Abstract
Sub-optimal nutrition and dental caries are both common with significant short and long-term implications for child health and development. We applied twin statistical methods to explore the relationship between body mass index (BMI) and dental caries. We measured BMI at 18 months and six years of age and cumulative dental caries experience at six years in 344 twin children. Dental caries in primary teeth was categorised into ‘any’ or ‘advanced’ and BMI was analysed as both a continuous and categorical variable. Statistical analyses included multiple logistic regression using generalized estimating equations and within/between-pair analyses. There was no association between BMI and ‘any’ dental caries experience at either time-point, neither overall nor in within/between pair analyses. However, ‘advanced’ dental caries at six years was associated with a within-pair difference in BMI of −0.55 kg/m2 (95% CI −1.00, −0.11, p = 0.015). A within-pair increase of 1 kg/m2 in BMI was associated with a lower within-pair risk of advanced dental caries (OR 0.68, 95% CI 0.52, 0.90, p = 0.007). These findings reveal a possible causal relationship between lower BMI and dental caries. As dental outcomes were only measured at one time point, the direction of this potentially causal relationship is unclear.
Highlights
Sub-optimal nutrition and dental caries are both common with significant short and long-term implications for child health and development
The relationship may be non-linear and depend on the study setting and socioeconomic profile of participants, with higher levels of dental caries reported in both underweight children in low to middle income countries (LMICs) and in obese children in high-income countries[4,6]
We tested three hypotheses: (1) body mass index (BMI) at 18 months is a predictor of dental caries at six years; (2) BMI at six years is a predictor of dental caries at six years and (3) dental caries at six
Summary
Sub-optimal nutrition and dental caries are both common with significant short and long-term implications for child health and development. There was no association between BMI and ‘any’ dental caries experience at either time-point, neither overall nor in within/between pair analyses. ‘advanced’ dental caries at six years was associated with a within-pair difference in BMI of −0.55 kg/m2 (95% CI −1.00, −0.11, p = 0.015). As dental outcomes were only measured at one time point, the direction of this potentially causal relationship is unclear. Poor nutrition and dental caries are both common with significant short and long-term implications for child health and development[1,2]. The aim of this study is to use twin cohort data to evaluate the associations, including potential causal relationships, between BMI and dental caries. Hypotheses 2 and 3 reflect the potential bi-directional association between cross-sectional observations at six years
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