Impact of treating dental caries on schoolchildren's anthropometric, dental, satisfaction and appetite outcomes: a randomized controlled trial

Heba A Alkarimi, Richard G Watt, Hynek Pikhart, Amal H Jawadi, Aubrey Sheiham, Georgios Tsakos, Heba A Alkarimi, Richard G Watt, Hynek Pikhart, Amal H Jawadi, Aubrey Sheiham, Georgios Tsakos

Abstract

Background: There are no randomized controlled trials to assess the impact of treating dental caries on various aspects of children's health. This study was conducted to assess the impact of dental treatment of severe dental caries on children's weight, height and subjective health related outcomes, namely dental pain, satisfaction with teeth and smile, dental sepsis and child's appetite.

Methods: The study was a community-based, randomized, controlled trial in schoolchildren aged 6-7 years with untreated dental caries. Participants were randomly assigned to early (test) or regular (control) dental treatment. The primary outcome was Weight-for-age Z-score. Secondary outcomes were Height-for-age and BMI-for-age Z-scores, dental pain, dental sepsis, satisfaction with teeth and child's appetite.

Results: 86 children were randomly assigned to test (42 children) and control (44) groups. Mean duration of follow-up was 34.8 (± 1.1) weeks. There were insignificant improvements in anthropometric outcomes between the groups after treatment of caries. However, treated children had significantly less pain experience (P = 0.006) (OR 0.09, [0.01-0.51]) and higher satisfaction with teeth (P = 0.001) (OR 9.91, [2.68-36.51]) compared to controls. Controls had significantly poorer appetites (P = 0.01) (OR 2.9, [1.24-6.82]) compared to treated children. All treated children were free of clinical dental sepsis whereas 20% (9 of 44) of controls who were free of sepsis at baseline had sepsis at follow-up.

Conclusions: Although dental treatment did not significantly improve the anthropometric outcomes, it significantly improved the dental outcomes and children's satisfaction with teeth, smile and appetite. This is the first study to provide evidence that treatment of severe dental caries can improve children's appetite.

Trial registration: Effect of Dental Treatment on Children's Growth. Clinical Trial Gov ID# NCT01243866.

Figures

Figure 1
Figure 1
CONSORT flow chart of participants.

