Nutritional status and its effect on dental health among children

Authors

  • Hend A. Alanazi Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia
  • Huda K. Alenazi Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia
  • Seham N. Alenazi Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia
  • Noura H. Alotaibi Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia
  • Khulud B. Alanazi Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia
  • Ahmed S. Alqahtani Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia
  • Yasser O. Alosaimi Department of Dentistry, Al Yamamah Hospital, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20223320

Keywords:

Malnutrition, Protein-energy malnutrition, Dental caries

Abstract

Nutritional status has a significant role in oral health and disease. Protein deficiency is the key deficiency in intermediate malnutrition. Malnutrition can disrupt homeostasis, resulting in disease progression of the oral cavity, decreased resistance to microbial biofilm, and decreased tissue healing capacity. This paper examines the association between malnutrition, protein-energy malnutrition, and dental health. Malnutrition is a risk factor for several dental diseases, such as dental caries and periodontal diseases. Studies have suggested that enamel hypoplasia, salivary gland hypofunction, and compositional changes in the saliva may be the mechanisms through which malnutrition is associated with caries. The exfoliation and eruption of teeth are impacted by malnutrition, or protein energy malnutrition (PEM), starting in the early years and continuing throughout infancy. The risk of hypoplasia was higher in malnourished children. The development of hypocalcemia as a result of diarrhoea in chronic undernutrition may explain the link between PEM and poor enamel formation. Deficiencies of vitamins A, C, and D are found to be associated with hypoplasia. Protein-deficit malnutrition and low vitamin D levels, as well as obesity, are risk factors for dental caries in children. Early childhood malnutrition affects salivary gland hypofunction and compositional changes in the saliva, and these might be the mechanisms through which malnutrition is associated with caries. Early childhood protein-energy malnutrition (ECPEM) is associated with poor periodontal status and causes cancrum oris, necrotizing gingivitis, and other periodontal disease conditions, as well as symptoms that mimic periodontal conditions.

References

Psoter WJ, Reid BC, Katz RV. Malnutrition and dental caries: a review of the literature. Caries Res. 2005;39(6):441-7.

Russell SL, Psoter WJ, Jean-Charles G, Prophte S, Gebrian B. Protein-energy malnutrition during early childhood and periodontal disease in the permanent dentition of Haitian adolescents aged 12-19 years: a retrospective cohort study. Int J Paediatric Dentistry. 2010;20(3):222-9.

Sheetal A, Hiremath VK, Patil AG, Sajjansetty S, Kumar SR. Malnutrition and its oral outcome - a review. J Clin Diagn Res. 2013;7(1):178-80.

Vargas-Palomino KE, Chipana-Herquinio CR, Arriola-Guillén LE. Oral health and oral hygiene conditions and nutritional status in children attending a health facility in the Huánuco Region, Peru. Revista peruana de medicina experimental y salud publica. 2019;36(4):653-7.

Alvarez JO, Lewis CA, Saman C, Caceda J, Montalvo J, Figueroa ML, et al. Chronic malnutrition, dental caries, and tooth exfoliation in Peruvian children aged 3-9 years. Am J Clin Nutr. 1988;48(2):368-72.

Ehizele A, Ojehanon P, Akhionbare O. Nutrition and oral health. Benin J Postgrad Med. 2009;11(1).

Madhusudhan KS, Khargekar N. Nutritional Status and its Relationship with Dental Caries among 3-6-year-old Anganwadi Children. Int J Clin Pediatr Dent. 2020;13(1):6-10.

Singh A, Bharathi M, Sequeira P, Acharya S, Bhat M. Oral health status and practices of 5 and 12 year old Indian tribal children. J Clin Pediatric Dentistry. 2011;35(3):325-30.

Vieira KA, Rosa-Júnior LS, Souza MAV, Santos NB, Florêncio T, Bussadori SK. Chronic malnutrition and oral health status in children aged 1 to 5 years: An observational study. Medicine. 2020;99(18):e19595.

Reis CLB, Barbosa MCF, Henklein S, Madalena IR, de Lima DC, Oliveira MAHM, et al. Nutritional Status is Associated with Permanent Tooth Eruption in a Group of Brazilian School Children. Global Pediatric Health. 2021;8:2333794-11034088.

Dimaisip-Nabuab J, Duijster D, Benzian H, Heinrich-Weltzien R, Homsavath A, Monse B, et al. Nutritional status, dental caries and tooth eruption in children: a longitudinal study in Cambodia, Indonesia and Lao PDR. BMC Pediatr. 2018;18(1):300.

