Diet Quality and Dental Caries Among Low-Income African-American Preschool Children

Objectives: To investigate the influence of diet quality on dental caries among inner-city low-income African-American preschool children.
Methods: This study included longitudinal data from Wave1 (2002-2004) and Wave2 (2004-2006) of Detroit Dental Health Project, a population-based study of 1021 African–American families living in 39 low-income Census tracts in Detroit, Michigan. Analyses were limited to data of 522 children aged 3-5 years at Wave1. Children’s dietary histories were obtained at Wave1 and Wave2 using the Block Kids Food Questionnaire. Diet Quality was determined by the Healthy Eating Index-2005 based on the FFQ data. Dental caries was examined using the ICDAS criteria and reported as decayed (both noncavitated and cavitated) and filled tooth or surfaces (dft/s). Covariates include child and family level information such as demographic characteristics, SES, various psychosocial measures, oral health related behaviors, dental insurance and utilization, WIC and Headstart participation, and BMI, collected by trained interviewers. Descriptive and negative binomial regression analyses were conducted using SAS(9.4) and STATA(14) with the consideration of complex sampling design. Statistical significance level was set at alpha= 0.05.
Results: Overall, the children’s diet quality was poor; mean total HEI-2005 (max=100) scores were 56.04 (Wave1) and 57.39 (Wave2). At each Wave, children with highest diet quality had significantly lower mean dft/s compared to the lowest quality group after controlling for confounding factors. Longitudinally, diet quality at Wave1 was a weak predictor of caries at Wave2. However, children who had consistently low HEI-2005 scores at both Waves, compared with those maintained high scores, were at significantly greater risk of caries development (IRR=1.70; CI: 1.04-2.79) after controlling for confounding factors.
Conclusions: The results suggest that diet quality may be significantly associated with low-income African-American children’s caries development. Caries prevention strategies and interventions among these children may need to focus on improving overall diet quality.