Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India

Abstract

In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and/or acute malnutrition. In children ages 3–6, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02–1.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food/sugary drinks into maternal–child health programs.

An overview on early childhood caries: A literature review

“…[13,14] On the other hand, heavy intake of non-healthy or junk food that is filled with sugar is a known factor in dentition decay. [15] Furthermore, eating heavy amounts of sweets combined with incorrect or sparingly brushing of teeth renders the child susceptible to developing dentition caries. [16] While other causes of poor oral hygiene may play an important role in the development of caries, such as parental incarceration.…”

Dietary practices among children with early childhood caries and the associated factors: A qualitative study

“…Though many studies have been conducted with parents of children with ECC from diverse cultural backgrounds exploring their dietary practices, their findings may not apply to all populations given that culture plays a significant role in dietary habits 8‐10 . With the rapidly growing economy, globalization, and urbanization, India has seen a significant increase in the availability of fast food and junk food, leading to nutrition transition 11 . This is further compounded by mother's time constraints as many mothers are working, availability and display of sugary food that attracts children, and lack of governmental policies on junk and sugary foods 12,13 .…”

“…This is further compounded by mother's time constraints as many mothers are working, availability and display of sugary food that attracts children, and lack of governmental policies on junk and sugary foods 12,13 . As a result, increasing rates of childhood obesity and ECC are seen in the Indian population 11 . Therefore, a comprehensive understanding of the perspectives of parents of Indian children with ECC is an essential step in targeted program planning to lessen the risk for ECC.…”

Tooth-Supported Prosthodontic Rehabilitation of a Child with Mutilated Dentition: An Interdisciplinary Approach

“…[1][2][3][4][5] Also, a child with ECC is more likely to suffer 10% increased odds of undernutrition with each deep carious tooth. [6] Treatment of S-ECC is complex, expensive, and due to high caries risk relapses after treatments are common in children managed for S-ECC. Premature extractions of primary teeth further have added psychological trauma, disturbed development of occlusion, diminished oral and general health.…”