Food Insecurity and Dental Caries in Adolescents: Effect of Gender and Race.

Objectives: To investigate the effect of gender and race on the relationship between food insecurity and dental caries in adolescents aged 12-19.
Methods: A cross-sectional study was carried out using the National Health and Nutrition Examination 2013-2014 dataset. The main outcome was dental caries experience, measured using the Decayed, Missing, Filled (DMF) index. The main predictor was household food insecurity, categorized into 2 groups: (1) food secure and (2) food insecure (including marginal, low, and very low). To determine the overall effect of food insecurity on caries, population weight bivariate logistic regression and multivariate regression models were used. Adjusted models were controlled for covariates (gender, age, race, poverty, barriers to dental care, last dental visit, food assistance program, and brushing frequency). In addition, subpopulation analyses were carried out by gender and race.
Results: A total of 1,028 adolescents were included in our analysis. Approximately 52% of those reported being food secure versus 65% of those who were food insecure had evidence of dental caries. Food insecure adolescents were 1.74 times more likely to have caries than food secure adolescents (Odds Ratio (OD)=1.74 p=0.001). In the adjusted model, food insecurity remained significantly associated with dental caries (OD=1.52 p=0.03). After stratifying by gender, food insecurity was significantly associated with increased odds of dental caries in females (OD= 1.78 p=0.02) with increased odds for dental caries was highest in White female (OD=2.00 p=0.05).
Conclusions: Food insecurity is a potential risk factor for dental caries. Females, in particular, are at a higher risk of experiencing the adverse effects of food insecurity on their dental health.