Food insecurity and dental caries in schoolchildren: a cross-sectional survey in the western Brazilian Amazon

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Abstract

We analyzed the association between food insecurity and dental caries in 7- to 9-yr-old schoolchildren. We performed a cross-sectional survey nested in a population-based cohort study of 203 schoolchildren. The participants lived in the urban area of a small town within the western Brazilian Amazon. Dental examinations were performed according to criteria recommended by the World Health Organization. The number of decayed deciduous and permanent teeth as a count variable was the outcome measure. Socio–economic status, food security, behavioral variables, and child nutritional status, measured by Z-score for body mass index (BMI), were investigated, and robust Poisson regression models were used. The results showed a mean (SD) of 3.63 (3.26) teeth affected by untreated caries. Approximately 80% of schoolchildren had at least one untreated decayed tooth, and nearly 60% lived in food-insecure households. Sex, household wealth index, mother's education level, and food-insecurity scores were associated with dental caries in the crude analysis. Dental caries was 1.5 times more likely to be associated with high food-insecurity scores after adjusting for socio–economic status and sex. A significant dose–response relationship was observed. In conclusion, food insecurity is highly associated with dental caries in 7- to 9-yr-old children and may be seen as a risk factor. These findings suggest that food-security policies could reduce dental caries.

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