Association between anthropometric measurements and dental caries among children in Asia: A systematic review and meta-analysis / Rokiah Mamikutty
Overweight and dental caries among children is increasing in Asia. The association between anthropometric measurements and dental caries is inconclusive and not representing the Asian context. Aim: To assess the association between anthropometric measurements and caries among children in Asia...
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| Format: | Thesis |
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2021
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| Online Access: | http://studentsrepo.um.edu.my/13675/ http://studentsrepo.um.edu.my/13675/4/rokiah.pdf |
| Summary: | Overweight and dental caries among children is increasing in Asia. The association
between anthropometric measurements and dental caries is inconclusive and not
representing the Asian context. Aim: To assess the association between anthropometric
measurements and caries among children in Asia by regions, sugar consumption per-capita, and SES of the countries. Methods: The review was registered with PROSPERO
and conducted following PRISMA guidelines. Twenty-six databases were employed for
searching the eligible studies from inception until Jun 2019. Two reviewers independently
screen, select studies, perform data extraction, and risk bias assessment, with
discrepancies resolved by discussion and reference to the third reviewers. Meta-analysis
was performed using a random-effect model. Heterogeneity was assessed using chi�square and quantify with Higgin I2
statistic. A sensitivity analysis and reporting bias was
assessed using funnel plots. Subgroup analysis was conducted by regions, sugar
consumption per-capita, and socio-economic of the countries. Harvest plot was employed
when meta-analysis is inappropriate. Quality of evidence was rated with
GRADE. Results: 4532 studies retrieved. Sixty-six studies were included after
deduplication, title, and abstract and full-text screening. Fifty-three studies were pooled
in meta-analysis and 13 studies analysed by Harvest plot. For primary dentition, BMI was
negatively associated with caries prevalence and caries severity. Overweight (OR: 0.64;
95%CI 0.53, 0,77) or obese children (OR: 0.58; 95%CI 0.44, 0.77) were less likely to
have caries compared to normal weight, and underweight children (SMD: 0.15; 95%CI
0.05, 0.25) have caries severity compared to normal weight. No significant association
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was observed between BMI, WC, WHtR, SFT and caries in permanent dentition. In mixed
dentition, obese children (OR: 0.60; 95%CI 0.52, 0.69) are less likely to have caries than
normal weight. In South Asia, West Asia, East Asia, high-income, upper- and lower�middle-income countries, overweight children are less likely to have caries in primary
dentition than normal-weight children. Highest inequalities are in South Asia, countries
with sugar consumption per-capita higher than the WHO recommendation and lower�middle-income countries. In West Asia, East Asia, high-income, and upper-middle�income countries, obese children are less likely to have caries in primary dentition than
normal-weight children. Highest inequalities are in West Asia and high-income countries.
Underweight children have more caries in primary dentition in South Asia, East Asia, and
West Asia, the highest inequalities in South Asia. In permanent dentition, underweight
children from South Asia are less likely to have caries. Also, in lower-middle-income
countries, underweight children less likely to have more caries in permanent dentition
than normal-weight children (positive association). In high-income countries,
underweight children have more severe caries than normal-weight children. Overweight
and obese children are less likely to have caries in permanent dentition than normal�weight children in West Asia, a negative association. These findings are rated as low to
very low by GRADE. Conclusion: In Asia, the negative association between BMI and
caries is revealed in the primary dentition. Regions, sugar consumption per-capita, and
SES of countries influenced the association between BMI and caries. Future studies for
other anthropometric measurements than BMI, studies from South East Asia and Central
Asia are required. |
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