Stunting Malnutrition Associated with Severe Tooth Decay in Cambodian Toddlers

Abstract

Background: The persistently high prevalence of undernutrition in Cambodia, in particular stunting or chronic malnutrition, calls for innovative investigation into the risk factors that affect children’s growth during critical phases of development. Methods: Secondary data analysis was performed on a subgroup of children who were present at two time points within the Cambodian Health and Nutrition Monitoring Study (CAHENMS) and who were less than 24 months of age at the nominated baseline. Data consisted of parent interviews on sociodemographic characteristics and feeding practices, and clinical measures for anthropometric measures and dental status. Logistic regression modelling was used to examine the associations between severe dental caries (tooth decay)—as indicated by the Significant Caries Index—and the presence of new cases of stunting malnutrition at follow-up. Results: There were 1595 children who met the inclusion criteria and 1307 (81.9%) were followed after one year. At baseline, 14.4% of the children had severe dental caries, 25.6% presented with stunted growth. 17.6% of the children transitioned from healthy status to a low height-for-age over the observation period. Children with severe dental caries had nearly double the risk (OR = 1.8; CI 1.0–3.0) of making that transition. Conclusion: Severe caries experience was associated with poorer childhood growth and, as such, could be an underinvestigated contributor to stunting.

Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries

“…The pooled proportion of caries among the 11 included studies in the total sample of 11,115 individuals was 38.7% (95% CI = 28.4% to 49.5%) (Q = 1277.61; DF = 10; p < 0.0001; I 2 = 99.22%; Egger’s test = 3.83; Kendall’s Tau = 0.09) ( Figure 2 ). The studies were conducted across six different LMICs, including Brazil [ 38 , 39 , 40 , 41 , 42 ], Nigeria [ 43 , 44 ], Cambodia [ 45 ], Tanzania [ 46 ], Mexico [ 47 ], and Ethiopia [ 48 ]. All the studies used either the dmft (decayed, missing, and filled primary teeth) or DMFT (decayed, missing, and filled permanent teeth) index, except for Pérez et al [ 47 ], who used the International Caries Detection and Assessment System II (ICDAS II) 1–6 index.…”

“…All the studies used either the dmft (decayed, missing, and filled primary teeth) or DMFT (decayed, missing, and filled permanent teeth) index, except for Pérez et al [ 47 ], who used the International Caries Detection and Assessment System II (ICDAS II) 1–6 index. The primary objective of the six studies [ 39 , 41 , 42 , 46 , 47 , 48 ] was to assess the contributing factors of dental caries, whereas five studies evaluated them as secondary objectives [ 38 , 40 , 43 , 44 , 45 ]. Four studies reported cross-sectional data of prospective cohorts, including birth cohorts, followed for three years [ 40 ] and twelve years [ 38 ], respectively, and childhood cohorts followed for one year each [ 41 , 45 ].…”

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

“…Severe early childhood caries (S-ECC) is highly prevalent globally and pose serious consequences for the child's quality of life. [1][2][3] The consequences of untreated S-ECC include multiple episodes of dental pain and infections, poor mastication, delayed physical growth and development, hypoplasia of developing permanent teeth, loss of school days, hampered learning, and compromised self-esteem. [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.…”

“…[1][2][3] The consequences of untreated S-ECC include multiple episodes of dental pain and infections, poor mastication, delayed physical growth and development, hypoplasia of developing permanent teeth, loss of school days, hampered learning, and compromised self-esteem. [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.…”

The Emerging Field of Nutritional Dentistry

“…Renggli et al [ 18 ] further analyzed data of the Cambodian Health and Nutrition Monitoring Study (CAHENMS) on sociodemographic characteristics, feeding practices and clinical measures for the anthropometric measures and dental status of related Cambodian toddlers. Based on the results, they concluded that severe caries experience was associated with poorer childhood growth and, as such, could be an underinvestigated contributor to stunting.…”