Effect of undernutrition on deciduous tooth emergence among Rajput children of Shimla District of Himachal Pradesh, India.

This article examines the influence of nutritional status on the emergence of deciduous dentition in a cross-sectional sample of 510 rural Rajput children from the Jubbal and Kotkhai Tehsils, Shimla District, Himachal Pradesh, India. The nutritional status of each child was evaluated using Z-scores of height/supine length-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ). The effects of sex and side on deciduous dental emergence were not statistically significant. Partial correlation indicates that the number of emerged teeth (T) was more strongly correlated with height than with other anthropometric variables. In most age groups, the stunted boys and girls (HAZ <-2) had fewer emerged teeth than nonstunted age peers (HAZ >-2). The mean T in underweight children was also less than that of the normal children, with a few exceptions. The stunted children have a significantly greater likelihood of delayed emergence of deciduous dentition. Measures of linear growth status are more closely related to dental development than measures of growth in mass. The findings indicate that even moderate undernutrition can delay deciduous tooth emergence.

Chronic malnutrition and oral health status in children aged 1 to 5 years: An observational study.

To evaluate the effect of chronic malnutrition on the oral health of children aged 1 to 5 years.An observational, analytical, cross-sectional study was conducted and involved 82 children (12-71 months of age). Nutritional status was evaluated using anthropometric indicators and oral health status/caries prevalence was measured. Non-stimulated saliva was collected and flow rate and buffering capacity was measured.The mean dmft index was 1.38 for the adequately nourished children, 3.04 for those with mild malnutrition, 2.5 for those with moderate malnutrition and 2.4 for those with severe malnutrition. 69 of the 82 children had low to very low buffering capacity. No significant differences among the groups were found between malnutrition and age, buffering capacity or the dmft index (P > .05). However, significant differences in salivary flow were found among the different malnutrition categories (P < .05). Spearman correlation coefficient revealed a weak negative correlation between nutrition and salivary flow (r = -0.267).Malnutrition exerts a negative impact on the oral cavity of children and a reduction in salivary flow rate was observed with the increase in malnutrition. Diagnosing the effects of malnutrition in oral environment of children is important because it could improve the quality of life and give them an adequate treatment.

Stress response in school-age children who have been growth retarded since early childhood.

BACKGROUND: Approximately 39% of children aged <5 y in developing countries are growth retarded (stunted) and many have poor mental development and behavioral abnormalities. Animal research suggests that an altered stress response may contribute to the negative outcomes following undernutrition. OBJECTIVE: We tested the hypothesis that stunted children have higher salivary cortisol concentrations and heart rates and altered behavior when compared with nonstunted children when social background was controlled for. DESIGN: We compared 30 stunted with 24 nonstunted children, all of whom were 8-10 y old and lived in the same poor areas of Kingston, Jamaica. All subjects were participants in a prospective, longitudinal, case-control study of children who were stunted in early childhood. We administered a test session (including psychologic and physical stressors), measured baseline and response levels of salivary cortisol and heart rate, and observed behavior. RESULTS: Compared with nonstunted children, stunted children had higher salivary cortisol concentrations (P = 0.007), had higher heart rates during the psychologic test session (P = 0.03), exhibited enhanced cardiovascular responsivity to a physical stressor (P = 0.04), vocalized less, were more inhibited, and were less attentive. After birth weight or social background and maternal and child intelligence quotients were controlled for, the differences in cortisol concentration and cardiovascular reactivity remained significant. CONCLUSIONS: Our findings suggest that consistent growth retardation since early childhood affects physiologic arousal, which, we speculate, may contribute to the poor cognitive functioning and immune responses of stunted children and the relation between adult short stature and increased cardiovascular risk.

Salivary cortisol and heart rate in stunted and nonstunted Nepalese school children.

OBJECTIVE: To test the hypothesis that stunted Nepalese children have an altered stress response system when compared with matched nonstunted children in response to a battery of psychological tests. DESIGN: Case-control study. SETTING: Poor urban areas of Kathmandu, Nepal. SUBJECTS: A total of 64 stunted (less than -2 s.d. height-for-age) children compared with 64 nonstunted (> -1s.d. height-for-age) schoolchildren between 8 and 10 y old matched for school and sex. METHODS: A psychological test session was administered, which included mental arithmetic and two tests of working memory. Salivary cortisol samples were obtained at five points during testing, and heart rate was measured during testing and also at baseline. Salivary cortisol samples were also obtained once early in the morning. Hemoglobin was assessed at the testing session, and extensive data were obtained on the social background of the children's families. RESULTS: Stunted Nepalese children showed a blunted physiologic response (salivary cortisol and heart rate) to psychological stressors (P<0.05) when compared with nonstunted children, but were not different from the nonstunted children in baseline measures, when controlling for social background. The two groups were not different in terms of social background. CONCLUSIONS: These findings suggest that childhood growth retardation may be associated with changes in physiological arousal, and that stunting could be associated with hyporesponsivity in response to psychological stress.

Inter-relationship between dental, skeletal and chronological ages in well-nourished and mal-nourished children.

Dental casts, wrist roentgenograms and full mouth radiographs of teeth of 80 mal-nourished and 40 well-nourished children were evaluated and compared for correlation of dental, skeletal and chronological ages. The findings revealed (1) very high correlation between dental and skeletal ages (r = 0.9584); (2) high correlation of chronological age with dental and skeletal ages (r = 0.8635 and r = 0.8716); (3) out of all the three correlations considered, dental and skeletal ages had the maximum correlation; (4) malnutrition had a significant adverse effect on the skeletal and dental ages. Greater the severity of malnutrition, more pronounced was its effect on the dental and skeletal ages; and (5) no evidence of severity of malocclusion with retarded skeletal and dental ages.