Malnourishment in a population of young children with severe early childhood caries.
Martha Clarke, David Locker, Glenn Berall, Paul B. Pencharz, David J. Kenny, Peter Judd
Abstract
Martha Clarke, David Locker, Glenn Berall, Paul B. Pencharz, David J. Kenny, Peter Judd
Abstract
PURPOSE: The purpose of this study was to describe the nutritional status of children with severe early childhood caries (S-ECC) using several clinical measurements. METHODS: Children aged 2 to 6 years with S-ECC were measured for height, weight, triceps skinfolds (TSF), and measurement of upper mid-arm circumference (MAC). Blood samples assessed: (1) hemoglobin; (2) mean corpuscular volume (MCV); (3) serum ferritin; and (4) serum albumin. Weight-for-height was converted into ideal body weight (IBW) percentiles. Body mass index (BMI) was calculated as kg/m2. TSF and MAC were converted into measurement of arm muscle circumference (MAMC). All measurements were compared with population reference values. RESULTS: Using weight for height centiles, 17% were diagnosed as being malnourished and 66% as within normal limits. Using BMI centiles, only 4% were identified as being malnourished and 75% as being normal. Conversely, the body fat of 24% was assessed as low (<10th percentile). Serum albumin was low for 16%. The majority had evidence of inadequate iron intake with low serum ferritin (80%), iron depletion (24%), iron deficiency (6%), or iron deficiency anemia (11%). CONCLUSIONS: All tests detected levels of malnutrition, with blood tests finding the most severe cases. The results suggest that severe Early Childhood Caries may be a risk marker for iron deficiency anemia. Since iron deficiency has permanent effects on growth and development, pediatric dentists should recommend assessment of iron levels in S-ECC patients regardless of their anthropometric appearance.
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PURPOSE: The purpose of this study was to describe the nutritional status of children with severe early childhood caries (S-ECC) using several clinical measurements. METHODS: Children aged 2 to 6 years with S-ECC were measured for height, weight, triceps skinfolds (TSF), and measurement of upper mid-arm circumference (MAC). Blood samples assessed: (1) hemoglobin; (2) mean corpuscular volume (MCV); (3) serum ferritin; and (4) serum albumin. Weight-for-height was converted into ideal body weight (IBW) percentiles. Body mass index (BMI) was calculated as kg/m2. TSF and MAC were converted into measurement of arm muscle circumference (MAMC). All measurements were compared with population reference values. RESULTS: Using weight for height centiles, 17% were diagnosed as being malnourished and 66% as within normal limits. Using BMI centiles, only 4% were identified as being malnourished and 75% as being normal. Conversely, the body fat of 24% was assessed as low (<10th percentile). Serum albumin was low for 16%. The majority had evidence of inadequate iron intake with low serum ferritin (80%), iron depletion (24%), iron deficiency (6%), or iron deficiency anemia (11%). CONCLUSIONS: All tests detected levels of malnutrition, with blood tests finding the most severe cases. The results suggest that severe Early Childhood Caries may be a risk marker for iron deficiency anemia. Since iron deficiency has permanent effects on growth and development, pediatric dentists should recommend assessment of iron levels in S-ECC patients regardless of their anthropometric appearance.
Key concepts: Medicine, Mean corpuscular volume, Anthropometry, Anemia, Malnutrition, Pediatrics, Hemoglobin, Iron deficiency