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BMC Public Health. 2012; 12: 725.
Published online Aug 31, 2012. doi:  10.1186/1471-2458-12-725
PMCID: PMC3490802
The effects of extraction of pulpally involved primary teeth on weight, height and BMI in underweight Filipino children. A cluster randomized clinical trial
Bella Monse,1 Denise Duijster,corresponding author2,3 Aubrey Sheiham,3 Carlos S Grijalva-Eternod,4 Wim van Palenstein Helderman,5 and Martin H Hobdell3
1Gesellschaft für Internationale Zusammenarbeit (GIZ), Leviste cor Rufino Street, Makati City, Metro Manila, Philippines
2Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA, The Netherlands
3Department of Epidemiology and Public Health, University College London, Torrington Place 1-19, London, WC1E 6BT, UK
4Centre for International Health & Development, UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
5Dental Health International Nederland (DHIN), Korte Linschoten OZ 14, Linschoten, 3461 CG, The Netherlands
corresponding authorCorresponding author.
Bella Monse: bella.monse/at/giz.de; Denise Duijster: d.duijster/at/acta.nl; Aubrey Sheiham: a.sheiham/at/ucl.ac.uk; Carlos S Grijalva-Eternod: c.eternod/at/ucl.ac.uk; Wim van Palenstein Helderman: w.vanpalenstein/at/gmail.com; Martin H Hobdell: m.hobdell/at/ucl.ac.uk
Received April 27, 2012; Accepted July 20, 2012.
Abstract
Background
Severe dental caries and the treatment thereof are reported to affect growth and well-being of young children. The objective of this study was to assess the effects of extraction of severely decayed pulpally involved primary teeth on weight and height in underweight preschool Filipino children.
Methods
Underweight preschool Filipino children with severe dental decay had their pulpally involved primary teeth extracted during a stepped wedge cluster randomized clinical trial. Day care centers were randomly divided into two groups; children from Group A day care centers received treatment as soon as practical, whereas children from Group B day care centers were treated four months after Group A. Clinical oral examinations using WHO criteria and the pufa-index were carried out. Anthropometric measurements were done on both groups immediately before treatment of Group A and at follow-up four months later. Height and weight z-scores were calculated using 2006 and 2007 WHO Growth Standards. Multilevel analysis was used to assess the effect of dental extractions on changes in anthropometric measurements after dental treatment.
Results
Data on 164 children (85 in Group A and 79 in Group B), mean age 59.9 months, were analyzed. Both groups gained weight and height during the trial period. Children in Group A significantly increased their BMI (p < 0.001), and their weight-for-age (p < 0.01) and BMI-for-age z-scores (p < 0.001) after dental treatment, whereas untreated children in Group B did not. Children in Group A had significantly more weight gain (p < 0.01) compared to untreated children in Group B. However, children in Group A had an inverse change in height gain (p < 0.001). Adjustment for the time interval between the two visits had little effect on the results.
Conclusions
The extraction of severely decayed primary teeth resulted in significant weight gain in underweight Filipino children. Untreated dental decay should be considered an important co-factor affecting child growth and should be considered when planning for interventions to improve child growth.
Keywords: Underweight, Weight gain, Growth, Dental caries, Dental decay, Tooth extraction, Dental extraction, Stepped wedge design, Cluster randomized trial, Clinical trial
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