Intervention Effectiveness on Children’s Oral Health and Nutrition in Vietnam

Objectives: A 3-year oral health intervention comprised of health education, fluoride varnish application, and dental screenings reached 593 children in 2011 from 5 pre-school/kindergartens in Ho-Chi Minh City and Da Nang, Vietnam. We investigated effectiveness of the intervention longitudinally on decayed/missing/filled teeth (dmft) scores, mouth pain, and nutritional status, in children ages 1-6 from 2011-2013.
Methods: We assigned family IDs in 2011 to track participants for 2 more years. We retained a longitudinal cohort of 239 children in 2012 and 151 children in 2013. Parental surveys were utilized to measure demographics, parental health knowledge, information on parent/child oral and nutritional health practices, and child mouth pain. Child anthropometric exams were calculated as z-scores using WHO software. Dental exams yielded decayed/missing/filled teeth (dmft) scores. We used SPSS (v.24) to compute descriptive statistics and run statistical tests.
Results: Average dmft scores decreased for 4 year-old children: 6.5 (Year 1), 5.9 (Year 2), 1.4 (Year 3). Children had high severity of caries: 45.2% (Year 1), 46.9% (Year 2), and 41.1% (Year 3) of children’s teeth. 65.5% of Da Nang children in Year 1 who had decay into the pulp experienced mouth pain, where 80.8% reported the same in Year 3.

Overweight status was common in these children and rates increased sharply: 19.9% (Year 1), 37% (Year 2), and 41.8% (Year 3). BMI-for-age z-scores for Year 1-3 were reported at 0.85 (SD±1.39), 1.22 (SD±1.48), and 1.11 (SD±1.52), respectively. Stunted, underweight, and wasted statuses remained under 5% over the entire project.
Conclusions: The dmft results suggest that children who enrolled earlier may have benefited from the intervention. With increasing age, depth of decay into pulp may penetrate deeper into pulpal tissue when left untreated, thus increasing mouth-pain. The intervention may benefit from placing more emphasis on junk-food consumption and exercise given our findings on obesity/overweight.