Life-conditions and anthropometric variables as risk factors for caries in children in Ladakh: A cross- sectional survey.

Abstract

Backgrounds The aim of this survey was to evaluate the severity of dental caries among Ladakh children and its association with anthropometric and background variables. Methods This cross‐sectional epidemiological survey was conducted on Ladakh schoolchildren divided into four age groups (<6, ≥6<11, ≥11≤14 and >14 years of age). A total of 1474 schoolchildren (607 males 41.18% and 867 females 58.82%) were examined. Actual dental caries prevalence (dt/DT) and gingival bleeding were recorded by four calibrated examiners. An ad hoc questionnaire evaluated general health, eating habits, oral hygiene and the self-perception of oral conditions. Height, weight, waist circumference, heart-rate and oxygen-saturation were also collected. Responses to questionnaire items were treated as categorical or ordinal variables. Relation between children’s caries data, gingival bleeding, gender, Body Mass Index (BMI) following the International Obesity Task Force, waist circumference and questionnaire items were assessed using the Kruskal–Wallis test. Conditional ordinal logistic regression was used to analyse associations among caries severity, gender, BMI, waist circumference, oxygen saturation and questionnaire. A forward stepwise logistic regression procedure was also assessed to estimate the ORs of gingival bleeding prevalence and the covariates derived from examination or questionnaire. Results Caries was almost ubiquitarian with only 10.04% of caries-free children (dt/DT=0). Caries severity, in both primary and permanent dentitions was statistically significantly related to gender, waist circumference, BMI, oral hygiene frequency and self-reported chewing problems (p<0.01 in both dentitions). An increasing relative risk for caries in permanent dentition compared to caries-free subjects was observed in children with a low BMI (RRR=1.67, 95% CI=1.54/2.83 for subjects with 1-3 caries lesions and RRR=1.52, 95% CI=1.36/1.74 for subjects with more than 3 caries lesions); also children with reduced waist circumference had a higher relative risk to have 1-3 caries lesions (RRR=2.16, 95% CI=1.84 / 2.53) and an even higher risk to have more than 3 caries lesions (RRR=4.22, 95% CI=3.33 / 5.34). Conclusion A significant impact of untreated caries lesions was observed; low BMI values and reduced waist circumference showed to be the main caries risk predictors. Preventive and intervention programmes should be implemented to improve children's oral health living in Ladakh.

Study protocol for a randomized clinical trial to evaluate the effect of the use of Xylitol gum in the prevention of caries lesions in children living in Ladakh – the Caries Prevention Xylitol in Children (CaPreXCh) trial

“…An increasing relative risk for caries in permanent dentition compared to caries-free subjects was observed in children with a low BMI [6].…”

“…It was also taken into account an increment of approximately 10% of the sample due to some changes in the prevalence of the disease. Thus, estimating a level of signi cance of 0.05 with a power of 80% and a caries prevalence of about 90% [6], the number of participants was set to 409 subjects (Kelsey method), based on a 10% absolute difference between the groups, using a two-tailed test [19].…”

“…Oral health data on population living in Ladakh are poor. A recent survey performed on schoolchildren living in Ladakh showed that caries was almost ubiquitarian with only 10% of caries-free children [6].…”