Obese or Overweight Children Do Not Have a Higher Risk of Dental Caries

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This analysis included data from 2 sequential nationwide surveys, namely the NHANES III (1988-1994) and NHANES 1999-2002. The analysis targeted children ages from 2 to 18 years in each dataset who completed dental examination and height and weight measurement. The NHANES III sample included 10,180 children and NHANES 99-02 included 7568 children.

Key Risk/Study Factor

The key risk factor in this analysis is body mass index (BMI) percentile based on the age and sex-specific 2000 Centers for Disease Control and Prevention (CDC) growth chart. Children's weight status was defined based on BMI percentile as (1) overweight: at or above 95th percentile, (2) at risk for overweight: at or above 85th percentile and less than 95th percentile, and (3) normal weight: less than 85th percentile.

Main Outcome Measure

The main outcome measure was dental caries experience in the primary (dfs) for 2- to 5-year-old children, and permanent dentition (DMFS) for 12- to 18-year-old children. For 6- to 11-year-old children, caries experience in both primary (dfs) and permanent dentition (DMFS) were recorded. In the analysis, the caries experience measure was dichotomized as either having caries experience (dfs > 0 or DMFS > 0) or having no caries experience (dfs = 0 and DMFS = 0). Examinations for dental caries were conducted based on the modified Radike's criteria (ie, disease is defined as dentinal cavitated lesion using a sharp #23 sickle-shaped explorer).

Main Results

The results from the analyses of 2 sequential cross-sectional datasets (NHANES III 1988-1994 and NHANES 1999-2002) suggest that there is no association between caries experience in the primary dentition and body weight status (normal weight, at risk for overweight, or overweight) among 2- to 5-year-old children in the United States.

Main Results

For older children, the results are not consistent in the 2 nationwide datasets.

Main Results

The results from NHANES III indicate that there is a negative association between caries experience in the primary dentition and body weight status among 6- to 11-year-old children (ie, overweight and at risk for overweight children are less likely to have caries experience in the primary dentition than normal weight children). In the permanent dentition (both 6- to 11- and 12- to 18-year-old children), a negative association is significant only between overweight children and normal weight children.

Main Results

These negative associations, however, are not significant in the NHANES 1999-2002; ie, for children 6 to 11 years of age and 12 to 18 years of age, there are no differences in having caries experience among normal, at risk for overweight, and overweight children.


The authors concluded that there is no evidence to suggest that overweight children are at an increased risk for dental caries based on the analysis of data from NHANES III and NHANES 1999-2002. The authors also suggested, based on some of the NHANES III results, that being overweight may be associated with decreased rates of caries in older children (6 to 18 years old).

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