imposes varied health implications throughout the life course and a significant burden on the healthcare system. Parental feeding attitudes and lifestyles, especially mothers', significantly influence the development of children's eating behaviours and nutritional outcomes. This study examines the relationship between 'maternal junk food consumption' and 'childhood obesity' in India.

METHODS

Using the 2021 round of the National Family Health Survey, we analysed data from 191,126 children aged 0-5 years across 36 states and Union Territories of India. The study measured childhood overweight/obesity through weight-for-height Z-scores (WHZ). Further, the study constructed a junk food consumption intensity score by creating a composite measure based on the intake frequency of aerated drinks and fried foods. We employed multiple binary logistic regression models and robustness checks to examine the association between 'maternal junk food consumption' and 'children with overweight/obesity' net of parental, household, and geographical characteristics.

RESULTS

Children of mothers with high junk food consumption exhibited a higher prevalence (4.01%) compared to those with moderate (3.29%) and no/low consumption (3.27%). The differences further increased when we adjusted the results for other covariates. Adjusted odds ratio shows that children of mothers with "high" and "moderate" junk food consumption have 1.390 (p < 0.01) times and 1.204 times (p < 0.05), respectively, higher odds of having children with overweight or obesity compared to those with "no/low" consumption. Further, the results are confirmed through multiple robustness checks.

CONCLUSIONS

Interpreting these results in the context of existing evidence and policy suggests that tackling childhood obesity necessitates comprehensive, multi-level interventions - spanning individual, family, community and facility levels. These interventions should aim to enhance food and nutrition literacy, foster healthy dietary practices, and promote positive behaviours that minimise risks associated with all obesogenic factors among children and their families.

Improved food habits and anthropometry among primary school children following a novel healthy eating programme

OBJECTIVE

Assess longer-term changes in food habits and anthropometry among Grades 1-2 primary school students from four public schools in Colombo, Sri Lanka, following a 3-week programme including a classroom-based motivational storybook discussion and self-monitoring food diary (FD).

METHODS

This follow-up study assessed changes from baseline (pre-intervention) BMI z-scores and food habits (increased healthy food-item consumption/decreased unhealthy food-item consumption reflected by an increase in FD score) and parental perceptions (anonymous questionnaires) among 863 students (aged 6-8 years), between 9 and 12 months after completing the programme (November 2019-February 2020).

RESULTS

Food habits showed sustained improvement from baseline mean FD score (baseline vs. follow-up: 51 ± 23% vs. 67 ± 22%, p < 0.001), with children from all BMI subgroups (underweight [UW], normal weight [NW], overweight [OW] and obesity [OB]) showing a significant increase in FD scores (ranging from 14.1% to 17.2%, p < 0.001). BMI z-scores increased in children living with UW (-2.85 to -2.21, p < 0.00) and NW (-0.70 to -0.57, p < 0.001), but did not change in children with OW (+1.5 to +1.49, p = 0.83) and OB (+2.85 to +2.21, p = 0.19). Most parents (n = 497, 97.8%) reported satisfaction with programme outcomes.

CONCLUSION

This programme led to sustained improvement in food habits among young primary school children from all BMI categories, increase in BMI towards the median among children living with UW and NW, and stabilization of BMI in children with OW and OB, suggesting it as a useful tool for improving nutritional status of young children in low- and middle-income countries (LMIC) facing the double burden of under- and overnutrition.

Oral Health and Hygiene Practices from Baramulla District, Jammu and Kashmir, India: A Questionnaire-Based Cross-Sectional Observational Survey

Background/Objectives: Oral hygiene practices are important for good oral health and overall well-being. In this study, we surveyed people across age groups and genders to understand the oral hygiene practices of Baramulla district of the Union Territory of Jammu and Kashmir. Methods: 488 participants-229 males and 259 females-were randomly interviewed through a structured 20-item questionnaire. A chi-square test was used to analyze the age and gender-specific associations in oral hygiene behaviors. Results: The study revealed that majority of participants brushed their teeth only once a day instead of the recommended twice a day; only young cohorts showed relatively higher practice of brushing twice daily. A significantly higher proportion of males (11.69%) rarely brushed their teeth compared to females (4.28%). Tongue cleaning was poorly reported across age and genders and more than 60% of respondents did not clean their tongue at all. Almost 75% and above had made dental visits at least once. However, the visits were made primarily in cases of pain and sensitivity, indicating negligence, financial issues, or a general lack of awareness. The younger cohorts reported eating fast food more frequently, indicating risk groups. The majority of male respondents (45.88%) reported fair oral health whereas the majority of female respondents (35.29%) reported poor overall oral health. Conclusions: Our results show that oral hygiene practices need more improvement, and the attitude and knowledge of the residents need to be ameliorated through oral health education policy interventions.