Reis CLB, Barbosa MCF, Henklein S, Madalena IR, de Lima DC, Oliveira MAHM, et al. Nutritional Status is Associated with Permanent Tooth Eruption in a Group of Brazilian School Children. Global Pediatric Health. 2021;8:2333794-11034088.

Heinrich-Weltzien R, Zorn C, Monse B, Kromeyer-Hauschild K. Relationship between malnutrition and the number of permanent teeth in Filipino 10- to 13-year-olds. BioMed Res Int. 2013;205950.

Psoter W, Gebrian B, Prophete S, Bc R, Rv K. Effect of early childhood malnutrition on tooth eruption in Haitian adolescents. Comm Dentistry Oral Epidemiol. 2008;36:179-89.

Psoter W, Gebrian B, Prophete S, Reid B, Katz R. Effect of early childhood malnutrition on tooth eruption in Haitian adolescents. Comm Dentistry Oral Epidemiol. 2008;36(2):179-89.

Setiawan AS, Abhista N, Andisetyanto P, Indriyanti R, Suryanti N. Growth Stunting Implication in Children: A Review on Primary Tooth Eruption. Eur J Gen Dentistry. 2022;11(1):7-16.

Nikiforuk G, Fraser D. The etiology of enamel hypoplasia: a unifying concept. J Pediatr. 1981;98(6):888-93.

Tinawi M. Disorders of Calcium Metabolism: Hypocalcemia and Hypercalcemia. Cureus. 2021;13(1):e12420.

Folayan MO, El Tantawi M, Oginni AB, Alade M, Adeniyi A, Finlayson TL. Malnutrition, enamel defects, and early childhood caries in preschool children in a sub-urban Nigeria population. PloS One. 2020;15(7):e0232998.

Masterson EE, Fitzpatrick AL, Enquobahrie DA, Mancl LA, Conde E, Hujoel PP. Malnutrition-related early childhood exposures and enamel defects in the permanent dentition: A longitudinal study from the Bolivian Amazon. Am J Physical Anthropol. 2017;164(2):416-23.

Rugg-Gunn AJ, Al-Mohammadi SM, Butler TJ. Malnutrition and developmental defects of enamel in 2- to 6-year-old Saudi boys. Caries Res. 1998;32(3):181-92.

Gutierrez Gossweiler A, Martinez-Mier EA. Chapter 6: Vitamins and Oral Health. Monographs Oral Sci. 2020;28:59-67.

Mubaraki SA. Hypoplasia Resulting from Nutritional Deficiency: A Case Report. Int J Clin Pediatr Dent. 2019;12(6):573-6.

Hong L, Levy SM, Warren JJ, Broffitt B. Association between enamel hypoplasia and dental caries in primary second molars: a cohort study. Caries Res. 2009;43(5):345-53.

Montero MJ, Douglass JM, Mathieu GM. Prevalence of dental caries and enamel defects in Connecticut Head Start children. Pediatric Dentistry. 2003;25(3):235-9.

Oliveira AF, Chaves AM, Rosenblatt A. The influence of enamel defects on the development of early childhood caries in a population with low socioeconomic status: a longitudinal study. Caries Res. 2006;40(4):296-302.

Pascoe L, Seow WK. Enamel hypoplasia and dental caries in Australian aboriginal children: prevalence and correlation between the two diseases. Pediatric Dentistry. 1994;16(3):193-9.

Hayden C, Bowler JO, Chambers S, Freeman R, Humphris G, Richards D, et al. Obesity and dental caries in children: a systematic review and meta‐analysis. Comm Dentistry Oral Epidemiol. 2013;41(4):289-308.

Masumo R, Bardsen A, Mashoto K, Åstrøm AN. Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6-36 months old children in Uganda and Tanzania. BMC Oral Health. 2012;12:24.

Nunn ME, Braunstein NS, Krall Kaye EA, Dietrich T, Garcia RI, Henshaw MM. Healthy eating index is a predictor of early childhood caries. J Dent Res. 2009;88(4):361-6.

Shakya A, Shenoy R, Rao A. Correlation between malnutrition and dental caries in children. J Nepal Paediatric Soc. 2013;33(2):99-102.

Heba E, Deema F, Leena M, Najat F, Sumer A, Najlaa A, et al. Prevalence of obesity among preschool children and its relation with dental caries. J Dentistry Oral Hygiene. 2017;9(1):1-7.

Bafti LS, Hashemipour MA, Poureslami H, Hoseinian Z. Relationship between Body Mass Index and Tooth Decay in a Population of 3-6-Year-Old Children in Iran. Int J Dentistry. 2015;126530.

Liang JJ, Zhang ZQ, Chen YJ, Mai JC, Ma J, Yang WH, et al. Dental caries is negatively correlated with body mass index among 7-9 years old children in Guangzhou, China. BMC Public Health. 2016;16:638.

