271410 Cross-sectional Examination of Early Childhood Caries and Obesity in Disadvantaged Three Year Old Hispanic Children Using Percentiles and Z-scores

Tuesday, October 30, 2012

Mary Pawlak, MD , Preventive Medicine, Colorado School of Public Health, Aurora, CO
Misoo Ellison, PhD , Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO
Simon Hambidge, MD, PhD , Community Health Services, Pediatrics, Denver Health, University of Colorado School of Medicine, Denver
Karen Savoie, RDH, BS , Colorado Area Health Education Center Program, University of Colorado Anschutz, School of Medicine, Aurora, CO
Katina Widmer, MA , Children's Outcomes Research, University of Colorado, Aurora, CO
Patricia Braun, MD, MPH , Children's Outcomes Research, University of Colorado Anchutz Medical Campus, Aurora, CO
Background: Caries is the most common chronic condition in children, and it is postulated to be associated with obesity.

Objectives: This study examined the relationship between early childhood caries (ECC) and body mass index (BMI) in 3-year old children and compared the BMI percentile to BMI z-score in assessing this relationship.

Methods: Using administrative data, we recruited a random, cross-sectional sample of 3-year old children receiving primary medical care in a large urban safety-net medical system. Three calibrated dental examiners measured their decayed (d), missing (m), and filled (f) tooth surfaces (dmfs). Height and weight were obtained at medical visits. Descriptive frequencies, chi-square tests and multiple logistic regression models were conducted to examine relationships between ECC and BMI percentile or BMI z-score.

Results: We measured ECC in 401 children whose caregivers reported them as Hispanic (87%) and having Medicaid (87%). Their mean age (standard deviation) was 3.4 (0.24) years. ECC prevalence (any dmfs) was 54%. Mean BMI percentile was 50 (27) and mean BMI z-score was -0.03 (0.89). Chi-square tests and multivariate analyses adjusting for socio-demographic variables revealed no significant associations between ECC and BMI percentile or BMI z-scores (p>0.05). The regression model beta coefficient for ECC and BMI percentile was 0.14 (p=0.5) and ECC and BMI z-score was -0.04 (p=0.7).

Conclusions: We found no significant association between ECC and BMI in this population. BMI percentile and BMI z-scores revealed comparable results. The use of BMI z-scores should be considered in future studies to ensure external comparability between study populations.

Learning Areas:
Public health or related research

Learning Objectives:
Explain why BMI z-scores are preferable to use in studies related to caries and BMI

Keywords: Early Childhood Caries, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a registered dental hygienist and Associate Professor at the University of Colorado, Anschutz Medical campus, Area Health Education Center program. I am the Director of Education for the Cavity Free at Three project, a statewide initiative aimed at raising awareness of the prevalence and consequences of early childhood caries in Colorado.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.