Role of oral health literacy in demand for oral healthcare services for missing teeth replacement among dental patients visiting a dental teaching hospital in India

AIMS

To assess the role of oral health literacy (OHL) in demand for oral healthcare services for missing teeth replacement among adult patients who are visiting the outpatient department of a teaching hospital, Andhra Pradesh, India.

SETTINGS AND DESIGN

This cross-sectional study was conducted in a dental teaching institute, Andhra Pradesh, southern part of India.

MATERIALS AND METHODS

Based on the inclusion and exclusion criteria, a sample of adult participants was selected through systematic random method from the patients who visited the outpatient department. Data from 740 participants were included in the final analysis. A prevalidated questionnaire adopted from Oral Health Literacy Adult Questionnaire (OHL-AQ) was used for data collection and american dental association (ADA) type IV clinical examination was used for recording missing teeth.

STATISTICAL ANALYSIS USED

Bivariate tests such as the Chi-square test, Mann-Whitney's test, and multinomial logistic regression analysis were used to assess the predictors for the demand for the replacement of missing teeth.

RESULTS

The overall demand for replacement of missing teeth was 46.22%. 37.88% of participants had adequate OHL, 24.72% had marginal OHL, and 37.4% had inadequate OHL. Demand for replacement was more in females than males (57.6% vs. 35.6%), which was statistically significant (P = 0.00). Participants with missing anterior teeth had nearly twice the demand for prosthodontic care (P = 0.046). Participants with adequate OHL had 3.63 times more demand for prosthodontic replacement of missing teeth (odds ratio = 3.63 and P = 0.002).

CONCLUSION

OHL has a positive role in the demand for prosthodontic replacement of missing teeth along with gender and anterior missing teeth. Oral health policies should incorporate strategies to improve OHL.

Food-Oral Processing: Current Progress, Future Directions, and Challenges

Oral processing refers to the series of physical, chemical, and biological processes inside the oral cavity when we consume food. This process affects the taste, quality, and nutrient absorption of the body. In the human diet, oral processing plays a crucial role because it impacts not only the food flavor and texture but also the absorption and utilization of nutrients. With the progress of science and technology and the increasing demand for food, the study of oral processing has become increasingly important. This paper reviews the history and definition of oral processing, its current state of research, and its applications in food science and technology, focusing on personalized taste customization, protein structure modification, food intake and nutrition, and bionic devices. It also analyzes the impact of oral processing on different types of food products and explores its potential in the food industry and science research.

Sugar-Sweetened Beverages, Foods of Low Nutritional Value, and Child Undernutrition in Cambodia

Child undernutrition persists in Cambodia despite recent progress. As Cambodia undergoes a shift in dietary consumption that coincides with economic, demographic, and epidemiologic changes, there is risk of ultra-processed foods and sugar-sweetened beverages displacing nutrient-dense foods during the critical period of infant growth in the first 24 months. The aim of this study was to assess the introduction and intake of foods of low nutritional value and sugar-sweetened beverages and their association with undernutrition among children 24 months of age in rural and semi-urban Cambodia. Cross-sectional analyses of a 24-h dietary recall from a sample (n = 377) of 24-month-olds found that the majority of infants had been introduced to packaged salty snacks and sweets by 12 months of age and to sugar-sweetened beverages by 15 months. By 24 months of age, 78% of children had consumed foods of low nutritional value and 57% consumed a sugar-sweetened beverage on the previous day. Multivariate logistic regression analyses demonstrated that infant intake of a flavored sugary drink on the previous day was associated with over two times the odds of both stunting and wasting, and consumption of packaged sweets on the previous day was associated with over two times the odds of wasting, but no association was found with stunting. These findings underscore the need to improve educational and policy interventions to support healthy feeding practices for infants and young children.

