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. 2011 Jul 13:11:558.
doi: 10.1186/1471-2458-11-558.

Untreated severe dental decay: a neglected determinant of low Body Mass Index in 12-year-old Filipino children

Habib Benzian  1 , Bella Monse, Roswitha Heinrich-Weltzien, Martin Hobdell, Jan Mulder, Wim van Palenstein Helderman
Affiliations

Untreated severe dental decay: a neglected determinant of low Body Mass Index in 12-year-old Filipino children

Habib Benzian et al. BMC Public Health. .

Abstract

Background: Dental decay is the most common childhood disease worldwide and most of the decay remains untreated. In the Philippines caries levels are among the highest in the South East Asian region. Elementary school children suffer from high prevalence of stunting and underweight.The present study aimed to investigate the association between untreated dental decay and Body Mass Index (BMI) among 12-year-old Filipino children.

Methods: Data collection was part of the National Oral Health Survey, a representative cross-sectional study of 1951 11-13-year-old school children using a modified, stratified cluster sampling design based on population classifications of the Philippine National Statistics Office. Caries was scored according to WHO criteria (1997) and odontogenic infections using the PUFA index. Anthropometric measures were performed by trained nurses. Some socio-economic determinants were included as potential confounding factors.

Results: The overall prevalence of caries (DMFT + dmft > 0) was 82.3% (95%CI; 80.6%-84.0%). The overall prevalence of odontogenic infections due to caries (PUFA + pufa > 0) was 55.7% (95% CI; 53.5%-57.9%) The BMI of 27.1% (95%CI; 25.1%-29.1%) of children was below normal, 1% (95%CI; 0.5%-1.4%) had a BMI above normal. The regression coefficient between BMI and caries was highly significant (p < 0.001). Children with odontogenic infections (PUFA + pufa > 0) as compared to those without odontogenic infections had an increased risk of a below normal BMI (OR: 1.47; 95% CI: 1.19-1.80).

Conclusions: This is the first-ever representative survey showing a significant association between caries and BMI and particularly between odontogenic infections and below normal BMI. An expanded model of hypothesised associations is presented that includes progressed forms of dental decay as a significant, yet largely neglected determinant of poor child development.

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Figures

Figure 1
Figure 1
Distribution of caries lesions and caries lesion that progressed into the pulp (PUFA) of 11-13-year olds.
Figure 2
Figure 2
Distribution of the 3 categories of BMI of the sample of 12-year-old boys and girls according to the cut-off points of the 11-, 12- and 13-year olds of WHO, CDC, Philippines (NHANS I) and Cole.
Figure 3
Figure 3
Distribution of the 3 BMI categories according to the number of caries lesions into the pulp (a) and the number of caries lesions (b).
Figure 4
Figure 4
Scatter plots presenting each child (*) with BMI and number of lesions into the pulp (PUFA) (a) and with BMI and number of DMFT (b) and regression line (formula).
Figure 5
Figure 5
Hypothesised relations between determinants of poor child development, poor school achievement and odontogenic infections.
See this image and copyright information in PMC

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