To overcome malnutrition, the Government of India has introduced Integrated Child Development Services (ICDS) program for children below 6 years and pregnant and nursing mothers. This program includes preschool education for children in the 3–6-year-age group, immunization of children and mothers, health checkup by medical officers, referral services for health, and education about importance of nutrition. Oral health conditions, dietary practices, nutritional status, and general health status are all interrelated factors. Malnutrition adversely affects the oral structures. The issue of malnourishment and infant mortality is rampant across the state of Karnataka. Studies have shown that early malnutrition affects tooth structure, delay in tooth eruption, and results in increased dental caries.
The children of India are malnourished because of factors attributed to overpopulation, poverty, large family size, poor maternal health, adverse cultural practices, destruction of the environment, and lack of education, gender inequality, and inaccessible medical care. Growing malnourished children exhibit behavioral changes, including irritability, apathy, decreased social responsiveness, anxiety, attention deficits, impaired growth, poor school performance, and decreased intellectual achievement. However, malnutrition is also known to produce high morbidity and mortality and considering its effect on oral cavity, malnutrition is shown to have preeruptive and posteruptive effects. Oral health conditions, dietary practices, nutritional status, and general health status are all interrelated factors. Malnutrition adversely affects the oral structures. Studies have shown that early malnutrition affects tooth structure, delay in tooth eruption, and results in increased dental caries. It is also associated with enhanced susceptibility to caries because of impaired saliva secretion due to salivary glandular hypofunction and saliva compositional changes. Malnutrition appears to have multiple effects on the oral tissues and subsequent development of oral disease. It results in altered tissue homeostasis, reduced resistance to microbial biofilms, and tissue repair capacity.
To reduce the high caries burden in this population, prevention and intervention should be initiated at the earliest. Regular oral hygiene aids along with remineralizing agents should be provided free of cost or at subsidized prices so that hypoplastic teeth do not progress to dental caries. It is evident from this study that malnourished children are prone to compromised oral health. Community-based oral preventive measures should be taken to reduce the oral health problems in these children. Oral health education should be given to the mothers on feeding and dietary practices. Both parents and children should be made aware of oral hygiene measures and continuous reinforcement should be carried out at regular intervals. Motivation of anganwadi workers is necessary to explain the oral health-related problems through nonconventional ways such as short plays, videos, and games. Establishment of dental home is utmost important in these children, so that their unmet dental caries needs can be treated. madhusudhan kempaiah siddaiah
Int J Clin Pediatr Dent
Int J Clin Pediatr Dent 2020;13(1):6–10.