A Review on Maternal Parenting, Child's Growth Stunting, and Oral Health

Stunting has gained global attention as one of the most critical problems in public health. As the first and dominant figure in a child's life, the mother is responsible for determining the proper parenting behaviors to apply to maintain the child's physical health. Stunting is often associated with early childhood caries (ECC) and molar incisor hypomineralization, which can be manifested into each other through various mechanisms. Therefore, it is crucial to explore how far maternal parenting behaviors affect stunting and oral health. This study aims to determine which maternal parenting behaviors can affect stunting and oral health. A systematic search was used through PubMed and Google Scholar to search for published articles between 2011 and 2021. The articles analyze maternal parenting behaviors with stunting and poor oral health. Final analysis was used on 21 articles containing 18 cross-sectional studies, 2 cohort studies, and 1 randomized controlled trial. The result implied that the high prevalence of stunting and ECC is the combined result of prolonged breastfeeding practices (7 articles), poor complementary feeding practice (6 articles), high consumption of sugar (5 articles), and poor oral hygiene practices (5 articles). Maternal parenting styles in the aspect of fulfilling nutrition and maintaining oral health affect the occurrence of stunting and ECC in children.

Exploring the association between early childhood caries, malnutrition, and anemia by machine learning algorithm

OBJECTIVE

The objective of this study was to determine the prevalence of early childhood caries in children with severe acute malnutrition (SAM) and also the hierarchy of association if any with malnutrition, anemia, and other risk factors with ECC using machine learning algorithms.

METHODS

A hospital-based preventive and interventional study was conducted on SAM children (age = 2 to <6 years) who were admitted to the malnutrition treatment unit (MTU). An oral examination for early childhood caries status was done using the deft index. The anthropometric measurements and blood examination reports were recorded. Oral health education and preventive dental treatments were given to the admitted children. Three machine learning algorithms (Random Tree, CART, and Neural Network) were applied to assess the relationship between early childhood caries, malnutrition, anemia, and the risk factors.

RESULTS

The Random Tree model showed that age was the most significant factor in predicting ECC with predictor importance of 98.75%, followed by maternal education (29.20%), hemoglobin level (16.67%), frequency of snack intake (9.17%), deft score (8.75%), consumption of snacks (7.1%), breastfeeding (6.25%), severe acute malnutrition (5.42%), frequency of sugar intake (3.75%), and religion at the minimum predictor importance of 2.08%.

CONCLUSION

Anemia and malnutrition play a significant role in the prediction, hence in the causation of ECC. Pediatricians should also keep in mind that anemia and malnutrition have a negative impact on children's dental health. Hence, Pediatricians and Pediatric dentist should work together in treating this health problem.

Maternal-child consumption of ultra-processed foods and sugar-sweetened beverages in informal settlements in Mumbai, India

BACKGROUND

The global nutrition transition is associated with increased consumption of ultra-processed snack foods and sugar-sweetened beverages (UPF/SSB), contributing to the double burden of child obesity and undernutrition.

METHODS

This cross-sectional study describes the prevalence of maternal and child UPF/SSB consumption and the factors associated with frequent consumption in a convenience sample of 749 children ages 6 months through 6 years and their mothers participating in a community-based child oral health program in five informal settlement communities in Mumbai, India. Mothers were interviewed regarding maternal and child oral health and nutrition characteristics, including consumption of beverages and foods associated with tooth decay-milk, soda, tea with sugar, sweets, and chips/biscuits-using standardized questionnaires. Spearman correlations were used to assess for associations between various social factors and the frequency of maternal and child consumption of the five food categories. Chi-square tests were used to assess differences in child consumption patterns by age groups.

RESULTS

Though reported soda consumption was low among both mothers and children, nearly 60% of children consumed sweets and chips/biscuits daily, four to five times the rate of mothers. Factors associated with children's frequent consumption of UPF/SSB included lower maternal education level, frequent maternal consumption of UPF/SSB, greater number of household members, greater amount of money given to the child, and closer proximity to a store.

CONCLUSION

Our findings demonstrate social factors that may promote UPF/SSB consumption. The nutritional dangers of sugary drinks and non-nutritious snacks for mothers and young children should be addressed across maternal-child health, education, and social service programs. Early childhood nutrition interventions should involve the entire family and community and emphasize the need to limit children's consumption of unhealthy foods and beverages from an early age.

