Malnutrition and Developmental Defects of Enamel in 2- to 6 -Year-Old Saudi Boys

Abstract

Three hundred and ninety boys aged 2, 4 or 6 years from Riyadh, Saudi Arabia, took part in a survey in 1993/94. The main aims of the study were first, to identify factors related to malnutrition in young children since a study of older children from the same area 1 year before had shown malnutrition to be strongly related to prevalence of developmental defects of enamel (DDE) of permanent teeth and, second, to identify factors related to the prevalence of developmental defects of primary teeth. Enamel defects were recorded by clinical examination of the buccal surfaces of all primary teeth by 1 examiner using the DDE index. A questionnaire to parents provided information on socio-economic status, illness in the mother and child, infant feeding, trauma to teeth and toothbrushing. A 24-hour dietary record, to estimate water and milk intake, and a 24-hour urine collection were obtained for each child twice. Nutritional status was calculated from height for age using WHO methods. Multiple regression analyses revealed four variables related (p < 0.05) to malnourished status: low birth-weight, low volume of water drunk, child stopped breast- and bottle-feeding before 1 year of age, and low class urban or rural area of residence. Birth-weight was itself related to area of residence (p = 0.02), parental education (p = 0.02) and maternal illness during pregnancy (p = 0.06). Malnutrition (p < 0.001), low birth-weight (p < 0.001), childhood illness (p < 0.001), brushing of child’s teeth (p = 0.003) and swallowing toothpaste (p < 0.001) were related to the prevalence of developmental defects of primary teeth. This study indicated several independent variables which may be related to the prevalence of enamel defects in primary and permanent teeth, but longitudinal studies are required to determine which are causes and which are markers of these developmental defects.

Aleitamento materno e cárie do lactente e do pré-escolar: uma revisão crítica

“…9,30,40 Malnutrition may cause enamel hypoplasia, and just like iron deficiency anemia, it may lead to reduced salivary secretion and low buffering capacity. 7,11,24,35,42,43 Childhood malnutrition is still a major problem in Brazil, especially in the North and Northeast regions, 44 which may contribute to a larger number of decayed teeth in these regions. The mean DMFT (number of deciduous teeth that are decayed, extracted or indicated to be extracted and filled) at the age of five years in the North region is approximately 27% higher than the mean for the Southeast region.…”

“…30,43 In these newborns, enamel defects are associated with gestational diseases, such as maternal infection, metabolic disorders (hypoxemia, nutritional disorders, hypocalcemia) and performance of medical procedures (laryngoscopy and endotracheal intubation). 46 In infants, the presence of infections, metabolic disorders, chemical toxicity and inherited diseases also cause the development of enamel hypoplasia.…”

“…46 In infants, the presence of infections, metabolic disorders, chemical toxicity and inherited diseases also cause the development of enamel hypoplasia. 11,30,43 The severity of ECC increases with the severity of bronchial asthma, having as major cause the use of beta 2 agonists, which reduce salivary secretion, in addition to the fact that powder inhalers and oral medications contain sugar in their formulation. 47 Other situations that reduce salivary flow and predispose to the appearance of caries are diabetes mellitus and the use of medications such as a n t i h i s t a m i n e s , b e n z o d i a z e p i n e s , a n t i e m e t i c s , expectorants and antispasmodics.…”

Prevalence and Distribution of Developmental Defects of Enamel in the Primary Dentition of IVF Children of West Bengal

“…A higher incidence of the enamel defects in the upper incisors than in the lower incisor in both groups was observed in our study. Li Y et al, [16], Rugg-Gunn AJ et al, [17] found relatively similar result. The deviation in the results may be due to the diversity of the methodological procedures and racial differences.…”

Critique of the review of 'Water fluoridation for the prevention of dental caries' published by the Cochrane Collaboration in 2015

“…This would overcome the anomaly in the Cochrane Review of, in effect, comparing fluorosis levels recorded in cooler, better nourished populations (such as Newcastle upon Tyne) with those in hot, less-wellnourished populations (such as India, Saudi Arabia and Namibia). Undernutrition is a recognised risk factor for dental enamel defects 32,33 and the severity recorded is substantially different in areas of the world with different levels of development. The rationale for including data from communities with water fluoride concentrations higher than those recommended is unclear, and it is not applicable to the evaluation of water fluoridation where fluoride concentrations are controlled and maintained within acceptable limits.…”