Undernutrition is associated with change in severe dental caries

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OBJECTIVES: To examine the association of baseline prevalence of thinness or stunting and the incidence of dental caries among preschool children in Liaoning Province, China.

METHODS: Children were recruited from 15 kindergartens in Liaoning Province. A total of 772 children were assessed at baseline and follow-up. The mean age of children at baseline was 50.82 months, and the median follow-up time was 10.12 months. Anthropometric measurement, dental caries, and questionnaire were assessed overtime, whereas only baseline questionnaire was used in the data analysis. z-Score for body mass index (BMI)-for-age, weight-for-age, and height-for-age were calculated using World Health Organisation (WHO) Child Growth Standards. Dental caries was assessed according to the fifth WHO Basic Methods for Oral Health Surveys. The presence of pulpal involvement, ulceration, fistula, and abscess (pufa) were used to indicate severe dental caries in deciduous teeth. A structured questionnaire mainly based on the fifth WHO Oral Health Surveys was used to collect sociodemographic and behavior data. Logistic regression was constructed to assess the association between change in severe dental caries and prevalence of thinness and stunting.

RESULTS: There was a positive association between prevalence of stunting and incidence of severe caries in the fully adjusted model [odds ratios 2.88; 95 percent confidence interval (CI): 1.01, 8.27]. Prevalence of thinness showed insignificant positive association with incidence of severe caries.

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.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalJournal of Public Health Dentistry
Issue number3
Early online date2 Aug 2020
Publication statusPublished - 1 Sept 2020


  • body mass index
  • child.
  • dental caries
  • growth
  • malnutrition
  • thinness


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