The Relationship Between Dental Caries and the Health Status of Anganwadi Children Aged 3–6 Years

Abstract

Introduction:

One of the most prevalent chronic oral diseases affecting children worldwide is dental caries. Every patient must have their caries risk evaluated, and this assessment needs to be done regularly. Primary preventive care should be provided to all children in order to lower their risk of dental cavities.

Aim:

This study was done to evaluate children’s dental caries status between the ages of three and six and investigate how it relates to their general health.

Material and Methods:

About 550 children between the ages of three and six, both male and female, were chosen at random to be screened. To determine if the child’s weight was suitable for their height, the body mass index (BMI) was calculated. Anthropometric data and dental caries status were recorded using a standardized proforma.

Results:

The results revealed that the mean decayed, extracted due to caries, or filled teeth (def) score increased significantly with age, and although the def score was nonsignificantly higher among males (226; 82.2%) compared to females (210; 76.6%). Furthermore, children’s dental caries status is highly influenced by both age and BMI.

Conclusion:

From the study, it can be concluded that BMI generally determines health status. If BMI is altered, its effect is seen in our overall health. In the present study, both age and BMI were found to have a significant impact on the dental caries status of children.

INTRODUCTION

Dental caries remains one of the most widespread and enduring oral diseases affecting children globally. It could be a major well-being issue, both from a population’s well-being point of view and for the person’s family, as they have to deal with small children who suffer from toothaches.[1]

An infant’s development depends heavily on a balanced diet.[2] A well-balanced diet that provides adequate calories and nutrients, distributed appropriately throughout the day, supports optimal physical and cognitive development in children. As children eat more sugar, they are more inclined to develop dental caries; thus, it is critical to provide legitimate nutrition instruction to the families and institutions.[3] The consumption of honey, sugary drinks, and added sugars, especially at night when salivary flow is significantly reduced through a pacifier or bottle in very young children, can lead to demineralization of the crowns of primary teeth. This early demineralization may progress into cavities, ultimately affecting oral health and disrupting the quality of the baby’s sleep.[2]

The second major health issue affecting children in India is malnutrition. It describes a cellular mismatch between the body’s requirements for development, maintenance, and vital processes and the nutritional and energy intake. The oral cavity is affected by malnutrition both before and after eruption. Early malnutrition can impact tooth development, postpone eruption, and increase the risk of dental caries, as numerous studies have shown. Changes in the content of saliva and decreased salivary gland activity are also associated with this increased vulnerability to dental cavities.[4,5]

A previous study considered only malnutrition as a criterion for association with dental caries; hence, in this study, we also included high sugar intake in dental caries. Moreover, this is the first such study conducted in the Mithilanchal region.

MATERIALS AND METHODS

This study aims to assess the dental caries status among children aged 3 to 6 years and its relationship with the health status of the child. Objectives of the study were to assess the health status of 3–6-year-old Anganwadi children using body mass index (BMI), to evaluate the dental caries status among 3–6-year-old Anganwadi children, and to assess the relationship between health status, as measured by BMI, and dental caries in 3–6-year-old Anganwadi children.

This study was carried out in Anganwadi centers of the Mithilanchal region of Darbhanga district and nearby areas in Bihar. A randomized sample of 550 children, including both boys and girls who were aged between 3 and 6 years, was selected for screening. During the screening process, the following criteria were applied: With their heels together and their shoulders, buttocks, and heels positioned against a vertical support, children stood barefoot. A portable glass electronic digital scale was used to measure weight in kilograms.

The study included children who could stand alone, were cooperative, were residents of the area, and had no pre-existing medical conditions. Children with severe malnutrition and those with particular medical needs were not allowed to participate in the trial. Anthropometric measurements, including body weight and height, were recorded to evaluate the nutritional status of the children by a single investigator. Table 1 presents the distribution of BMI and dental caries status according to age group and gender among all study participants.

Table 1.

Distribution of BMI and dental caries status according to age group and gender

Distribution of BMI
BMI classification		According to age												According to gender
		3–4 years				4–5 years				5–6 years				Female				Male
		n		%		n		%		n		%		n		%		n		%
Underweight		17		20.5		87		43.9		92		34.3		115		42.0		81		29.5
Normal		57		68.7		99		50.0		160		59.7		136		49.6		180		65.5
Risk of overweight		9		10.8		7		3.5		10		3.7		16		5.8		10		3.6
Overweight		0		0.0		5		2.5		6		2.2		7		2.6		4		1.5
Total		83		100.0		198		100.0		268		100.0		274		100.0		275		100.0
Dental caries status
Caries status		According to age												According to gender
		3–4 years				4–5 years				5–6 years				Female				Male
		n		%		n		%		N				n		%		n		%
Absent		30		36.1		42		21.2		41		Absent		30		36.1		42		21.2
Present		53		63.9		156		78.8		227		Present		53		63.9		156		78.8
Total		83		100.0		198		100.0		268		Total		83		100.0		198		100.0
Chi-sq		16.9						P		<0.001**				Chi-sq		2.576		P		0.108 (NS)

**Highly significant (P<0.001); NS: Not significant (P>0.05); BMI: body mass index; Chi-sq: Chi-squared

RESULTS

The mean decayed, extracted due to caries, or filled teeth (def) score increased significantly with age, according to the results, and this difference was statistically significant (P < 0.001). Although the difference between boys and girls was not statistically significant (P = 0.108), males exhibited a higher def score—226 children (82.2%)—compared to females—210 children (76.6%). The result shows that dental caries status according to BMI is statistically highly significant (P < 0.001) [Table 1].

DISCUSSION

BMI is a tool used to evaluate an individual’s weight in relation to their height in relation to each other, helping to categorize them into specific health or nutritional status groups.[6] By calculating BMI, individuals can be broadly classified as underweight, normal weight, overweight, and obese.

According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), for individuals aged 2 to 19 years, BMI is interpreted using age- and sex-specific percentiles to account for variations in growth and development. The highest concern is for obese individuals, who fall above the 95^th percentile, followed by overweight (85–95 percentile), healthy weight (5–85 percentile), and underweight (below 5 percentile).

Malnutrition increases a child’s vulnerability to infections, while infections can worsen malnutrition by suppressing appetite, triggering catabolic processes, and raising nutritional demands. As a result, malnutrition and infections are recognized as two of the most significant factors affecting children’s growth. Preschool-aged children are particularly at risk within any community.

Saliva’s inherent defenses against plaque acids may be compromised by changes in its composition. Precise information on the oral and general health of children is essential for tracking and promoting healthy development. Nevertheless, there are not many thorough studies examining the relationship between children’s dental health and nutrition. Determining the relationship between dental caries and health status in Anganwadi children aged 3 to 6 from the Mithilanchal region of Darbhanga was the goal of the current study. The study sought to determine whether there was a possible correlation between the prevalence of dental caries and BMI, which was used to assess health conditions in general.[7]

The current investigation was restricted to anthropometric measurements and clinical tests due to time, money, and resource limitations. The development and execution of focused health promotion initiatives, as well as additional research to better understand children’s nutritional status and dental health, are advised.

CONCLUSION

Anganwadi centers are a vital part of India’s public health and education system, particularly in rural areas. Most of the families benefiting from the Anganwadi center are economically weak. The food provided under this service reduces the financial burden of the family. Thus, the services of supplemental nutrition impact both health and the economy of the family by reducing their economic burden. Health status is generally determined by BMI. If BMI is altered, its effect is seen in our overall health. The results of this study show that children’s dental caries status is highly influenced by both age and BMI.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.