title: Untreated severe dental decay: a neglected determinant of low Body Mass Index in 12-year-old Filipino children.
abstract: BACKGROUND
  Dental decay is the most common childhood disease worldwide and most of the decay remains untreated. In the Philippines caries levels are among the highest in the South East Asian region. Elementary school children suffer from high prevalence of stunting and underweight.The present study aimed to investigate the association between untreated dental decay and Body Mass Index (BMI) among 12-year-old Filipino children.
  
  
  METHODS
  Data collection was part of the National Oral Health Survey, a representative cross-sectional study of 1951 11-13-year-old school children using a modified, stratified cluster sampling design based on population classifications of the Philippine National Statistics Office. Caries was scored according to WHO criteria (1997) and odontogenic infections using the PUFA index. Anthropometric measures were performed by trained nurses. Some socio-economic determinants were included as potential confounding factors.
  
  
  RESULTS
  The overall prevalence of caries (DMFT + dmft > 0) was 82.3% (95%CI; 80.6%-84.0%). The overall prevalence of odontogenic infections due to caries (PUFA + pufa > 0) was 55.7% (95% CI; 53.5%-57.9%) The BMI of 27.1% (95%CI; 25.1%-29.1%) of children was below normal, 1% (95%CI; 0.5%-1.4%) had a BMI above normal. The regression coefficient between BMI and caries was highly significant (p < 0.001). Children with odontogenic infections (PUFA + pufa > 0) as compared to those without odontogenic infections had an increased risk of a below normal BMI (OR: 1.47; 95% CI: 1.19-1.80).
  
  
  CONCLUSIONS
  This is the first-ever representative survey showing a significant association between caries and BMI and particularly between odontogenic infections and below normal BMI. An expanded model of hypothesised associations is presented that includes progressed forms of dental decay as a significant, yet largely neglected determinant of poor child development.
authors.affiliation: Fit for School Inc, Salcedo Village, Makati City, Manila, Philippines. habib.benzian@health-bureau.com
authors.forename: Habib
authors.initials: H
authors.lastname: Benzian
authors.forename: Bella
authors.initials: B
authors.lastname: Monse
authors.forename: Roswitha
authors.initials: R
authors.lastname: Heinrich-Weltzien
authors.forename: Martin
authors.initials: M
authors.lastname: Hobdell
authors.forename: Jan
authors.initials: J
authors.lastname: Mulder
authors.forename: Wim
authors.initials: W
authors.lastname: van Palenstein Helderman
mesh_terms: D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology* / Q000503:physiopathology*; D003945:Diagnosis, Oral; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D010679:Philippines / Q000453:epidemiology; D012720:Severity of Illness Index