title: Associations between oral health-related impacts and rate of weight gain after extraction of pulpally involved teeth in underweight preschool Filipino children.
abstract: BACKGROUND
  Severe dental caries in young children is associated with underweight and failure to thrive. One possible mechanism for severe caries affecting growth is that the resulting pain and discomfort influences sleeping and eating, and that affects growth and weight. The objective of this study was to assess whether rate of weight gain after extraction of severely decayed teeth in underweight preschool Filipino children was related to reductions in oral health-related impacts and dental pain from severe dental caries affecting eating and sleeping.
  
  
  METHODS
  Data are from the Weight Gain Study, a stepped wedge cluster randomized clinical trial where underweight Filipino children with severe dental decay had their pulpally involved teeth extracted. Day care centers were randomly divided into two groups; A and B. Group A children received treatment first and Group B children were treated four months after Group A. Clinical oral examinations used WHO criteria and the pufa-index. Self-reported oral health-related impacts and anthropometric measurements were collected for both groups at baseline, four months after treatment of Group A children and four months after treatment of Group B children. Weight-for-age z-scores were calculated using 2006 and 2007 WHO standards. Data were converted to a one-group pre-test post-test study design, where all children received treatment. Associations between changes in oral health-related impacts and weight-for-age z-scores after dental treatment were assessed.
  
  
  RESULTS
  Data on 145 children (mean age 61.4 months) were analyzed. There was a significant association between oral health-related impacts and rate of weight gain after extraction of pulpally involved teeth (p=0.02). Children free of impacts on sleeping related to having severely decayed teeth extracted gained significantly more weight compared to children who reported sleeping problems after dental treatment (p<0.01).
  
  
  CONCLUSIONS
  After extraction of severely decayed teeth in underweight Filipino children, levels of oral health-related impacts were associated with rate of weight gain. Decreases in oral health impacts on sleeping appeared to be most strongly associated with weight gain.
  
  
  BACKGROUND
  ISRCTN: ISRCTN90779069.
authors.affiliation: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Gustav Mahlerlaan 3004, 1081LA, Amsterdam, The Netherlands. d.duijster@acta.nl
authors.forename: Denise
authors.initials: D
authors.lastname: Duijster
authors.forename: Aubrey
authors.initials: A
authors.lastname: Sheiham
authors.forename: Martin H
authors.initials: MH
authors.lastname: Hobdell
authors.forename: Gina
authors.initials: G
authors.lastname: Itchon
authors.forename: Bella
authors.initials: B
authors.lastname: Monse
mesh_terms: D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004245:DMF Index; D003731:Dental Caries / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009909:Oral Health / Q000592:standards*; D010510:Periodontal Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D010679:Philippines / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D013851:Thinness / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014076:Tooth Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D014081:Tooth Extraction; D015430:Weight Gain