The bi-directional relationship between growth stunting and early childhood caries: a rapid review

Objective

This review aims to determine the two-way relationship between stunting and ECC in developing countries worldwide.

Methods

The procedure in this study was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Rapid Review protocol. Article searches were carried out using databases Cochrane and PubMed. In addition, searches were also carried out using backward and forward snowballing techniques to identify articles that were not detected through database searches.

Results

Nine observational epidemiological articles were found in children aged six months to six years, published in 2015-2020. Five articles discussed the features of ECC in stunted children, and the other five discussed stunting in children with caries in their primary teeth.

Conclusion

Several studies found associations between severe ECC and stunting, with ECC and stunting as both independent and dependent variables, suggesting a bi-directional relationship, also supported by literature on the physiological relationship between oral health and nutrition.

Early Childhood Caries and Nutritional Status of Children: A Review

BACKGROUND

Early childhood caries (ECC) is a serious public health issue affecting children around the world. Severe symptoms and complications commonly found with ECC are adverse effects on health and growth retardation triggered by sensitivity, pain, and abscesses associated with decayed teeth, premature tooth loss, and insufficient food intake due to difficulty in chewing and keeping food in the mouth.

OBJECTIVE

This article aims to provide an overview of the most recent and current evidence on the association between ECC and nutritional status with an aim to stimulate further research and to identify the impact of nutritional status on ECC and vice versa.

METHODS

PubMed, Web of Science, and Google Scholar databases were used to search the studies conducted between 2016 and 2022. The included studies were searched using some keyword combinations and saved in Mendeley Desktop for review and referencing. All books, policy briefs, thesis/dissertations, and non-peer-reviewed articles were excluded, and 47 studies were selected for this narrative review.

RESULTS

Many studies have identified long-term, frequent, and nocturnal bottle-feeding and breastfeeding as well as frequent consumption of sugary food and beverages as high-risk factors for ECC. Adverse nutritional status assessed by anthropometric measures, vitamin D status, and iron-deficiency anemia have been studied as risk factors for ECC.

CONCLUSIONS

Most of the prevailing studies are either case-control or cross-sectional studies, which are unable to provide strong evidence to prove the direction of causality. Thus, further prospective studies are needed to clarify the association between ECC and the nutritional status of children.

Predicting a Child's Oral Health Status from the Mother's Oral Health Behavior

OBJECTIVE

 A mother has a decisive role in maintaining children's oral health, especially before the child is of preschool age. The behavior of mother becomes a source of learning for children who can determine the child's condition, including health behavior. This study analyzes the relationship between maternal oral health behavior and children's oral health status.

MATERIALS AND METHODS

 The research methodology used is a quantitative observational study with a cross-sectional approach to determine the oral health behavior of mothers and children's oral health status. The population of this study were mothers with their first child aged between 3 and 5 years in Tanjungsari, Tanjungsari, Sumedang, West Java, Indonesia. The sampling method and technique used nonrandom and consecutive sampling from six health center units which yielded 46 mothers. Correlation analysis was done with chi-squared validity statistical test and Spearman rank correlation.

RESULTS

 The score for the mother's oral health behavior was 75.54, while the score for the child's oral health status was 54.46. The results of the Spearman rank correlation test showed that the maternal oral health behavior score's correlation coefficient (r) was 0.198 (p-value: 0.188). The calculation of the Spearman rank correlation shows that the mother's oral health behavior affects the child's oral health status in the food and beverage consumption selection.

CONCLUSION

 Based on all indicators of maternal oral health behavior studied, the behavior in maternal food and beverage consumption has a relationship with the child's oral health status, namely the better the behavior in the mother's food and drink consumption, the better the child's oral health status. Other indicators of oral health behavior did not show any relationship with the oral health status of children.