Soares ME, Ramos-Jorge ML, de Alencar BM, Oliveira SG, Pereira LJ, Ramos-Jorge J. Influence of masticatory function, dental caries and socioeconomic status on the body mass index of preschool children. Arch Oral Biol. 2017;81:69-73.

Manohar N, Hayen A, Fahey P, Arora A. Obesity and dental caries in early childhood: A systematic review and meta-analyses. Obesity Rev. 2020;21(3):e12960.

Atasoy HB, Ulusoy ZI. The relationship between zinc deficiency and children's oral health. Pediatric Dentistry. 2012;34(5):383-6.

Hujoel PP. Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis. Nutrition Rev. 2013;71(2):88-97.

Williams TL, Boyle J, Mittermuller BA, Carrico C, Schroth RJ. Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children. Nutrients. 2021;13(12).

Carvalho Silva C, Mendes R, Manso MDC, Gavinha S, Melo P. Prenatal or Childhood Serum Levels of Vitamin D and Dental Caries in Paediatric Patients: A Systematic Review. Oral Health Prev Dentistry. 2020;18(1):653-67.

Schroth RJ, Lavelle C, Tate R, Bruce S, Billings RJ, Moffatt MEK. Prenatal Vitamin D and Dental Caries in Infants. Pediatrics. 2014;133(5):e1277-84.

Kim I-J, Lee H-S, Ju H-J, Na J-Y, Oh H-W. A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children. BMC Oral Health. 2018;18(1):43.

Lin HS, Lin JR, Hu SW, Kuo HC, Yang YH. Association of dietary calcium, phosphorus, and magnesium intake with caries status among schoolchildren. Kaohsiung J Med Sci. 2014;30(4):206-12.

Spielmann N, Wong DT. Saliva: diagnostics and therapeutic perspectives. Oral Dis. 2011;17(4):345-54.

Singh P, Dua S, Varshney T, Saha S. A study to assess reaction time and its association with adiposity indices in healthy individuals in Uttarakhand. Indian J Dent Sci. 2018;10(2):78-82.

Johansson I, Saellström AK, Rajan BP, Parameswaran A. Salivary flow and dental caries in Indian children suffering from chronic malnutrition. Caries Res. 1992;26(1):38-43.

Psoter WJ, Spielman AL, Gebrian B, St Jean R, Katz RV. Effect of childhood malnutrition on salivary flow and pH. Arch Oral Biol. 2008;53(3):231-7.

Hashem D, El-Bayoumy S, Fahmy W, El Malt M. Effect of Childhood Malnutrition on Salivary Flow and pH. Al-Azhar Dent J Girls. 2016;3(2):141-5.

Russell S, Psoter W, Jean-Charles G, Prophte S, Gebrian B. Protein-energy malnutrition during early childhood and periodontal disease in the permanent dentition of Haitian adolescents aged 12–19 years: A Retrospective Cohort Study. Int J Paediatric Dentistry. 2010;20:222-9.

Enwonwu CO, Phillips RS, Ferrell CD. Temporal relationship between the occurrence of fresh noma and the timing of linear growth retardation in Nigerian children. Trop Med Int Health. 2005;10(1):65-73.

Jiménez LM, Duque FL, Baer PN, Jiménez SB. Necrotizing ulcerative periodontal diseases in children and young adults in Medellín, Colombia, 1965--2000. J Int Acad Periodontol. 2005;7(2):55-63.

Cazzolla AP, Cosola MD, Ballini A, Santacroce L, Lovero R, Testa NF, et al. The Association between Nutritional Alterations and Oral Lesions in a Pediatric Population: An Epidemiological Study. BioMed Res Int. 2021;9992451.

Słotwińska SM, Słotwiński R. Host response, malnutrition and oral diseases. Part 1. Central-Eur J Immunol. 2014;39(4):518-21.

Farley E, Mehta U, Srour ML, Lenglet A. Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021). PLoS Neglected Trop Dis. 2021;15(12):e0009844.

Enwonwu CO, Falkler WA Jr, Idigbe EO, Afolabi BM, Ibrahim M, Onwujekwe D, et al. Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection. Am J Trop Med Hygiene. 1999;60(2):223-32.

Downloads

Published

2022-12-29

How to Cite

Alanazi, H. A., Alenazi, H. K., Alenazi, S. N., Alotaibi, N. H., Alanazi, K. B., Alqahtani, A. S., & Alosaimi, Y. O. (2022). Nutritional status and its effect on dental health among children. International Journal Of Community Medicine And Public Health, 10(1), 393–397. https://doi.org/10.18203/2394-6040.ijcmph20223320

Issue

Section

Review Articles