“Malnourishment in early life is likely to affect oral health later in life.”
— Germain Jean-Charles, B.D.S.
Haitian children who were exposed to protein-energy malnutrition during the first five years of their lives had a higher occurrence of periodontal disease by adolescence than children who had sufficient nutrition during those years, according to a study presented at the recent International Association for Dental Research (IADR) meeting in Miami.
"This study shows that malnourishment in early life is likely to affect oral health later in life," said study author Germain Jean-Charles, B.D.S., a resident in maxillofacial pathology at the University at Buffalo School of Dental Medicine, in an interview with DrBicuspid.com. "Malnourishment is likely to affect the development of the immune system, which can impact the balance between immune response and bacteria [and] lead to the development of periodontal problems later in life."
This is the first study to report that a documented history of early childhood protein-energy malnutrition is related to the subsequent development of periodontal problems in the permanent dentition, Dr. Jean-Charles added.
The researchers examined 96 subjects between the ages of 12 and 19 in rural Haiti for clinical signs of periodontal disease using Community Periodontal Index (CPI), an epidemiologic tool developed by the World Health Organization.
The researchers ranked them on a scale of 0 to 4, with 0 signifying healthy tissue and 4 indicating a pathologic pocket or gum/periodontal disease.
The subjects had already participated in a nutrition study during their first five years. Data for that study was collected by a nongovernment organization from 1988 to 1993 in the rural community of Jérémie, Haiti. The authors noted that socioeconomic status was related to malnutrition, and that children from the poorest category were more likely to be malnourished.
In the more recent study, more than 50% of the study participants had been exposed to early protein-energy malnutrition, and more than 57% of them had a CPI score of 3 or greater in at least one of the six sections of permanent teeth.
Early childhood protein-energy malnutrition was independently and positively related to mean CPI score, and adolescents who were malnourished during the first five years of life had higher mean CPI scores compared to those who were not malnourished, the authors noted.
Early childhood protein-energy malnutrition measured in childhood "was related to the subsequent development of periodontal disease associated with permanent teeth in Haitian adolescents aged 12-19," they concluded.
This was a small pilot study, however, and larger studies are needed to fully test this hypothesis, Dr. Jean-Charles said.
He is hoping to receive funding to train Haitian lay health workers to apply sealants to teeth of young children to prevent the development of dental decay and gum disease.
The study was supported by a grant from the National Institute for Dental and Craniofacial Research.
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