Research Confirms Link Between Childhood Caries Risk and Food Insecurity

A recent evaluation of data collected from the 2013/2014 National Health and Nutrition Examination Survey (NHANES) reveals that children ages 1 to 19 are at increased risk of developing dental caries in the presence of food insecurity. The analysis confirms a significant correlation between food security and children’s oral health.¹

While such findings aren’t particularly surprising, they indicate that the chance of developing caries is 2.9 times higher than average among children with very low food security. In addition, the prevalence of tooth decay for these kids appears to increase with age. Within this group, the incidence of caries is 2.6 times higher for kids ages 6 to 11; 2.9 times higher for those ages 12 to 15; and for adolescents ages 16 to 19, the likelihood of developing caries is a whopping 4.2 times higher than average.¹

UNDERSTANDING FOOD SECURITY CLASSIFICATIONS

Assessments for food security (or insecurity) have been used by the United States Department of Agriculture (USDA) since 1995. Food security pertains to situations in which access to nutrition, required to sustain a healthy life, is uncertain. This is usually a product of socioeconomic status.

The USDA defines various levels of food security as follows:²

• High food security: no indication of lack of access or limitations to food.
• Marginal food security: presence of anxiety about obtaining food or shortage of food, with little indication of dietary or food intake changes.
• Low food security: reduced quality, variety, or desirability of diet, without actual reduction of food intake.
• Very low food security: multiple indications of reduced food intake and disrupted eating patterns.

NOT AN OUTLIER

The 2013-2014 NHANES survey statistics are in line with the conclusions of numerous investigations, including a 2019 study, whose findings indicate a high correlation between food insecurity and decay in preschool children. In that study, 82 children, ages 12 months to 71 months were examined after their caregivers filled out a USDA food insecurity questionnaire. Examination results were recorded using the decayed, missing, filled teeth (DMFT) index.³ Researchers found statistically significant correlations between food insecurity and DMFT in these very young children. Results also indicated that parental age made a difference, with higher levels of food insecurity being associated with circumstances in which the father was younger than 25. Of the 82 children, 11% had marginal food security; 24.4% had low food security; and 6.1% had very low food security.³

Lack of food security is, of course, implicated in more oral health issues than just caries risk. Inadequate nutrition can foster everything from periodontal diseases to abnormal alveolar bone patterns.⁴ It’s one more factor for oral health professionals to consider when examining and educating their patients.

References

1. Hill B. Evaluating the association between food insecurity and dental caries in US children 1-19 years: results from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Available at: Click here.
2. United States Department of Agriculture. Definitions of Food Security. Available at: Click here.
3. Angelopoulou MV, Shanti SD, Gonzalez CD, Love A, Chaffin J. Association of food insecurity with early childhood caries. Available at: Click here.
4. Tungare S, Paranjpe AG. Diet and nutrition to prevent dental problems. Available at: Click here.