TABLE 3.

Literature reviews of the included studies¹

Study (reference)	Study design	Initial data and follow-up scheme	Sample size, n	Measurements taken	Key findings
Gerdin et al. (24)	Cohort study	• Initial: 4-y-old	2303	• Caries: deft (6-y-old), DFT (10 and 12-y-old), and DFSa	• Children who were obese at age 4-y-old had more caries when they were 12-y-old compared with those who had normal weight at 4-y-old; DFT: 1.1 vs. 0.7*
		• Follow-up: BMI (4, 5, 7, and 10-y-old), dental status (6, 10, and 12-y-old) and socioeconomic status (10-y-old)		• Anthropometric: isoBMI	• Similar results were seen when comparing children who were not obese at 10-y-old
					• DFSa: overweight or obese at 4, 5, 7, and 10-y-old > normal weight from 4 to 10-y-old > overweight or obese at 4 y but with normal weight at 5, 7, and 10-y-old*
					• Childhood BMI had independent weak effect on caries prevalence at 12-y-old; adjusted estimate (β-value ± SE): BMI at 4-y-old: 0.048 ± 0.020*; 5-y-old: 0.050 ± 0.018**; 7-y-old: 0.032 ± 0.013*; 10-y-old: 0.024 ± 0.009*
Lempert et al. (25)	Case-control study	• Initial: 9.6-y-old	385	• Caries: dmft and DMFT	• No significant association was found between caries experience and BMI or △BMI; adjusted estimate (β-value ± SE) △BMI: −0.022 ± 0.020; △BMI z score: −0.010 ± 0.007
		• Follow-up: 6 y later (from 1997 to 2003)	280	• Anthropometric: BMI, BMI z score, and △BMI	• Inverse association was found between caries at baseline and subsequent changes in BMI over a period of 6 y later in children whose mothers were well educated; adjusted estimate (β-value ± SE) △BMI: −0.059 ± 0.024*; △BMI z score: −0.023 ± 0.009
Scheutz et al. (17)	Cohort study	• Initial: mean 7.6-y-old	145	• Caries: DMFS and new caries lesions in the permanent dentition	• No significant difference in new caries lesions was found between malnourished children (BMI z score ≤1.96 SDs) and those without malnutrition (BMI z score >1.96 SDs); crude RR: 1.42; adjusted RR: 1.55 (95% CI: 0.92, 2.62)
		• Follow up: 6 y later (from 1997 to 2003)		• Anthropometric: BMI (without clear criteria)
Sánchez-Perez et al. (16)	Cohort study	• Initial: 7-y-old	110 (7-y-old)	• Caries: dmft, DMFT, dmfs, and DMFS	• Children with a higher BMI had lower amounts of dental caries in primary dentition**
		• Follow-up: 4 y later (examination at each year)	88 (11-y-old)	• Anthropometric: BMI (CDC criteria)	• The effects of the risk of being overweight and actually being overweight were significantly negative when compared with thin children*; dmft: 7-y-old: 3.2 vs. 6.2 9-y-old: 2.1 vs. 5.8
					• No association was found between BMI and DMFS scores in permanent dentition
Peres et al. (26)	Cross-sectional study (nested in a birth cohort study)	• At birth: socioeconomic and demographics variables	359 (6-y-old for survey)	• Caries: DMFT	• No significant difference was found for caries between different groups of birth weight and gestation age
		• 6-y-old: oral health–related behaviors, dental service use, and primary dental caries	339 (12-y-old for oral examination)	• Anthropometric: height-for-age z score at 1 and 4-y-old and birth weight	• The prevalence of caries (DMFT ≥1) in 12-y-old children with height deficiency at 1-y-old (height-for-age z score ≤2) was significantly higher than for children with adequate height (height-for-age z score >2); prevalence of caries: 82.1% vs. 49.2%**
		• 12-y-old: family economic level, oral health–related behaviors, dental service use, and dental caries			• Mean DMFT of 12-y-old children with height-for-age z score ≤2 at 1-y-old was significantly higher than for children with height-for-age z score > 2; mean DMFT: 1.86 vs. 1.18**
					• The prevalence of caries (DMFT ≥1) in 12-y-old children with height deficiency at 4-y-old (height-for-age z score ≤2) was significantly higher than for children with adequate height (height-for-age z score >2); prevalence of caries: 82.1% vs.49.0%**
					• Mean DMFT of 12-y-old children with height-for-age z score ≤2 at 4-y-old was significantly higher than for children with height-for-age z score >2; adjusted RR: 1.50 (95% CI 1.03, 2.18)
					• No interactions were found between height-for-age deficiency at 1-y-old and dental caries at 6-y-old in primary dentition
Peres et al. (27)	Cross- sectional study (nested in a birth cohort study)	• Initial: at birth	352 (6-y-old)	• Caries: dmft	• No significant difference of high amount of dental caries (dmft ≥4) was found in 6-y-old children between the adequate (>2500 g) birth weight group and the low (≤2500 g) birth weight group
