Journal of Indian Association of Public Health Dentistry

LETTER TO EDITOR
Year
: 2018  |  Volume : 16  |  Issue : 3  |  Page : 256--257

Association between overweight and dental caries among 8–13-year-old school children in Central India


Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P. O. Box 55302, Baghdad Post Office, Baghdad
Iraq




How to cite this article:
Al-Mendalawi MD. Association between overweight and dental caries among 8–13-year-old school children in Central India.J Indian Assoc Public Health Dent 2018;16:256-257


How to cite this URL:
Al-Mendalawi MD. Association between overweight and dental caries among 8–13-year-old school children in Central India. J Indian Assoc Public Health Dent [serial online] 2018 [cited 2024 Mar 28 ];16:256-257
Available from: https://journals.lww.com/aphd/pages/default.aspx/text.asp?2018/16/3/256/238592


Full Text

Sir,

I have two comments on the interesting study by Reddy et al. on the association between overweight and dental caries (DC) among 8–13-year-old schoolchildren in Central India.[1]

First, Reddy et al. mentioned in the methodology that the overweight was assessed using body mass index (BMI) for age, in which BMI was calculated using the formula weight in kilograms divided by height in meter square. The value obtained was plotted for age-specific percentile curves on the Centers for Disease Control (CDC) 2000 Growth Charts.[1] Accordingly, Reddy et al. found a significant association between overweight and DC, and out of the selected demographic variables such as age, gender, diet, sugar exposure, and socioeconomic status (SES), only SES was significantly associated with DC among the overweight children.[1] I presume that these results ought to be cautiously interpreted owing to the presence of the following methodological limitation. It is obvious that there are many growth standards used to evaluate anthropometric measurements in the pediatric clinical field, notably CDC standards, World Health Organization standards, and national standards. Evaluation of different types of growth standards suggested that the use of country-specific growth standards might describe the growth of children more accurately.[2] To my knowledge, the Indian Academy of Pediatrics (IAP) Growth Standards 2007 were designed to evaluate the growth of Indian children. As India is in the nutrition transition and the previous IAP Standards 2007 were based on data that are over two decades old, the growth standards committee of IAP has revised the growth standards for children in January 2015.[3] Currently, IAP Growth Standards Committee recommends the use of these new standards to replace the IAP Standards 2007 in the researches field and clinical practice.[3] I presume that if Reddy et al.[1] employed IAP Standards, the study results might be altered.

Second, interestingly, the significant association between overweight and DC addressed by Reddy et al.[1] contradicts with insignificant association recently reported by Choudhary et al.[4] This contradiction further supports the debatable association found in the systematic review of the longitudinal studies on that association.[5] There were 1338 studies with 59 potentially effective studies (κ = 0.82) and 17 effective studies (κ = 0.88). Among 17 effective studies, two studies in which DC was used to predict anthropometric measurements consistently found an inverse association and 15 studies in which anthropometric estimations were used to predict DC were inconsistent, with results appearing to be influenced by nonuniformity of assessments, setting, and procedure of measurements; age and ethnicity of participants; and confounders of DC. It was concluded that the evidence of the association between anthropometric measurements and DC is conflicting and remains inconclusive.[5]

References

1Reddy KV, Thakur AS, Moon N, Reddy KE, Chandrakala S, Saxena S. Association between overweight and dental caries among 8-13 year old school children in central India. J Indian Assoc Public Health Dent 2018;16:22-5.
2Natale V, Rajagopalan A. Worldwide variation in human growth and the World Health Organization growth standards: A systematic review. BMJ Open 2014;4:e003735.
3Khadilkar VV, Khadilkar AV. Revised Indian academy of pediatrics 2015 growth charts for height, weight and body mass index for 5-18-year-old Indian children. Indian J Endocrinol Metab 2015;19:470-6.
4Choudhary R, Sharma R, Bhat M, Satish V, Khairwa A, Solanki J, et al. Prevalence of dental caries in overweight school going children of 12-15 years in and around Jaipur city, Rajasthan, India Przegl Epidemiol 2017;71:623-8.
5Li LW, Wong HM, Peng SM, McGrath CP. Anthropometric measurements and dental caries in children: A systematic review of longitudinal studies. Adv Nutr 2015;6:52-63.