Heterogeneity of Dietary practices in India: current status and implications for the prevention and control of type 2 diabetes

Diet is one of the important modifiable factors in prevention of type 2 diabetes (T2D), making it important to understand geographical variations of food consumption pattern, their similarities and differences across various regions. Asian Indian diet patterns are mostly carbohydrate-based and with vast regional diversity. Staple food, food groups consumed, meat consumption pattern, type of fermented foods, food preparations, type of cooking oil used and food ingredients vary with different regions of India. There has been a slow transition from consumption of coarse grains to refined grains owing to socio-economic, cultural and other factors. Consumption of fruits and vegetables, fats, ready-to-eat foods and sugar is higher in urban population whereas consumption of carbohydrates in the form of cereals and millets is higher among the rural population. Cereal grains followed by pulses and legumes are main sources of protein, given that the frequency of meat consumption is low even among non-vegetarians in India compared to other countries. Overall, there is a tendency towards consumption of calorie-dense foods at the cost of food diversity, which may also result in micronutrient deficiencies as well as development of T2D and related metabolic diseases. Public health strategies and policy level decisions involving stakeholders with diet and lifestyle modification as focal points are absolute priorities to prevent and manage the burden of obesity and T2D in India.

Evaluation of Some Dental Myths Among the Adult Population in Riyadh, Saudi Arabia: A Cross-Sectional Study

Background To provide effective oral health care to patients and healthy individuals, it is critical to recognize prevalent myths. Most myths cause patients to follow the wrong protocol in dentistry, which can make treatment difficult for the dentist. This study aimed to assess dental myths among the Saudi Arabian population in Riyadh. Methodology A descriptive cross-sectional questionnaire survey was conducted among Riyadh adults between August and October 2021. Saudi nationals aged 18-65 living in Riyadh without cognitive, hearing, or vision impairments and with limited or no trouble interpreting the questionnaire were surveyed. Only participants who consented to participate in the study were included. JMP Pro 15.2.0 was used to evaluate survey data. Frequency and percentage distributions were used for dependent and independent variables. The chi-square test evaluated the statistical significance of the variables, with a p-value of 0.05 being considered statistically significant. Results A total of 433 participants completed the survey. Half of the sample (50%) were aged 18-28; 50% were men; and 75% had a college degree. Higher-educated men and women did better on the survey. In particular, 80% of the participants believed "teething causes fever." "Placing a (pain killer) tablet on a tooth reduces pain" was believed by 34.40% of the participants, and 26% thought pregnant women should not get dental work. Lastly, 79% of the participants believed that "infants obtain calcium from their mother's teeth and bone." Most sources of these pieces of information were online (62.60%). Conclusions Nearly half of the participants believe in dental health myths, and as a result, people follow unhealthy practices. This results in long-term health consequences. The government and health professionals must prevent the spread of such misconceptions. In this regard, dental health education may be helpful. Most of this study's crucial findings are consistent with those of prior studies, indicating its accuracy.

Associations between Maternal Education and Child Nutrition and Oral Health in an Indigenous Population in Ecuador

The global nutrition transition has increased the prevalence of childhood dental caries. Greater understanding is needed of the impact of social determinants—including maternal education—on child oral health. This is a cross-sectional analysis of a convenience sample of families of 458 indigenous Ecuadorian children aged 6 months through 6 years from 2011−2013. Data was collected by mother interviews and child dental and anthropometric examinations. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between years of maternal education and maternal-child oral health practices and child oral health outcomes. Each additional year of maternal education was significantly (p < 0.05) associated with some healthier practices including greater likelihood of mothers and children drinking milk daily (OR 1.20; 95% CI 1.08, 1.34); and less healthy practices including greater likelihood of bottle-feeding children with sugary liquids (OR 1.14; 95% CI 1.06, 1.22) and to older age, giving children sweets daily, calming children with a bottle or sweets, and less likelihood of helping brush their children’s teeth (OR 0.93; 95% CI 0.88, 0.98). Each year of maternal education had a small but statistically non-significant influence on increasing the odds of children being among those who are cavity-free (OR 1.03; 95% CI 0.92, 1.16). Interventions to improve health outcomes should focus not just on maternal education but also address social and commercial determinants of health through nutrition and oral health education, as well as policies to reduce sugar and ensure universal access to oral health care.

Family Influences on the Dental Caries Status of Children with Special Health Care Needs: A Systematic Review

Oral health is a likely source of health inequalities in children with special health care needs (CSHCN), according to multiple studies. This systematic review aimed to explore the evidence of family influence—as well as family features, such as societal variables and parents’ perspectives—on these children’s dental caries status. Embase, Ebsco, Scopus, PubMed, and Web of Science databases were all searched. All cross-sectional research published on the variables of family impact ranging from 2010 to 2021 were considered. The DMFT and dmft index was utilised for the report data of dental caries, whereas the National Heart, Lung, and Blood Institute (NHLBI) was used for the purposes of assessing quality. Of the 3861 records identified, 14 were eligible. Further, most of the studies had a caries prevalence of over 50%, (p-value < 0.005). Family influences imparted a significant relationship and association towards the dental caries status of the demographic being studied. The influences on the children included tooth brushing behaviour, parents’ education level, parents’ occupation level, diet pattern, dental visit, snacking frequency, parents’ psychological status, family size, and parents’ knowledge towards oral health. Future research should further explore the family functioning domains, specifically among the CSHCN population. This study was registered on PROSPERO, number CRD42021274923.

