Overweight, obese, underweight, and frequency of sugar consumption as risk indicators for early childhood caries in Brazilian preschool children.

BACKGROUND: A possible association between being overweight or obese and early childhood caries (ECC) remains controversial. AIM: To investigated this association in a developing country testing the confounding effects of socioeconomic factors and frequency of sugar consumption. METHODS: Historical cohort study, 388 children (aged 24-71 months) living in São Luís, Brazil. A theoretical model adjusted according to income, birthweight, and nutritional status at twelve months and frequency of sugar consumption was generated with directed acyclic graphs to analyze this association. Caries were considered a discrete variable in the Poisson regression models; incidence density ratios (IRs) and 95% confidence intervals (95% CIs) were estimated. RESULTS: Being overweight or obese (IR = 1.52; 95% CI: 1.03-2.22) was independently associated with ECC. Being thin or very thin (IR = 1.97; 95% CI: 1.52-2.54), a high frequency of sugar consumption (IR = 1.83; 95% CI: 1.42-2.38), and age (IR = 3.62; 95% CI: 2.58-5.08) were associated with ECC. CONCLUSIONS: Children overweight or obese, as well as children exhibiting being thin/very thin, were associated with ECC independent of socioeconomic variables and a high frequency of sugar consumption.

[Is the severity of caries associated with malnutrition in preschool children?]. / A gravidade da cárie está associada à desnutrição proteico-calórica em pré-escolares?

An analysis was conducted to evaluate if the severity of caries is associated with protein-calorie malnutrition in preschool children. The cross-sectional study was performed on a retrospective cohort of 625 children aged 24-71 months attending daycare centers in São Luís, Maranhão. A hierarchical model was evaluated at five levels: 1.) Socio-economic variables (economic group, mother's educational level and skin color); 2) Access variables; 3) Low birth weight (LBW) and exclusive breastfeeding; 4) Weight per height at 12 months; and 5) Severity of caries and albumin (Alb) levels. The outcome was protein-calorie malnourishment (weight per height z score < -2). The prevalence of outcome was 5.0% and the prevalence of caries was 32%. At the first level, the variables were not associated with the outcome, but the economic group was maintained until the final model. The variables in the second and third levels were not significant. At the fourth level, weight for height at 12 months was not significant, but was maintained until the final model. In the last level, severity of caries was positively associated with malnourishment. The association between severity of caries and malnourishment suggest that oral health should be integrated with public health care policies for children.

Association between prolonged breast-feeding and early childhood caries: a hierarchical approach.

OBJECTIVES: This study was conducted to investigate the association between prolonged breastfeeding and early childhood caries(ECC) with adjustment for important confounders, using hieraschical approach. METHODS: This retrospective cohort study involved 260 low-income children (18-42 months). The number of decayed teeth was used as a measure of caries. Following a theoretical framework, the hierarchical model was built in a forward fashion, by adding the following levels in succession: level 1: age; level 2: social variables; level 3: health variables; level 4: behavioral variables; level 5: oral hygiene-related variables; level 6: oral hygiene quality measured by visible plaque; and level 7: contamination by mutans streptococci. Sequential forward multiple Poisson regression analysis was employed. RESULTS: Breast-feeding was not a risk factor for ECC after adjustment for some confounders (incidence density ratio, 1.15; 95% confidence interval, 0.84-1.59, P = 0.363). CONCLUSION: Prolonged breast-feeding was not a risk factor for ECC while age, high sucrose comption between main meals and the quality of oral higiene were associated with disease in children.

A gravidade da cárie está associada à desnutrição proteico-calórica em pré-escolares? / Is the severity of caries associated with malnutrition in preschool children?

Avaliou-se se gravidade da cárie está associada à desnutrição proteico-calórica em pré-escolares. Foi realizado um estudo seccional aninhado a uma coorte retrospectiva de 625 crianças entre 24 -71 meses, em São Luís, Maranhão. Um modelo hierarquizado foi avaliado em cinco níveis: 1º) Variáveis socioeconômicas (classe econômica, escolaridade materna, cor da pele); 2º) Variáveis de acesso; 3º) Baixo peso ao nascer e amamentação exclusiva; 4º) Peso para altura aos 12 meses e 5º) Gravidade da cárie e níveis de albumina (Alb). O desfecho foi desnutrição proteico-calórica (z escore altura para idade < -2). A prevalência do desfecho foi de 5,0 %, e da cárie foi de 32%. As variáveis do primeiro nível não foram associadas ao desfecho, porém a classe econômica foi mantida até o modelo final. As variáveis do segundo e do terceiro níveis não foram significativas. No quarto nível, peso para altura aos 12 meses não foi significativo, porém foi mantido até o modelo final. No último nível, os níveis de Alb não foram associados ao desfecho e a gravidade da doença cárie foi positivamente associada com desnutrição proteico-calórica em pré-escolares. A associação da gravidade da cárie com déficit antropométrico sinaliza que a saúde bucal deva ser parte importante nas políticas públicas de atenção à infância.

An analysis was conducted to evaluate if the severity of caries is associated with protein-calorie malnutrition in preschool children. The cross-sectional study was performed on a retrospective cohort of 625 children aged 24-71 months attending daycare centers in São Luís, Maranhão. A hierarchical model was evaluated at five levels: 1.) Socio-economic variables (economic group, mother's educational level and skin color); 2) Access variables; 3) Low birth weight (LBW) and exclusive breastfeeding; 4) Weight per height at 12 months; and 5) Severity of caries and albumin (Alb) levels. The outcome was protein-calorie malnourishment (weight per height z score < -2). The prevalence of outcome was 5.0% and the prevalence of caries was 32%. At the first level, the variables were not associated with the outcome, but the economic group was maintained until the final model. The variables in the second and third levels were not significant. At the fourth level, weight for height at 12 months was not significant, but was maintained until the final model. In the last level, severity of caries was positively associated with malnourishment. The association between severity of caries and malnourishment suggest that oral health should be integrated with public health care policies for children.