Peer-reviewed article
Does stunting modify the impact of salivary factors and early childhood caries on oral health-related quality of life?
Setiawan AS, Caesarini M, Musnamirwan IA, Primarti RS, Indriyanti R ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether stunting (chronic malnutrition) changes how oral health problems affect quality of life in young children in Indonesia. Researchers compared 210 preschool children aged 2-5 years, half with stunting and half without, measuring their dental cavities, saliva properties, and reported impacts on daily life. While stunted children had more acidic saliva and fewer cavities, stunting did not significantly change how dental or salivary factors affected children's quality of life. The authors recommend combining oral health education with nutrition support to address both stunting and tooth decay.
Key points
- Non-stunted children had higher mean deft scores (dental cavities) at 6.50 compared to stunted children at 5.12
- Acidic saliva was more common in stunted children (11.4%) than non-stunted children (3.8%)
- No significant differences in oral health-related quality of life scores between stunted and non-stunted groups
- Stunting did not modify the relationship between salivary factors, early childhood caries, and quality of life
- Study suggests combining oral health education with nutritional interventions for comprehensive prevention
Limitations
This is a cross-sectional study, so it cannot establish causation or determine how relationships change over time. The study measures associations at one point in time and cannot explain why stunted children had fewer cavities despite more acidic saliva, limiting understanding of underlying mechanisms.
Abstract
Background Stunting, a form of chronic malnutrition, is associated with impaired growth and potential changes in salivary function that may increase susceptibility to early childhood caries (ECC). These oral conditions may further influence a child's oral health-related quality of life (OHRQoL). However, the extent to which stunting modifies the impact of salivary factors and ECC on OHRQoL remains unclear. Methods This analytical cross-sectional study included 210 preschool children aged 24-59 months in Bandung, Indonesia, equally divided into stunted and non-stunted groups based on height-for-age z-scores (HAZ <-2 SD for stunted). Dental caries was assessed using the deft index, while salivary pH and buffering capacity were measured using the GC Saliva Check Buffer Test. OHRQoL was evaluated using a modified Early Childhood Oral Health Impact Scale (ECOHIS) with a dichotomous response format (never = 0, ever = 1) validated through pilot testing (Cronbach's α = 0.870). Statistical analyses included Mann-Whitney U, Chi-square, and t-tests, followed by logistic regression with interaction terms to examine effect modification by stunting. Results Non-stunted children had higher mean deft scores (6.50 ± 4.43) compared to stunted children (5.12 ± 4.38, p = 0.020). Acidic Saliva was more frequent among stunted children (11.4%) than non-stunted children (3.8%, p = 0.037). However, no significant differences were observed in ECOHIS total scores or in the impact of OHRQoL between groups (p > 0.05). Logistic regression revealed no significant interactions between stunting, ECC, salivary pH, or buffering capacity (all p > 0.05). Conclusion Stunting did not affect the association between salivary factors, early childhood caries, and oral health-related quality of life in preschool children. Although children with stunted had slightly higher salivary acidity, these differences did not result in measurable differences in quality of life. Prevention should combine oral health education and nutritional interventions to comprehensively address the risk of stunting and dental caries.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Measurement and analysis of the relationship between stunting status, salivary factors (pH and buffering capacity), dental caries, and oral health-related quality of life using validated scales and clinical assessments
- Population
- 210 preschool children aged 24-59 months in Bandung, Indonesia, divided equally into stunted (height-for-age z-score <-2 SD) and non-stunted groups
Key finding
Non-stunted children had higher mean deft scores (6.50 ± 4.43) versus stunted children (5.12 ± 4.38, p = 0.020)