Nutritional counseling can benefit families and create healthy food choices. If a dietitian can show how to buy healthy food at a low cost, it can help families eat healthier and have fewer medical and dental problems. The relationship between childhood dental caries and childhood obesity is a multifactorial issue that includes age, race, ethnicity, gender, socioeconomic status, living in a rural versus urban area, and insurance.
Does an obese child living in a low socioeconomic area have an increased risk of childhood dental caries? When looking at research on the association between childhood caries and childhood obesity, multiple variables and factors come into play – different indicators used to collect data, surveys, reliability of data, sample size and time constraints for to mention a few.
While fluoridated water has helped alleviate tooth decay in children, it cannot stop the disease. Early childhood tooth decay is five times more common than asthma, yet there is a lack of support around the issue.6 More than 50% of children aged five to nine have at least one cavity or filling, and this rises to 78% among 17-year-olds.6 More than 51 million school hours are lost due to dental disease.5
According to European Journal of Pediatric Dentistry (EJPD), Dental hygiene plays an important role in reducing tooth decay. Children are not allowed to brush and floss twice a day. They may have irregular hygiene at home and often eat after brushing. One study looked at schools that took preventive measures by providing toothbrushes and toothpaste for children to brush after lunch.2
Bio Med Central reported that 99.8% of the children in their study had a dental problem, whether it was tooth decay, tartar, gingivitis, or periodontal disease, with untreated tooth decay being the most common. Also, boys had 100% dental problems and women had slightly less. There was no reason or evidence as to why this happened. The study showed that lack of parental education was a major issue. Many parents believe that because baby teeth will be replaced by permanent teeth, they don’t need to take cavities seriously, even though their children’s dental services are covered by insurance.3
Early caries detection and non-invasive interventions are important for caries prevention according to Journal of the American Dental Association (JADA). Not all lesions progress to cavitation, but how do we determine which white spot lesions will progress?
Some surveys included questionnaires to obtain information about fluoride intake from water, dietary fluoride supplements, and fluoride toothpaste. Fluoride intake was used as a control variable in models developed to predict caries risk.4 Studies show that topical fluoride can also help reduce tooth decay and remineralize enamel. It is recommended to apply fluoride varnish at least every six months to be effective in reducing tooth decay.
The research I found was able to present evidence that in some aspects there is a direct correlation between obesity and childhood tooth decay. However, I think more research is needed on this topic. Both childhood obesity and caries risk are multifactorial as separate entities. Combining the two makes it much more complicated. Different aspects of this topic need to be evaluated in depth to give more specific, valid, well-rounded research results with a study population of sufficient size. RDH
Dental sealant programs for school
According to the CDC, children in low socioeconomic areas are less likely to have dental fillings and have more urgent dental needs than children in high socioeconomic areas. Having a dental sealant program in schools located in low-income areas will help reduce tooth decay, increase early detection of tooth decay, and educate children about oral care. These programs have had a great impact on these communities. Research has also shown that most children in low-income areas do not use their insurance and often go without dental care. By fitting sealants to children at school, we can reduce time lost in the classroom due to illness or pain and provide children with the care they need. Dental sealants and preventive care can help improve children’s oral health and reduce their risk of pain and fear of the dentist.
Here are three noteworthy statistics released by the CDC in October 2016 from research gathered from school sealant programs. These statistics speak volumes!
- “About 43% of children aged six to 11 had a dental filling. Low-income children were 20% less likely to have sealants than higher-income children.”
- “School-aged children without sealants have nearly three times as many cavities as children with sealants.”
- “Applying sealants in school-based programs to the nearly seven million low-income children who do not have them could save up to $300 million in dental treatment costs.”
Children from low-income areas often eat their meals through school meal programs, local food pantries and soup kitchens. The foods provided are not always the healthiest and certainly not the best for children’s teeth. These factors influence childhood obesity and high dental caries in children. How can we bridge the gap? How can we give these children greater access to care?
The multidisciplinary workforce can help these children by offering education, dental care, medical care, behavioral health care, and nutritional counseling. Dentists can also help bridge this gap by working in public health settings and caring for children. Dental sealants are a great way to help fight tooth decay, and if we put all these pieces of work together, the results can make a huge impact!
-Katie Melko, RDH, MSDH
Katie Melko, RDH, MSDH, is a public health hygienist at Community Health Center Inc. He graduated from the Fones School of Dental Hygiene at the University of Bridgeport in 2016 with an MSDH. He is involved in three working groups, two for ADHA and one for NBDHE, and has been practicing dental hygiene since 2009.
bibliographical references
1. Alswat K, Waleed SM, Moustafa AW, Ahmed AA. The association between body mass index and dental caries: a cross-sectional study. J Clin Med Res Journal of Clinical Medicine Research 8.2 (2016): 147-52. Web.
2. Costacurta ML, DiRenzo L, Sicuro L. Dental caries and childhood obesity: analysis of food intake, lifestyles. European Journal of Pediatric Dentistry (2014): n. pp. Web.
3. Yang RJ, Sheu JJ, Chen HS, Lin KC, Huang HL. Morbidity at entry to primary school differs by gender and level of residential urbanization: a comparative cross-sectional study. BMC Public Health 7.1 (2007): 358. Web.
4. Marshall TA, Eichenberger-Gilmore JM, Broffitt BA, Warren JJ, Levy SM. Dental caries and childhood obesity: roles of diet and socioeconomic status. Community Dentistry and Oral Epidemiology 35.6 (2007): 449-58. Web.
5. Oral Health in America: A Report of the Surgeon General (Executive Summary). Np, n.d. Web. 26 Apr 2016.
6. Werner S, Phillips C. Association between childhood obesity and dental caries. Pediatric Dentistry 34.1 (2012): 23-27. Web.
