Tooth decay may lead to malnutrition in children below 6 years —Experts

LIKE the children who have them, baby teeth are small, delicate, and could  easily become rotten. Tooth decay, also referred to as dental caries or cavities, is common among young children. Studies suggest that about 42 per cent of children aged 2 to 11 have had at least one cavity in their baby teeth.

This high incidence is only partially explained by  increased children’s  consumption of sugary snacks such as candies between meals, which cause dental caries, and the likelihood of not practising proper oral hygiene, compared to adults.

Tooth decay is a challenging problem faced by infants, toddlers and preschool children in developed and developing countries. Severe forms of it impact children’s growth, development and well-being and can have negative social and economic effects on parents and society.

Now, the evidence is suggesting that children’s teeth might give clues about their nutritional status. Experts found that being stunted, underweight and overweight could be associated with tooth decay in children less than 6 years of age even in a suburban population with a low prevalence of tooth decay in children under 6 years of age.

The study which looked at the link between tooth decay in children under 6 years of age and malnutrition was based on a household survey conducted in Ile-Ife, Osun State raised concern that holes in children’s tooth can contribute to poor dietary habits and food intake.  If not addressed, these can result in a child being underweight and stunted.

In the study, oral examination for each child was conducted in their homes. Other variables determined were age, sex, socio-economic status, frequency of sugar consumption between meals, oral hygiene status and mother’s knowledge of oral health.

Of the 370 children, 20 (5.41 per cent) were underweight, 20 (5.41per cent) were overweight, 67 (18.11 per cent) were wasting, 120 (32.43 per cent) were stunted and 18 (4.86per cent) had tooth decay.

The prevalence of early tooth decay was lower in children who were stunted, almost seven times higher in children who were overweight, and predicatively absent in children who were underweight when compared with children who had normal weight.

The 2019 study published in the journal, BMC Paediatrics, indicated that risk of factors like consuming sugar between meals three times a day or more, having low socio economic status and being female contributing to tooth decay in children less than 6 years of age was not significant.

Professor Morenike Folayan, a co-author of the study at the Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife said: “The risk of underweight and stunting is very high in a child having a hole in the tooth. With a hole in the tooth, the child can’t eat well due to pain and that can worsen the malnutrition.”

She added, “if it is not addressed, the pain causes some chemicals to be sent out in the body, what is called an inflammatory reaction, which now increases again further the risk of that child going down with malnutrition. The pain can also interfere with sleep.”

Chewing difficulty can also lead to gastrointestinal disorders that can result in a failure to thrive, poor sleep habits, low self-esteem and poor school performance.

Professor Folayan declared that a deficiency in micro nutrients such as vitamin D, iron, calcium and protein-energy malnutrition due to insufficient intake of food as a result of chewing difficulty, may also lead to enamel defects that make the enamel surface rough and prone to accumulation of plaque with subsequent holes developing in the tooth.

Good oral health is strongly linked to good nutrition. “In a child that is underweight, once the dental caries is treated within six months, an appreciable improvement in the baby’s weight would be recorded,” she stated.

Malnutrition, in every form, presents significant threats to human health. It accounted for 21 to 50 per cent of under-five deaths and a large proportion of poor health in low and middle-income countries in 2017. Malnutrition also contributes to deaths of children less than five years of age. The prevalence of malnutrition in Nigeria is higher in rural than in urban areas.

The underlying causes of malnutrition in Nigeria are poverty, inadequate food production, inadequate food intake, ignorance and uneven distribution of food, poor food preservation techniques, improper preparation of foods, food restrictions and taboos, and poor sanitation.

There is a strong link between tooth decay and malnutrition in older adults, too. A study of dental health records found that more than 25 per cent of older patients who received treatment at the Rutgers School of Dental Medicine clinic showed signs of malnutrition or was at risk for malnutrition. The findings were published in the Journal of Aging Research and Clinical Practice said the highest risk for malnutrition was for those who have fewer than 20 teeth.

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