		• Follow up: 0.08, 0.25, 0.5, 1, and 6-y-old		• Anthropometric: birth weight, height by age at 1-y-old, weight by height at 1-y-old, and weight by age at 1-y-old	• Children with height deficiency for 1-y-old (height-for-age z score ≤2) had a significantly higher chance of having a high amount of dental caries (dmft ≥4) than those with adequate height for age at 1-y-old; adjusted OR (inadequate group): 4.5 (95% CI: 1.5, 13.6)*
					• No significant difference of a high amount of dental caries (dmft ≥4) was found in 6-y-old children between the group with adequate weight by age at 1-y-old (z score >2) and those with inadequate weight by age at 1-y-old (z score ≤2)
					• No significant difference of a high amount of dental caries (dmft ≥4) was found in 6-y-old children between the group with adequate weight by height at 1-y-old (z score >2) and those with inadequate weight by height at 1-y-old (z score ≤2)
Alvarez (32)	2 cross-sectional studies and a longitudinal study	For longitudinal study:	209	• Caries: deft, DMFT, DMFS, and dft	• The deft of stunted and wasted children at 4-y-old was significantly higher than the normal, wasted, stunted groups*
		• Initial: 0.5-y-old and 0.92-y-old		• Anthropometric: height and weight (classified into normal, wasted, stunted, and stunted and wasted groups by NCHS)	• The proportion of stunted and wasted children at 4-y-old with ≤3 caries was significantly lower than the normal, wasted, stunted groups; the percentage of children with 0–3 deft: 3.4% (stunted and wasted group) vs. 35% (normal group) vs. 20% (stunted group) vs. 37% (wasted group)
		• Follow-up: 4 y later			• The dft of stunted and wasted children at 6-y-old was significantly higher than the normal, wasted, stunted groups**
					• The DMFS of stunted and wasted children at 6-y-old was significantly higher than the normal, wasted, stunted groups**
					• The DMFT of stunted and wasted children at 6-y-old was significantly higher than the normal, wasted, stunted groups*
Kay et al. (28)	Case-control study	• Initial: at birth	985	• Caries: dmft	• No association was found between caries and current weight
		• Follow-up: 5.08 y later		• Anthropometric: weight, height, birth weight, birth height, and BMI	• Higher birth weight was associated with increased risk of caries; model a and c: OR: 1.05 (95% CI: 1.01,1.08)**; model d: OR: 1.08 (95% CI: 1.03,1.13)
					• No association was found between caries and current height
					• Higher birth height was associated with increased risk of caries; model a: OR: 1.08 (95% CI: 1.01,1.16)*; model c: OR: 1.09 (95% CI: 1.01,1.18)*; model d: OR: 1.14 (95% CI: 1.03,1.26)*
					• Children who had caries at 5.08-y-old had a smaller increase in weight (measured as change in SD score) than those without tooth decay; change in SD score (model d): “no caries” vs. “any caries”: 0.183 vs. −0.142**
					• Children who had caries at 61-mo-old had a smaller increase in height (measured as change in SD score) than those without tooth decay; change in SD score (not adjusted): “no caries” vs. “any caries”: 0.026 vs. −0.151*
					• No association was found between BMI1 and dental caries
Werner et al. (23)	Case-control study	• Initial: 6- to 9-y-old	230	• Caries: DT, dt, new caries lesion	• DT at the initial exam was not significantly different between different BMI groups
		• Follow-up: mean interval, 1.8 y later		• Anthropometric: height, weight, and BMI (categorized into underweight /healthy weight, overweight, and obese groups)	• Overweight and obese children had less dt than underweight/healthy children
					• Obese vs. overweight vs. underweight/healthy: 34% vs. 30% vs. 51%*
					• The presence of new carious lesions at recall exams in primary teeth and permanent teeth was not significantly different between different BMI groups
Delgado-Angulo et al. (30)	Cohort study	• Initial: 7- to 9-y-old	121	• Caries: net DMFS increment	• Stunting was related to net DMFS increment. CDC criteria: IRR: 1.61 (95% CI: 1.07, 2.44); WHO standards: IRR: 1.79 (95% CI: 1.28, 2.51)
		• Follow-up: 3.5 y later	83	• Anthropometric: height and weight (defined stunting using 2000 CDC and 2007 WHO criteria)
Seow et al. (22)	Case-control study	• Initial: at birth	617	• Caries: ECC-free or ECC	• The birth weight of ECC group was not significantly different from birth weight of non-ECC group
		• Follow-up: until 4-y-old		• Anthropometric: birth weight
Nelson et al. (18)	Cohort study	• Initial: at birth	224 (80 HR-VLBW, 59 LR-VLBW, and 85 term adolescents)	• Caries: DMFT-IM and DMFT	• The term adolescents had significantly increased DMFT-IM and DMFT scores compared with the LR-VLBW group; unadjusted means ± SDs: HR-VLBW vs. LR-VLBW vs. term DMFT-IM scores (means ± SDs): 1.06 ± 1.6 vs. 1.00 ± 1.5 vs. 1.49 ± 1.7; total DMFT scores (means ± SDs): 1.70 ± 3.1 vs. 1.56 ± 2.1 vs. 2.39 ± 2.9; adjusted estimated by race, sex, SES, age, sociodemographics DMFT-IM % increase: 26.1 vs. 26.2 (term vs. HR-VLBW), 60.1 vs. 35.4 (term vs. LR-VLBW); DMFT % increase: 33.5 vs. 29.6 (term vs. HR-VLBW), 71.6 vs. 36.8 (term vs. HR-VLBW)*
		• Follow-up: 14 y later		• Anthropometric: birth weight (HR-VLBW and LR-VLBW)
Lai et al. (20)	Case-control study	• Initial: at birth	50 (25 cases and 25 controls)	• Caries: dt, ft, and dmft	• Prevalence of dental caries in the VLBW children was not significantly different from that of NBW
		• Follow-up: 2.5-, 3.67-, and 4.33-y-old		• Anthropometric: birth weight (VLBW)	• VLBW vs. NBW (means dmft ± SDs): 2.5-y-old: 0 vs. 0 ± 0.2; 3.67-y-old: 0.6 ± 1.4 vs. 0.5 ± 1.5; 4.33-y-old: 0.8 ± 1.5 vs. 1.4 ± 3.2
Ismail et al. (31)	Cohort study	• Initial: 0- to 5-y-old	788	• Caries: d1–6mfs and d3–6mfs (ICDAS criteria)	• Children in the highest weight-for-age percentile group (84.3–100%) had a significantly higher d3–6mfs than the lowest weight-for-age percentile group (0–26.9%); IRR: 0.8 (95% CI: 0.6, 1.0)*
		• Follow-up: 2 y later		• Anthropometric: weight for age	• Children in the higher weight-for-age percentile group (27.0–56.4%) had a significantly higher d3–6mfs than the lowest weight-for-age percentile group (0–26.9%); IRR: 0.6 (95% CI: 0.4 1.0)*
Rajshekar and Laxminarayan (21)	Case-control study	• Initial: at birth	500 (250 FTNBW and 250 PTNBW)	• Caries: dmft, dt, mt, and ft	• The caries rate (dmft >0) in PTLBW was significantly higher than in the FTNBW group; caries rate: 48% vs. 38.8%*
		• Follow-up: 3–5.5 y later		• Anthropometric: birth weight (FTNBW, PTNBW)	• The mean dmft, dt, mt, and ft of FTNBW groups were not significantly different from the PTLBW group
					• Mean dmft was significantly higher in the PTLBW girl group than in the FTNBW girl group; mean dmft: 1.3 ± 1.9 vs. 0.7 ± 1.4**
					• The mean dmft was not significantly different between PTLBW and FTNBW boy groups
Zhou et al. (19)	Cohort study	• Initial: at birth	225	• Caries: dmfs	• ECC was not significantly related to birth weight (P = 0.128)
		• Follow-up: 0.67, 1.17, 1.67, and 2.67 y later		• Anthropometric: birth weight (≥2500 g, <2500g)	• ECC was significantly related to children’s z values of weight and height**; z values of weight: IDR: 0.77 (0.67, 0.88) (P < 0.001)**; z values of height: IDR: 1.41 (1.12, 1.78) (P < 0.003)**
Shulman (29)	Case-control study	• Initial: at birth	4207	• Caries: dfs	• Mean dft was not related to birth weight (P < 0.096)
		• Follow-up: 2–6 y later		• Anthropometric: birth weight

¹*P < 0.05, **P < 0.01. deft, the number of decayed, extracted, and filled primary teeth; dfs, the number of decayed and filled primary tooth surfaces; DFSa, the number of decayed and filled approximal permanent tooth surfaces; dft, the number of decayed and filled primary teeth; DFT, the number of decayed and filled permanent teeth; dmfs, the number of decayed, missing, and filled primary tooth surfaces; d_1–6mfs, the number of decayed, missing, and filled primary tooth surfaces according to ICDAS codes 1–6; d_3–6mfs, the number of decayed, missing, and filled primary tooth surfaces according to ICDAS codes 3–6; DMFS, the number of decayed, missing, and filled permanent tooth surfaces; dmft, the number of decayed, missing, and filled primary teeth; DMFT, the number of decayed, missing, and filled permanent teeth; DMFT-IM, the number of decayed, missing, and filled permanent teeth of incisors and molars; dt, the number of decayed primary teeth; DT, the number of decayed permanent teeth; ECC, early childhood caries; ft, the number of filled primary teeth; FTNBW, full term and normal birth weight; HR-VLBW: very low birth weight adolescents with high risk; ICDAS, International Caries Detection and Assessment System; IDR, xxx ; IRR, incidence rate ratio; isoBMI, international age- and sex-adjusted BMI; LR-VLBW, very low birth weight adolescents with low risk; mt, the number of missing primary teeth; NBW, normal birth weight; NCHS, National Center for Health Statistics; PTLBW, preterm and low birth weight; Δ, change.