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Objectives To examine whether oral health-related quality of life (OHRQoL) explained the negative associations between dental caries and anthropometric measures of child growth among a sample of 5- to 9-year-old children in Dhaka, Bangladesh, while taking potential confounding factors (maternal education, family income, study setting, child's birth weight and childhood diseases) into account. In addition, to test whether specific oral impacts had a role in explaining these associations. Methods Data collection was conducted via a cross-sectional survey among children and their parents from both hospital and school settings in Dhaka. Dental caries and severe consequences of dental caries (defined here as dental sepsis) were the exposure variables, and age- and sex-adjusted height-z-scores (HAZ), weight-z-scores (WAZ) and BMI-z-scores (BAZ) were the outcome variables. OHRQoL was measured using the Bengali version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). First, associations between oral impacts (prevalence of overall impacts and specific items of the SOHO-5) and outcome measures were assessed. Multiple linear regression was used to assess associations between caries and anthropometric measures, adjusted for potential confounders. Oral impacts were then added to test whether their inclusion attenuated the associations between exposures and outcomes. To further investigate potential mediating role of oral impacts, structural equation modelling (SEM) was used to test the hypothesis that dental caries and sepsis were associated with the outcomes directly and also indirectly via oral impacts in general. A similar approach was used to investigate mediation by specific SOHO-5 items. Results The sample consisted of 715 children, 73.1% of whom had dental caries, 37.5% presented with sepsis, and 57.3% reported at least one oral impact (SOHO-5 score ≥1). Prevalence of overall oral impacts and also the impact on 'eating difficulty' (a specific item of SOHO-5) were negatively associated with all three outcomes. Dental caries and sepsis was associated with lower HAZ, WAZ and BAZ, and adjustment for overall oral impacts considerably attenuated the associations between 'severe dental caries' and outcomes, and dental sepsis and outcomes. Using SEM, we found significant indirect associations between caries and sepsis and anthropometric measures via oral impacts (except for dental caries and HAZ). Considering specific oral impacts, eating difficulties explained about 44% and 65% of the associations between caries and anthropometric outcomes, and dental sepsis and anthropometric outcomes, respectively. Conclusions Oral impacts, in particular eating difficulties, appear to mediate associations between caries and markers of child growth among this population.

Objectives This study aimed to investigate the influence of community water fluoridation on ethnic inequalities in untreated dental caries among children and adolescents in Brazil while taking the human development context into account. Methods Data from a nationwide Brazilian epidemiological population oral health survey were used (SB Brazil 2010). Outcomes were caries prevalence measured by the proportion of individuals with one or more untreated decayed teeth and caries severity defined by the mean number of untreated decayed teeth (DT). Three different contexts were considered: 1-cities with no water fluoridation; 2-cities with water fluoridation and low Human Development Index (HDI); and 3-cities with water fluoridation and high HDI. The exposure was ethnic/racial group (White, Pardo, Black) and covariates were age, sex and household income. Multilevel logistic and negative binomial regressions were performed with 6696 children (aged 5 years) and 11 585 adolescents (aged 12 and 15-19 years). Results For both children and adolescents, ethnic differences in caries prevalence and mean DT were found in the nonfluoridated cities with low HDI and also in cities with high HDI, most of which were fluoridated. For example in nonfluoridated cities with low HDI, 5-year-old Pardo children were more likely to have untreated decay (OR = 1.22; 95% CI: 1.02, 1.46) and had more decayed teeth (RR = 1.18; 95% CI: 1.04, 1.34) than their White counterparts after adjusting for sex and household income. No statistically significant differences were observed in fluoridated cities with low HDI. Conclusion Water fluoridation appears to be associated with reduced ethnic inequalities in dental caries prevalence and mean DT among children and adolescents in more disadvantaged settings.

