Examining the link between prevalence of severe early childhood caries and self-reported oral health and quality of life outcomes

Abstract

Program/Project Purpose: Children in developing nations are vastly affected by malnutrition and tooth decay with rates of tooth decay increasing over the last several years. Oral health diseases have affected approximately 2.1 billion individuals worldwide, yet little attention has been given to improving oral health. Oral diseases negatively impact child nutrition, child growth, and child well-being. Many children in Ecuador are severely affected by oral diseases, so we aimed to work with different communities within the country in attempts to evaluate the effectiveness of public health interventions developed by Dr. Sokal-Gutierrez. Structure/Method/Design: The interventions focus on reducing child malnutrition and oral diseases by educating communities, distributing toothbrushes and toothpaste, and providing fluoride varnish. We additionally surveyed parents and screened for malnutrition and childhood caries. We referred those children that had severe tooth decay to dentists at the Ministry of Health to ensure appropriate treatment. Over the past four years, this project has worked with seventeen different indigenous Kichwa tribes in the amazon jungle and has seen hundreds of children aged 6 months to 6 years. Outcomes & Evaluation: In 2011, 732 children participated and 80.7% had tooth decay with an average of 6.80 decayed teeth per child. Two years later 78% of 700 children still had some tooth decay, but the average number of decay per child decreased to 5.64. In 2011 and 2013, the percentage of children with severe mouth pain was 25.03% and 25.20%, respectively. Malnutrition rates were between 30-40% during these years as well. The percentage of children with tooth decay, malnourishment, and mouth pain are very high due to a collection of risk factors. These include a lack of knowledge, increased access to junk food, lack of necessary resources such as toothbrushes and toothpaste, and poor practices from both parents and children. We hope to minimize those risk factors and poor outcomes. Our primary analysis, however, will focus on examining the relationship between prevalence of early childhood caries and malnutrition on selfreported oral health outcomes and quality of life. We also partnered with the Ecuadorian USFQ dental and public health school and reached out to 200 more children aged 6 months to 15 years in mountainous communities with a similar interventional approach. Going Forward: Even though we worked with specific populations, we believe malnutrition and tooth decay continue to be a problem for children all over developing nations and developed nations alike. As access to and consumption of unhealthy and sugary foods become increasingly common in developing nations, tooth decay and malnutrition rates will continue to rise and negatively impact child health rise unless successful interventions are developed to combat this.