title: Socioeconomic status, food security, and dental caries in US children: mediation analyses of data from the National Health and Nutrition Examination Survey, 2007-2008.
abstract: OBJECTIVE
  We examined associations of household socioeconomic status (SES) and food security with children's oral health outcomes.
  
  
  METHODS
  We analyzed 2007 and 2008 US National Health and Nutrition Examination Survey data for children aged 5 to 17 years (n = 2206) to examine the relationship between food security and untreated dental caries and to assess whether food security mediates the SES-caries relationship.
  
  
  RESULTS
  About 20.1% of children had untreated caries. Most households had full food security (62%); 13% had marginal, 17% had low, and 8% had very low food security. Higher SES was associated with significantly lower caries prevalence (prevalence ratio [PR] = 0.77; 95% confidence interval = 0.63, 0.94; P = .01). Children from households with low or very low food security had significantly higher caries prevalence (PR = 2.00 and PR = 1.70, respectively) than did children living in fully food-secure households. Caries prevalence did not differ among children from fully and marginally food-secure households (P = .17). Food insecurity did not appear to mediate the SES-caries relationship.
  
  
  CONCLUSIONS
  Interventions and policies to ensure food security may help address the US pediatric caries epidemic.
authors.affiliation: Donald L. Chi, Erin E. Masterson, Lloyd A. Mancl, and Susan E. Coldwell are with the Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle. Adam C. Carle is with the Department of Pediatrics, School of Medicine, and the Department of Psychology, College of Arts and Sciences, University of Cincinnati, Cincinnati, OH.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Chi
authors.forename: Erin E
authors.initials: EE
authors.lastname: Masterson
authors.forename: Adam C
authors.initials: AC
authors.lastname: Carle
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Mancl
authors.forename: Susan E
authors.initials: SE
authors.lastname: Coldwell
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology*; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D011203:Poverty / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology