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The association between nutritional status and dental caries in low-income children: a multi-level analysis.

BACKGROUND
The possible association between obesity, underweight and dental caries remains in debate. In addition, the role of sugar consumption on the abovementioned relationship was little explored.


AIM
This study aimed to investigate the relationship between nutritional status and dental caries in 12 years-old low-income children.


DESIGN
This cross-sectional school-based study involved 406 12-year-old children living with limited economic resources. Dental caries was assessed using the decayed component of DMFT and PUFA/pufa index. Children were weighed and measured to assess nutritional status according to z-score/Body Mass Index. Data on socioeconomic and demographic characteristics, sugar consumption, sedentary behaviour and psychosocial factors were collected through validated questionnaires. Multivariable multilevel Poisson regression was performed.


RESULTS
Underweight children had 60% (RR=1.60; 95% CI 1.13-2.57) higher mean of decayed teeth and had mean PUFA/pufa 2.8 times higher than children with normal nutritional status. Underweight children with high annual sugar intake had a greater mean of decayed teeth (RR=2.72; 95% CI 1.46-5.06) than underweight children with low sugar intake.


CONCLUSIONS
Our findings suggest that malnutrition is associated with dental caries among children from low-income families.