Impact of Caries on Childern

7/31/2019 Impact of Caries on Childern

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The effect of a relatively commonchronic disease, severe dentalcaries, affects young childrengrowth and well-being.

Children with severe cariesweighed less than controls, andafter treatment of decayed teeth

there was more rapid weightgain and improvements in theirquality of life.


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This may be due to dietaryintake improving because painaffected the quantity and varietyof food eaten, and second,chronic inflammation from cariesrelated pulpitis and abscesses isknown to suppress growth

through a metabolic pathway andto reduce haemoglobin as aresult of depressed erythrocyte

production.


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If a common condition, such asuntreated dental caries, doesaffect the growth and well-beingof millions of young children,then dental intervention toeradicate dental pain andpulpitis is an important way to

enhance growth and well-beingin young children.


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Untreated dental caries withassociated discomfort or toothacheaffects weight gain, growth and

quality of life as well as the cognitivedevelopment of young children A review of the possible effects of

dental caries on failure to thrive (FTT)

showed that in otherwise healthychildren, severe dental decay couldcontribute to FTT


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Acset al

. showed that three-year-olds with nursing caries with at leastone pulpally involved tooth weighedabout 1 kg less than control children

without nursing caries.8.7% of children with caries weighed

less than 80% of ideal weightcompared to 1.7% of the comparison

group a finding confirmed in youngTurkish children with rampant ornursing caries.


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They were significantly lighter andshorter than controls without caries.The mean weight of children with

caries was between the 25th and

50th percentiles compared tocontrols who were between the 50thand 75th percentiles

Seven percent of cases and 0.7% ofcontrols weighed less than the 20thpercentile.


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Further evidence of the effect ofdental caries on growth comes fromstudies of 'catch-up growth' following

comprehensive dental treatment.Children with early childhood carieswere dentally treated orrehabilitated. Again, dental treatmentwas followed by greater weight gain.


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The weight categories of children withearly childhood caries were comparedwith caries-free patients before and aftercomprehensive dental treatment under

general anaesthesia.Percentile weight categories of caries

children were significantly less thancontrols. Of the early childhood caries

(ECC) children, 13.7% weighed less than80% of their ideal weight.


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Following therapeutic dentaltreatment the children with ECC hadsignificantly increased growthvelocities.

After treatment there was nodifference in age adjusted weightsbetween the ECC and control groups.


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All the children showed an immediateincrease in weight, shifting them tohigher percentile categories withincreased six-month increments ofgrowth after carious teeth had beenrestored.

At the end of the study, none of the

children were considered to havefaltering growth.


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Although undernourished childrenmay develop more dental cariesbecause a high sugar intake may bedetrimental to teeth and nutrition,there are at least three other highlyplausible mechanisms for how dentalcaries may be associated with

underweight and poor growth inyoung children.


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First, untreated caries and associatedinfection can cause pain anddiscomfort and reduce intake offoods because eating is painful.

Second, severe caries can affectchildren's quality of life and therebygrowth. Impacts include pain,

irritability and disturbed sleepinghabits.


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Disturbed sleep may affectglucosteroid production and growth.Although not all untreated dental

caries affects general health, itsignificantly impacts on the quality oflife of children and their dietary

intake.


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The consequences of high carieslevels also include a higher risk ofhospitalisations and emergencydental visits, increased days with

restricted activity and absence fromschool, and a diminished ability tolearn

Dental pain has an impact not only

on the child's educationaldevelopment, but also on theeconomy due to time taken off by

parents to take children to the dentist


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Dental treatment makes a verysignificant difference to thepsychological and social aspects ofthe child's life.

These improvements include lesspain and improved abilities to eatand sleep.

In one study, parents perceived

treatment had positive social impactson their child: more smiling,improved school performance and

increased social interaction


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A third possible mechanism of howuntreated severe caries with pulpitisaffects growth is that chronicinflammation from pulpitis and

chronic dental abscesses affectsgrowth via chronic inflammationaffecting metabolic pathways where

cytokines affect erythropoiesis


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For example, interleukin-1 (IL-1),which has a wide variety of actions ininflammation, can induce inhibition oferythropoiesis.

This suppression of haemoglobin canlead to anaemia of chronic disease asa result of depressed erythrocyte

production in the bone marrow.


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This review indicates that treatingdental caries in children wouldincrease growth rates and the qualityof life of millions of children.

Obviously, prevention of caries wouldbe preferable to treatment, but the

high level of untreated cariesworldwide suggests that currentpreventive approaches are not

working

Impact of Caries on Childern

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