Undernutrition is Associated with Change in Severe Dental Caries

Objectives: To examine the association of baseline prevalence of thinness and stunting with incidence of severe dental caries among preschool children in Liaoning province, China.
Methods: Ethical approval was obtained from King’s College London (KCL Ethics Ref: HR-15/16-2901), and Shenyang Dental Hospital. Children were recruited from 15 kindergarten in Liaoning Province. A total of 772 children who were assessed at baseline and follow-up were included. The mean age of children at baseline was 50.82 months, and the median follow-up time was 10.12 months. Dental caries was assessed according to the World Health Organization (WHO) methods. Z-score for weight-for-age and height-for-age were calculated using WHO Child Growth Standards. Sociodemographic and behaviour data were also collected using a structured questionnaire. The presence of pulpal involvement, ulceration, fistula and abscess (pufa) were used to indicate severe dental caries. Logistic regression was constructed to assess the association between change in severe dental caries and prevalence of thinness and stunting.
Results: The findings showed a positive and statistically significant association between baseline prevalence of stunting and incidence of severe caries in the fully adjusted model (odds ratios 2.88; 95% CI: 1.01, 8.27). Baseline prevalence of thinness showed positive association with incidence of severe caries but was not statistically significant.
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.