AIM This study aimed to assess associations between dental caries and anthropometric measures among a sample of children aged 5-9 years in Dhaka, Bangladesh. METHODS A cross-sectional observational study was conducted among 5- to 9-year-old children in Dhaka, Bangladesh. Data were collected from children and their parents attending the Dhaka Dental College Hospital and from three nearby primary schools. The outcome measures were as follows: age and sex adjusted height-z-scores (HAZ), weight-z-scores (WAZ) and BMI-z-scores (BAZ). Multiple linear regressions were used to assess the associations between caries and anthropometric measures, adjusted for maternal education, family income, study setting, birth weight and childhood diseases as potential confounders. RESULTS The final sample comprised 788 children, and the overall response rate was 96.7%. The majority (73.2%) had experience of dental caries. The mean dmft + DMFT score was 2.84 (95% CI 2.64, 3.03) and 35.8% experienced dental sepsis. Dental caries and sepsis were negatively associated with HAZ, WAZ and BAZ scores. After adjustment for potential confounders, children with severe levels of caries had lower HAZ scores (coefficient: -0.40; 95% CI -0.69, -0.10), lower WAZ scores (coefficient: -0.59; 95% CI -0.94, -0.24) and lower BAZ scores (coefficient: -0.50; 95% CI -0.87, -0.13) than those who were caries free. Children with moderate levels of caries also had lower WAZ scores (coefficient: -0.43; 95% CI -0.72, -0.15) and lower BAZ scores (coefficient: -0.43; 95% CI -0.72, -0.13) than caries-free children. Children with dental sepsis had lower HAZ (coefficient: -0.23; 95% CI -0.42, -0.03), WAZ (coefficient: -0.33; 95% CI -0.56, -0.10) and BAZ scores (coefficient: -0.29; 95% CI -0.53, -0.05) than dental sepsis-free children. CONCLUSIONS Dental caries was associated with lower height, weight and BMI among this sample of Bangladeshi children, even after adjusting for age and sex and a number of potential confounders.

OBJECTIVES: The aim of this study was to assess whether traumatic dental injuries (TDI) were socially graded among children and adolescents in England, Wales and Northern Ireland, using nationally representative data from the Children's Dental Health Survey (CDHS) 2013. METHODS: This cross-sectional study used data from the Children's Dental Health Survey 2013 which was conducted among a nationally representative sample of schoolchildren in England, Wales and Northern Ireland. Children's family socioeconomic position (SEP) was measured through free school meal eligibility and relative area deprivation using the Indices of Multiple Deprivation. The analytical sample included 6707 schoolchildren aged 8, 12 and 15. Multiple logistic regression was used to model the associations between experience of TDI and the two markers of SEP, after adjusting for sex and age. RESULTS: The overall prevalence of traumatic dental injuries to permanent incisors was 9% (n = 590). There were no statistically significant associations between TDI and either SEP measure. Further subgroup analyses (n = 2650) showed also no significant associations between TDI and additional SEP markers (parental education and social class). The odds of having sustained a traumatic dental injury were higher for boys than for girls and were greater in older age groups. CONCLUSIONS: This study found no significant relationships between the experience of traumatic dental injuries and two markers of family socioeconomic position among children living in England, Wales and Northern Ireland. This implies that rather than specifically targeting the more deprived sectors of society, TDI prevention policies should use upstream public health strategies incorporating a whole-population approach.© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Language: en

In the last two decades, there has been increasing application of the concept of social capital in various fields of public health, including oral health. However, social capital is a contested concept with debates on its definition, measurement, and application. This study provides an overview of the concept of social capital, highlights the various pathways linking social capital to health, and discusses the potential implication of this concept for health policy. An extensive and diverse international literature has examined the relationship between social capital and a range of general health outcomes across the life course. A more limited but expanding literature has also demonstrated the potential influence of social capital on oral health. Much of the evidence in relation to oral health is limited by methodological shortcomings mainly related to the measurement of social capital, cross-sectional study designs, and inadequate controls for confounding factors. Further research using stronger methodological designs should explore the role of social capital in oral health and assess its potential application in the development of oral health improvement interventions.