Avaliação longitudinal do índice de massa corporal antes e após restauração de lesões cavitadas de cárie em pré-escolares.

Abstract

Body Mass Index (BMI) non ideal may have risk factors in common with dental caries, but it can also be considered an outcome of this disorder. Obese children tend to consume foods with fermentable carbohydrates more often. On the other hand, children with dental caries may avoid eating or tend to swallow food without adequate mastication, leading to weight loss and weight gain, respectively. Thus, it is possible that the restorative treatment of dental caries, improving masticatory function, promotes some change in BMI. The aim of this study was to assess whether restorative treatment influences changing the BMI of preschool children with cavitated dental caries in posterior teeth. A longitudinal study with children aged 3 to 4 years, accompanied by a period of between three and six months, was carried out in the city of Diamantina, Minas Gerais. The sample was composed by 132 children distributed into two groups. One group was composed by children with untreated cavitated dental caries, without pulp involvement, in posterior teeth (intervention group) and the other group was composed by children without dental caries (control group). For the composition of the control group, children from the group that received the intervention were paired with children of the same age, sex and school who did not have cavitated dental caries. All assessment instruments were applied in two moments for both groups. For the group that received the intervention, evaluations were performed before treatment (M1) and after a minimum interval of 3 months and a maximum of 6 months after its completion (M2). For the control group, the assessments were performed on the same day as the pair in the intervention group. Before the clinical examination and restorative dental treatment, parents/guardians, the parents/caregivers filled out a form addressing socioeconomic characteristics. The children underwent clinical oral examination and anthropometric assessment to calculate the Body Mass Index (BMI). Dental caries was assessed using the International Caries Detection and Assessment System (ICDAS II). Those children with obvious caries lesions (ICDAS codes 3, 4, 5 and 6) in their posterior teeth were included in the intervention group. The presence of malocclusion was defined according to the criteria proposed by Foster and Hamilton (1969). The calculation of BMI was performed using the formula that divides weight (kg) by height (m) squared (BMI = weight/height2). Restorative treatment was carried out using the principles of selective caries removal. Resin-modified glass ionomer cement (it was the material of choice, following the manufacturer's recommendations. Descriptive analysis and uni- and multivariate logistic regression were performed. The outcome was dichotomized into maintenance of BMI, between baseline and follow-up, and change from BMI to normal BMI, that is, children who had low or high BMI in the first assessment and normal in the second assessment. Children aged 4 years (OR= 17.6; 95%CI= 2.2-24.8; p=0.006) and who belonged to the group that received restorative treatment (OR=5.0; 95%CI 1.6-16.2; p=0.004) had a greater chance of change to normal BMI. The number of restored teeth was associated with a change to normal BMI in the unadjusted analysis but lost the association after adjustment. Restorative treatment had a positive effect on change of BMI of preschool children.