Background Malnutrition when occurs during development period may cause irreversible effect on developing dental tissues leading to dental caries. The aims of the present study were to evaluate the nutritional status of primary school children and its influence on dental caries.
Methods This study was conducted among primary school children (6–10 years old) in the middle region of Iraq (five governorates). The total sample composed of 4,089 children randomly selected. The assessment of nutritional status was performed using height for age indicator for chronic malnutrition (stunted), the values were compared with the international reference values defined by the National Center for Health Statistics (NCHS) and classify them into mild, moderate, and sever stunted. The nutrient analysis was done through the dietary assessment using semi-quantitative food frequency questionnaires the assessment was converted to nutrient data (according to nutrient composition of Iraqi food) which was performed using software program especially designed for this study. Diagnosis and recording of dental caries was conducted according to World Health Organization criteria in 1997 using dmfs and DMFs indices for primary and permanent teeth respectively. Statistical analyses were performed using Analysis of Variance and Least Significant Different tests.
Results The prevalence of stunted, was found to be 49%, where the mild grade was the most prevalent (29%). The data presented in the study showed that there is a significant difference in mean of caries experience between different grades of nutritional status (P<0.01). The well-nourished children had significantly lower dmfs values (11.76±0.95) than mild (10.44±0.61) and sever stunted (16.32±1.07). Concerning caries experience of permanent dentition, apposite figure were found, well-nourished children had higher DMFS values (2.11±0.93) than mild (1.39±0.07), moderate (1.56±0.10), and sever stunted (1.14±0.18). However all these differences were statistically not significant (P>0.05).
The daily nutrients intake for the well-nourished children were recorded to be for protein 52.0±0.62grams, calcium 0.63±0.01 grams, phosphorus 1.01±0.01grams, calcium/phosphate ratio 0.61±0.004, iron 0.01±0.0002 milligrams, vitamin A 6981±84.04 I.U and vitamin C 0.10±0.002 milligrams. These amounts tended to be decreased significantly with increased severity of malnutrition. Multiple linear regressions showed correlation between nutrients and dmfs, DMFs with R² value 0.7%, 0.5% respectively.
Conclusion The oral cavity is considered a mirror of nutritional status of the body. Stunted children with inadequate nutrients intake during growth and development had a significant effect on tooth development and subsequent caries initiation and progression.
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