title: Food insecurity and dental caries in schoolchildren: a cross-sectional survey in the western Brazilian Amazon.
abstract: We analyzed the association between food insecurity and dental caries in 7- to 9-yr-old schoolchildren. We performed a cross-sectional survey nested in a population-based cohort study of 203 schoolchildren. The participants lived in the urban area of a small town within the western Brazilian Amazon. Dental examinations were performed according to criteria recommended by the World Health Organization. The number of decayed deciduous and permanent teeth as a count variable was the outcome measure. Socio-economic status, food security, behavioral variables, and child nutritional status, measured by Z-score for body mass index (BMI), were investigated, and robust Poisson regression models were used. The results showed a mean (SD) of 3.63 (3.26) teeth affected by untreated caries. Approximately 80% of schoolchildren had at least one untreated decayed tooth, and nearly 60% lived in food-insecure households. Sex, household wealth index, mother's education level, and food-insecurity scores were associated with dental caries in the crude analysis. Dental caries was 1.5 times more likely to be associated with high food-insecurity scores after adjusting for socio-economic status and sex. A significant dose-response relationship was observed. In conclusion, food insecurity is highly associated with dental caries in 7- to 9-yr-old children and may be seen as a risk factor. These findings suggest that food-security policies could reduce dental caries.
authors.affiliation: Department of Public Health Practice, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Frazão
authors.forename: Maria H D
authors.initials: MH
authors.lastname: Benicio
authors.forename: Paulo C
authors.initials: PC
authors.lastname: Narvai
authors.forename: Marly A
authors.initials: MA
authors.lastname: Cardoso
mesh_terms: D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006794:Household Articles / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009035:Mothers / Q000193:education; D009752:Nutritional Status; D011159:Population Surveillance; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D014099:Toothbrushing / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data
keywords: food supply; health policy; oral health; socio-economic factors; vulnerable populations