Association Between Body Mass Index and Caries Lesions in Preschool Children in Santiago, Chile / Asociación entre Lesiones de Caries y Estado Nutricional en Niños Preescolares de la Región Metropolitana

ABSTRACT: The objective of the study was to determine the association between caries prevalence and body mass index (BMI) in preschool children in Santiago, Chile. Children aged 2 and 3 years old (n = 342) attending 16 nursery schools in Santiago, Chile were examined to record the status of dental caries using the modified criteria of the International Caries Detection and Assessment System (ICDAS II) (International Caries Detection and Assessment System (ICDAS) Coordinating Committee, 2005). BMI was calculated for each of the subjects and their nutritional state was classified as underweight, normal-weight, overweight and obesity according to the WHO. The caries prevalence (ICDAS 2-6 > 0) of the children was 45.9 % (IC 95 % 40.50 - 51.21). Data showed that none of the preschoolers were underweight. 39.1 % were classified as normal-weight (IC 95 % 33.98 - 44.38), 34.8 % as overweight (IC 95 % 29.72 - 39.86) and 26 % as obese (IC 95 % 21.34 - 30.96). Normal-weight children had a prevalence of 51.5 % of ICDAS 2-6 lesions and prevalence of 28.3 % of ICDAS 5-6 lesions. Children with overweight had prevalence of 51.4 % ICDAS 2-6 lesions and of 19.3 % ICDAS 5-6 lesions, and obese children of 39.5 % and 25.8 % respectively. Subjects with normal-weight presented a mean of ICDAS 2-6 caries lesions significantly higher (p < 0.05) than the rest of the children. In conclusion, normal-weight preschool children presented a higher prevalence of caries lesions than those with overweight and obesity. Iso-BMI was found to be associated with lower dental caries and severity. Future studies should address which specific factors related to overweight in children might be protective against dental caries.

RESUMEN: La caries dental es una enfermedad crónica multifactorial que afecta a niños denominada Caries Temprana de la Infancia (CTI). Su etiología es multifactorial y se asocia a determinantes biológicos, conductuales y sociodemográficos. Entre estos, se ha planteado la obesidad como presunto factor de riesgo para el desarrollo de caries en población infantil. El objetivo de este estudio fue establecer si existía o no asociación entre la presencia de lesiones de caries y el estado nutricional en una muestra de 342 preescolares entre 1 y 4 años de edad, que asisten a jardines infantiles de la Fundación INTEGRA, en la Región Metropolitana de Santiago. Se realizaron exámenes clínicos dentales y medición de la talla y peso. Se calculó IMC para cada uno de los sujetos y su estado nutricional fue clasificado como por debajo del peso adecuado, peso normal o normopeso, sobrepeso y obesidad según los gráficos y tablas de la OMS. La prevalencia total de lesiones de caries (ICDAS II = 2 -6) fue de 45,9 % (IC 95 % 40,59 - 51,21). El estado nutricional de la muestra completa fue de 0 % bajo el peso normal, 134 (39,1 %) niños presentaron peso normal (IC 95 % 33,98 - 44,38), 119 niños (34,8 %) presentaron sobrepeso (IC 95 % 29,72 - 39,86) y a 89 (26 %) niños se les diagnosticó obesidad (IC 95 % 21,34 - 30,96). Los sujetos con normopeso presentaron un promedio de lesiones de caries (ICDAS II = 2 - 6) significativamente mayor (p < 0,05). Por lo tanto, se puede concluir que los preescolares con peso normal presentaron mayor número de lesiones de caries de acuerdo al criterio ICDAS II, que aquellos preescolares con sobrepeso y obesidad.

Probiotic Compared with Standard Milk for High-caries Children: A Cluster Randomized Trial.

The aim of this study was to compare milk supplemented with probiotic lactobacilli with standard milk for the increment of caries in preschool children after 10 mo of intervention. The study was a triple-blind, placebo-controlled randomized trial. Participants were children aged 2 and 3 y (n = 261) attending 16 nursery schools in a metropolitan region in Chile. Nursery schools were randomly assigned to 2 parallel groups: children in the intervention group were given 150 mL of milk supplemented with Lactobacillus rhamnosus SP1 (10(7) CFU/mL), while children in the control group were given standard milk. Interventions took place on weekdays for 10 mo. Data were collected through a clinical examination of participants. The primary outcome measure was the increment of caries in preschool children. This was assessed using the International Caries Detection and Assessment System (ICDAS). The dropout rate was 21%. No differences in caries prevalence were detected between the groups at baseline (P = 0.68). After 10 mo of probiotic intake, the caries prevalence was 54.4% in the probiotic group and 65.8% in the control group. The percentage of new individuals who developed cavitated lesions (ICDAS 5-6) in the control group (24.3%) was significantly higher than that in the probiotic group (9.7%). The increment of dental caries showed an odds ratio of 0.35 (P < 0.05) in favor of the probiotic group. At the cavitated lesion level, the increment of new caries lesions within the groups showed 1.13 new lesions per child in the probiotic group compared with 1.75 lesions in the control group (P < 0.05). The probiotic group showed an increment of 0.58 ± 1.17 new lesions compared with 1.08 ± 1.70 new lesions observed in the control group. The difference in caries increment was significant at the cavitated lesion level (P < 0.01). In conclusion, the regular long-term intake of probiotic-supplemented milk may reduce caries development in high-caries preschool children (ClinicalTrials.gov: NCT01648075).