Modelling Analysis on Dietary Patterns and Oral Health Status among Adolescents

Adolescence is a crucial stage between childhood and adulthood during which an individual learns new behaviours and practices including dietary patterns. This study aimed to examine the diet and oral health status among adolescents, and employed a structured questionnaire with three sections, namely, demographic, Adolescents' Food Habits Checklist (AFHC) and the Kayser-Jones Brief Oral Health Status Examination (BOHSE). The AFHC was formulated consisting of 23 items to collect information about dietary patterns with respect to food purchase, preparation and consumption habits. Meanwhile, the BOHSE contained nine items to evaluate the oral conditions of adolescents. The relationship between dietary pattern and oral health in adolescents was investigated. A total of 160 adolescents were randomly selected in this study. The data analysis was presented in the form of tables. This study adhered to the STROBE checklist's Guidelines for Systematic Reporting of Examination. According to the findings, food consumption dietary patterns among adolescents had the highest mean score (4.475). This demonstrates that adolescents practiced healthy food consumption. A significant positive correlation was found between food purchase, food preparation, food consumption and dietary patterns. Moreover, females had a slightly higher mean score than males, showing that females have a healthier diet status than males. This study can serve as points of reflection and recommendations on dietary patterns and oral health status.

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries

Oral health is integral to overall health and is often neglected, especially in low- and middle-income countries (LMICs). Oral disease, including untreated dental caries, affects nearly 3.5 billion people globally, contributing to poor health and quality of life. To examine the relationship between the utilization of general healthcare and oral healthcare, we conducted an exploratory cross-sectional study of first-visit interview data collected from a convenience sample of 3,422 low-income mothers and 4,324 children aged 6 months through 6 years participating in a community-based oral health and nutrition program in five LMICs (Ecuador, El Salvador, India, Nepal, and Vietnam) from 2006–2015. We used descriptive and exploratory association analysis to identify patterns of oral healthcare utilization for mothers and children compared to medical care utilization, specifically maternal prenatal care and child immunizations. Overall, 89.6% of the mothers had received prenatal care for at least one child, but only 76.4% had ever received dental care and 50% were currently suffering from oral health symptoms, primarily oral pain. Mothers who received prenatal care were significantly more likely to have accessed dental care compared to those who had not received prenatal care (OR = 2.62, 95% CI: 2.06, 3.32). Overall, 95.4% of the children had current immunizations, but only 30.1% had ever received dental care, and 32.4% were currently suffering from oral pain. Children whose immunizations were up-to-date were more likely to have received dental care, with a significant association in Ecuador (OR = 3.29, 95% CI: 2.06, 5.30). Compared to utilization of general healthcare, oral healthcare was under-utilized by mothers and children in our sample from five LMICs. Integration of prevention- and treatment-oriented oral healthcare into primary medical care services, particularly prenatal care and child immunizations, could help increase access to oral healthcare and improve women's and children's oral health.

Prevalence and Risk Factors for ECC Among Preschool Children from India along with the Need of its Own CRA Tool- A Systematic Review

Introduction

Caries in the deciduous dentition of children under six years of age is termed as early childhood caries (ECC). ECC is prevalent among Indian children and identifying modifiable risk factors is important for prevention. This systematic review was undertaken to describe the burden of ECC in India, its prevalence, associated risk factors along with its repercussions on childhood health.

Materials and Methods

A search was conducted for published Indian studies on ECC through electronic databases and complemented with hand search. The protocol for the present systematic review was registered at PROSPERO (Ref No.CRD42022306234)Care was taken to include studies which could represent all parts of India- Central, North, South, East and West. Included papers were reviewed for prevalence of ECC and reported risk factors.

