title: Overweight, obese, underweight, and frequency of sugar consumption as risk indicators for early childhood caries in Brazilian preschool children.
abstract: BACKGROUND
  A possible association between being overweight or obese and early childhood caries (ECC) remains controversial.
  
  
  OBJECTIVE
  To investigated this association in a developing country testing the confounding effects of socioeconomic factors and frequency of sugar consumption.
  
  
  METHODS
  Historical cohort study, 388 children (aged 24-71 months) living in São Luís, Brazil. A theoretical model adjusted according to income, birthweight, and nutritional status at twelve months and frequency of sugar consumption was generated with directed acyclic graphs to analyze this association. Caries were considered a discrete variable in the Poisson regression models; incidence density ratios (IRs) and 95% confidence intervals (95% CIs) were estimated.
  
  
  RESULTS
  Being overweight or obese (IR = 1.52; 95% CI: 1.03-2.22) was independently associated with ECC. Being thin or very thin (IR = 1.97; 95% CI: 1.52-2.54), a high frequency of sugar consumption (IR = 1.83; 95% CI: 1.42-2.38), and age (IR = 3.62; 95% CI: 2.58-5.08) were associated with ECC.
  
  
  CONCLUSIONS
  Children overweight or obese, as well as children exhibiting being thin/very thin, were associated with ECC independent of socioeconomic variables and a high frequency of sugar consumption.
authors.affiliation: Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil.|Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors.forename: Cecilia Claudia Costa
authors.initials: CCC
authors.lastname: Ribeiro
authors.affiliation: Dentistry Course, CEUMA University, São Luís, Maranhão, Brazil.
authors.forename: Mariana Carvalho Batista da
authors.initials: MCBD
authors.lastname: Silva
authors.affiliation: Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors.forename: Ana Margarida Melo
authors.initials: AMM
authors.lastname: Nunes
authors.affiliation: Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil.|Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors.forename: Erika Bárbara de Abreu Fonseca
authors.initials: EBAF
authors.lastname: Thomaz
authors.affiliation: Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors.forename: Cadidja Dayane Sousa
authors.initials: CDS
authors.lastname: Carmo
authors.affiliation: Graduate Program of Medicine, Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors.forename: Marizélia Rodrigues Costa
authors.initials: MRC
authors.lastname: Ribeiro
authors.affiliation: Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
authors.forename: Antônio Augusto Moura da
authors.initials: AAMD
authors.lastname: Silva
mesh_terms: D001835:Body Weight; D001938:Brazil; D002675:Child, Preschool; D015331:Cohort Studies; D003731:Dental Caries / Q000209:etiology*; D004032:Diet / Q000009:adverse effects; D000073417:Dietary Sugars; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D063766:Pediatric Obesity / Q000150:complications*; D013851:Thinness / Q000150:complications
chemical_list: D000073417:Dietary Sugars