References

    1. Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007;369(9555):51–59. doi: 10.1016/S0140-6736(07)60031-2.
    1. CDC Data & Statistics | Feature. Untreated Dental Caries (Cavities) in Children Ages 2-19, United States [Internet]. [cited 2012 Feb 25] Available from:
    1. Yee R, Sheiham A. The burden of restorative dental treatment for children in Third World countries. Int Dent J. 2002;52(1):1–9. doi: 10.1111/j.1875-595X.2002.tb00589.x.
    1. Curzon MEJ, Preston AJ. Risk Groups. Nursing Bottle Caries/Caries in the Elderly. Caries Research. 2004;38(Suppl. 1):24–33. doi: 10.1159/000074359.
    1. Brook I. Brain abscess in children: microbiology and management. J. Child Neurol. 1995;10(4):283–288. doi: 10.1177/088307389501000405.
    1. Acs G, Shulman R, Ng MW, Chussid S. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatr Dent. 1999;21(2):109–113.
    1. Malek Mohammadi T, Wright CM, Kay EJ. Childhood growth and dental caries. Community Dent Health. 2009;26(1):38–42.
    1. Ayhan H, Suskan E, Yildirim S. The effect of nursing or rampant caries on height, body weight and head circumference. J Clin Pediatr Dent. 1996;20(3):209–212.
    1. Oliveira LB, Sheiham A, Bönecker M. Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children. Eur J Oral Sci. 2008;116(1):37–43. doi: 10.1111/j.1600-0722.2007.00507.x.
    1. Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009;140(6):650–657.
    1. Griffin SO, Gooch BF, Beltrán E, Sutherland JN, Barsley R. Dental services, costs, and factors associated with hospitalization for Medicaid-eligible children, Louisiana 1996-97. J Public Health Dent. 2000;60(1):21–27. doi: 10.1111/j.1752-7325.2000.tb03287.x.
    1. Schwartz S. A one-year statistical analysis of dental emergencies in a pediatric hospital. J Can Dent Assoc. 1994;60(11):959–962. 966–8.
    1. Pongpichit B, Sheiham A, Pikhart H, Tsakos G. Time absent from school due to dental conditions and dental care in Thai schoolchildren. J Public Health Dent. 2008;68(2):76–81. doi: 10.1111/j.1752-7325.2007.00051.x.
    1. Anderson HK, Drummond BK, Thomson WM. Changes in aspects of children’s oral-health-related quality of life following dental treatment under general anaesthesia. Int J Paediatr Dent. 2004;14(5):317–325. doi: 10.1111/j.1365-263X.2004.00572.x.
    1. Low W, Tan S, Schwartz S. The effect of severe caries on the quality of life in young children. Pediatr Dent. 1999;21(6):325–326.
    1. Gemert-Schriks MCM, Amerongen EW, Aartman IHA, Wennink JMB, Cate JM, Soet JJ. The influence of dental caries on body growth in prepubertal children. Clinical Oral Investigations. 2010;15(2):141–149.
    1. Thomas CW, Primosch RE. Changes in incremental weight and well-being of children with rampant caries following complete dental rehabilitation. Pediatr Dent. 2002;24(2):109–113.
    1. Al-Malik MI, Rehbini YA. Prevalence of dental caries, severity, and pattern in age 6 to 7-year-old children in a selected community in Saudi Arabia. J Contemp Dent Pract. 2006;7(2):46–54.
    1. Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR. Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent. 2003;25(5):431–440.
    1. Hahn CL, Falkler WA Jr. Antibodies in normal and diseased pulps reactive with microorganisms isolated from deep caries. J Endod. 1992;18(1):28–31. doi: 10.1016/S0099-2399(06)81139-8.
    1. Plitnick LM, Banas JA, Jelley-Gibbs DM, O’neil J, Christian T, Mudzinski SP. et al.Inhibition of interleukin-2 by a Gram-positive bacterium, Streptococcus mutans. Immunology. 1998;95(4):522–528. doi: 10.1046/j.1365-2567.1998.00631.x.
    1. Hahn CL, Best AM, Tew JG. Cytokine induction by Streptococcus mutans and pulpal pathogenesis. Infect Immun. 2000;68(12):6785–6789. doi: 10.1128/IAI.68.12.6785-6789.2000.
    1. RT M Jr. others. Recent developments in the anemia of chronic disease. Current hematology reports. 2003;2(2):116.
    1. Barton BE. IL-6: insights into novel biological activities. Clin Immunol Immunopathol. 1997;85(1):16–20. doi: 10.1006/clin.1997.4420.
    1. Stephensen CB. Burden of Infection on Growth Failure. J Nutr. 1999;129(2):534–538.
    1. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ. et al.CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. Journal of Clinical Epidemiology. 2010;63(8):e1–e37. doi: 10.1016/j.jclinepi.2010.03.004.
    1. WHO. Development of a WHO growth reference for school-aged children and adolescents [Internet] WHO; [cited 2012 Mar 2]. Available from: .
    1. WHO. AnthroPlus 2007: software for the global application of the WHO Reference 2007 for 5-19 years to monitor the growth of school-age children and adolescents. Geneva: World Health Organization; 2007.
    1. Cogill B. Anthropometric Indicators Measurement Guide. Food and Nutrition Technical Assistance Project, Academy for Educational Development, Washington; 2003. pp. 1–92.
    1. Pine CM, Harris RV, Burnside G, Merrett MCW. An investigation of the relationship between untreated decayed teeth and dental sepsis in 5-year-old children. Br Dent J. 2006;200(1):45–47. doi: 10.1038/sj.bdj.4813124. discussion 29.
    1. Jokovic A, Locker D, Guyatt G. Short forms of the Child Perceptions Questionnaire for 11-14-year-old children (CPQ11-14): development and initial evaluation. Health Qual Life Outcomes. 2006;4:4. doi: 10.1186/1477-7525-4-4.
    1. Wright CM, Callum J, Birks E, Jarvis S. Effect of community based management in failure to thrive: randomised controlled trial. BMJ. 1998;317(7158):571–574. doi: 10.1136/bmj.317.7158.571.
    1. Wright CM, Parkinson KN, Drewett RF. How Does Maternal and Child Feeding Behavior Relate to Weight Gain and Failure to Thrive? Data From a Prospective Birth Cohort. Pediatrics. 2006;117(4):1262–1269. doi: 10.1542/peds.2005-1215.
    1. Shih WJ. Problems in dealing with missing data and informative censoring in clinical trials. Trials. 2002;3(1):4.

Source: PubMed

3
Abonner