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Int. J. Environ. Res. Public Health 2017, 14(5), 550;

Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive S., Los Angeles, CA 90095, USA
Doctor en Odontología General, Quito, Ecuador
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
University of California, Berkeley-University of California San Francisco Joint Medical Program, University of California, Berkeley School of Public Health, 570 University Hall, MC 1190, Berkeley, CA 94720, USA
Joint First Authors.
Joint Senior Authors.
Author to whom correspondence should be addressed.
Academic Editors: Loc Do and Jane Scott
Received: 22 April 2017 / Revised: 13 May 2017 / Accepted: 18 May 2017 / Published: 22 May 2017
(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)
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Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1407 children from birth through age 6 in the “Alli Kiru” program (2011–2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth (dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for being underweight (Adjusted Odds Ratio (AOR): 1.27; 95% CI: 1.02–1.54) and decreased odds for being overweight (AOR: 0.76; 95% CI: 0.58–0.97). This relationship was most pronounced among 3–6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions. View Full-Text
Keywords: early childhood caries; mouth pain; malnutrition; Ecuador; community-based intervention early childhood caries; mouth pain; malnutrition; Ecuador; community-based intervention

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So, M.; Ellenikiotis, Y.A.; Husby, H.M.; Paz, C.L.; Seymour, B.; Sokal-Gutierrez, K. Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region. Int. J. Environ. Res. Public Health 2017, 14, 550.

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