Results

Overall 37 studies on ECC in India were identified relating to prevalence, 11 reported risk factors and two reported on the association between severe ECC and nutritional health and well-being. The prevalence of ECC in India in these studies varied from16% to 92.2%. This systematic review revealed that ECC is prevalent among Indian children and highlights the need of preventive intervention and early risk assessment by its own caries risk assessment (CRA) tool. Occurrence seems to be firmly connected with age, snacking frequency, feeding and oral hygiene habits and with social determinants of health including parental education level, low socioeconomic status and number of siblings.

Dietary practices among children with early childhood caries and the associated factors: A qualitative study

BACKGROUND

Parents play a vital role in their children's dietary habits. A comprehensive understanding of the perspectives of parents of children with early childhood caries (ECC) is required for prevention program planning.

AIM

To describe the parental perspective of the dietary habits of children with ECC.

DESIGN

In this descriptive qualitative study, the participants were parents of children with ECC receiving routine dental care. Data were collected through focus groups using an interview guide. Data were analyzed manually using the content analysis method.

RESULTS

Five focus groups involving 27 participants were conducted. Two main categories emerged: cariogenic food literacy and factors that affect food choices. Most of the participants knew that sugary foods are responsible for tooth decay. Parents felt that children's snacking habits were influenced by multiple factors, such as family environment, peers, commercials on television or the Internet, and affordability of food.

CONCLUSIONS

Parents are not able to translate their knowledge into action to modify their children's diet as they may lack self-efficacy and feel pressured by their children, the media and the environment in which they live. Motivational interviewing of parents and governmental and school policies to reduce sugary food consumption may be required.

Association between Ultraprocessed Food Intake and Overweight, Obesity, and Malnutrition among Children in Tehran, Iran

Childhood is a critical period for susceptibility to malnutrition. The consumption of ultraprocessed foods (UPFs) has been increasing among children. The objective of this study was to evaluate the relationship between UPF intake and overweight/obesity and malnutrition in children. 788 children aged 6 years were included in a population-based cross-sectional study in Tehran. A 168-item semiquantitative food frequency questionnaire was used to evaluate dietary intake. UPFs were detected using the NOVA classification system. Logistic regression analyses were used, and results were reported as odds ratios (ORs) and 95% confidence interval (CI) of obesity and malnutrition across the tertiles of UPFs adjusted for energy intake, socioeconomic status, and physical activity. The mean weight, height, BMI, and total energy intake of participants were 20.85 ± 2.35 kg, 113.75 ± 2.00 cm, 16.12 + 1.84 kg/m², and 1014.74 ± 259.16 (kcal/d), respectively. There were no significant associations between UPF intake and obesity (OR = 0.97; 95% CI 0.31 to 3.01; P-trend = 0.98), wasting (OR = 0.94; 95% CI 0.30 to 2.87; P-trend = 0.87), overweight/obesity (OR = 0.86; 95% CI 0.59 to 1.25; P-trend = 0.45), underweight/wasting (OR = 0.69; 95% CI 0.40 to 1.17; P-trend = 0.17), marginal-stunting (OR = 1.16; 95% CI 0.71 to 1.89; P-trend = 0.53), or marginal-stunting/overweight/obesity (OR = 1.25; 95% CI 0.62 to 2.54; P-trend = 0.47). There was no evidence of an association between intake of UPFs and risk of overweight, obesity, and malnutrition in children.

Factors Associated with Non-Attendance at Dental Preventive Care in Slovak High School Students

This study aimed to determine the factors associated with the avoidance of dental preventive care in high school students and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia, the ongoing cross-sectional school-based survey of students and their parents or legal representatives. The data were collected using two separate standardized questionnaires: (i) the questionnaire for students (n = 515) and (ii) the questionnaire for parents (n = 681). The study group included 57 high school students (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group included 458 students (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents, and young adults (21.8%; 20.0%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents and young adults were not visiting either dental preventive care or pediatric preventive care (adjusted odds ratio (AOR) = 5.14; 95% confidence interval (CI) = 2.40, 10.99). Children of divorced mothers and mothers with household income lower than EUR 900 had significantly higher dental care avoidance in bivariate analysis. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%, p < 0.05). The results of the study can be used as an educational intervention step focusing on the parental influence on adolescent and young adults' behavior and as a challenge for the improvement of dental preventive care in older adolescents and young adults.