Salivary Urease and ADS Enzymatic Activity as Endogenous Protection against Dental Caries in Children.

UNLABELLED: The aim of this cross sectional study was to evaluate the ureolytic and arginolytic activities of saliva in children and associate them with their caries status. STUDY DESIGN: 65, 8 year old children, were randomly selected. The ureolytic and arginolytic activity of non stimulated saliva was studied and associated with DMFT and dmft index. Saliva of children were sampled under fasting conditions; Children refrained from any oral hygiene procedures during the 12 hours that preceded the sample collection. Caries activity was scored and divided in 3 groups: Group A: Index zero: without lesions; Group B: Moderate Index: 1 to 3 enamel caries lesions; and Group C: High Index: more than 4 dentin caries lesions. RESULTS: DMFT scores were moderate: 0.4(±0.79) and dmft: 2.78(±2.45). Results expressed in µmol/min/mg/protein, for urease activity were statistically significant (p=0.048): Group A= 0.69 (±0.7); Group B= 0.45 (±0.43); and Group C= 0.39 (±0.55). The arginine deiminase activity was not statistically significant (p=0.16): Group A= 2.53 (±1.42), Group B= 2.31 (±1.57) and Group C= 1.97 (±2.0). CONCLUSION: Higher levels of ureolytic (statistically significant) and arginolytic activity (trend) in saliva were associated with lower DMFT/dmft scores in 8 year old children. There was a higher production of ammonia from the arginine deiminase system than the urease enzyme in saliva (p>0.05).

Absence of Non-Carious Cervical Lesions (NCCLs) in a Chilean Pre-Columbian Sample with Severe Occlusal Tooth Wear / Ausencia de Lesiones Cervicales no Cariosas (NCCLs) en una Muestra Chilena Precolombina con Severo Desgaste Oclusal

This study evaluates the non-carious cervical lesions (NCCLs) and the occlusal tooth wear in a pre-Columbian sample (n= 67, adults) from San Pedro de Atacama (North of Chile, 400-1300 BCE). The cervical regions of tooth were observed for loss of enamel and/or dentine in order to identify them as NCCLs and the tooth wear was characterized by the Basic Erosive Wear Examination (BEWE) index. None of the individuals analyzed presented NCCLs, whereas the 98.5% (66/67) of them showed occlusal wear. The mean BEWE index was 2.5, indicating severe dental wear (3 being the highest possible score of BEWE). This lack of relation among severe tooth wear and NCCLs gives support to the idea of loss of crown height reduces cervical stress and develop of NCCLs in archaeological populations.

Este estudio evalúa las lesiones cervicales no cariosas (NCCLs) y el desgaste dental oclusal en una muestra precolombina (n= 67, adultos) de San Pedro de Atacama (Norte de Chile, 400-1300 AEC). Se analizó la perdida de esmalte y/o dentina en las áreas cervicales de los dientes con el propósito de identificarlas como NCCLs y el desgaste dental fue evaluado según el índice Basic Erosive Wear Examination (BEWE). Ninguno de los individuos analizados presentó NCCLs, mientras el 98,5% (66/67) de ellos mostró desgaste oclusal. El promedio del índice BEWE fue de 2,5, indicando severo desgaste dental (siendo 3 el puntaje más alto posible). La falta de relación entre severo desgaste dental y NCCLs apoya la idea que la pérdida de altura de las coronas reduce el estrés cervical y el desarrollo de NCCLs en poblaciones arqueológicas.

Dental caries prevalence and tooth loss in chilean adult population: first national dental examination survey.

The purpose of this study was to assess the prevalence of dental caries, tooth loss, and risk factors among adult population of Chile. Furthermore, age, gender, and behavioural specific differences in caries prevalence and tooth loss were examined. A national stratified multistage probabilistic sample design in two-age cohorts was applied to the Chilean population. A sample of 1553 adults, comprising 1088 individuals aged 35-44 and 465 senior individuals aged 65-74, were examined. The DMFT was evaluated following WHO recommendations using diagnostic criteria of caries lesions into dentin. The data were analyzed by univariate and multivariate models using logistic regression analyses. Results showed a mean DMFT of 15.06 in the 35-44-year-old group and of 21.57 in the 65-74 group. Factors related to tooth loss in the 35-44 group through univariate logistic regression were depression (OR 1.9 CI 95% 1.26-2.85), education level <12 years (OR 2.24 CI 95% 1.31-3.73), personal income (OR 1.51 CI 95% 1.04-2.19), and familiar income (OR 2.05 CI 95% 1.34-3.13), and through multivariate logistic regression in the same age group were depression (OR 1.93 CI 95% 1.24-3.0), education level <12 years (OR 1.94 CI 95% 1.2-3.14), and familiar income (OR 1.71 CI 95% 1.09-2.68). Factors related to tooth loss in the 65-74-year-old group through univariate logistic regression were education level <12 years (OR 2.54 CI 95% 1.3-4.96) and personal income (OR 1.66 CI 95% 1.05-2.63), and for multivariate logistic regression in the same age group, it was education level <12 years (OR 2.51 CI 95% 1.21-5.18). In conclusion, adult population in Chile showed a high prevalence of dental caries and tooth loss, as age, education level, personal and familiar incomes, and depression are being the main risk factors.