The present study was conducted with a total of 254 12-year-old children enrolled in three different middle schools (high, moderate, and low socioeconomic status) to examine the effects of socioeconomic status, oral and dental health practices, dietary habits, and anthropometric measurements on oral and dental health.
Oral and dental health in school-age children totally depends on such factors like oral hygiene behavior of children, dietary habits, socioeconomic status, regular dental examination, age, and other demographic and cultural characteristics [3, 6, 7]. Socioeconomic factors have become increasingly scrutinized in studies as they affect the prevalence of dental caries, oral health practices, and parental knowledge on oral and dental health [13, 14]. It is stated that families with high socioeconomic status behave more conscious about their children’s dental health . In this study, it was shown that factors affecting oral and dental health, such as tooth brushing practices, age, and frequency of seeing a dentist and oral and dental health education vary by the one’s socioeconomic status. Oral and dental health practices were found to be better in the children of families with high socioeconomic status (Table 2). Similarly, in other studies, children with high socioeconomic status are more likely to see a dentist [4, 16] and to have higher rates of regular brushing . The fact that children from higher-income households have more chances to access to dental care, including a more specific diagnostic assessment and have one or more filled teeth explains the difference in oral and dental health by the ones’ socioeconomic status. Higher prevalence of caries in lower socioeconomic status may be due to lack of prevention and treatment services most of the time. It is important that both children and their parents with low socioeconomic level are educated in oral health, awareness raising, and guided to make more use of treatment services.
Oral and dental diseases are seen different rates in every society and ages. The World Health Organization and the World Dental Federation (FDI) recommended that DMFT should not be more than 3 for 12 years until 2000, as one of the global goals for oral and dental health . In this study, the mean DMFT value is 2.0 ± 1.90 and the recommended goal was reached. Considering certain studies conducted by countries, the mean DMFT values were determined as 4.8 ± 3.22 in Bosnia and Herzegovina , 0.14 in Nigeria , 3.3 ± 2.3 in Russia and 0.5 ± 0.8 in Norway , and 1.64 in Thailand . Dental caries were determined in 70.9% of the children in the general sample, 61.6% of boys and 78.2% of girls (p < 0.05) (Table 2). There was no significant difference between gender and the mean DMFT\dmft value which was found to be 1.9 ± 2.2 in 12-year-old children in the Study for Oral and Dental Health Profile of Turkey . In parallel with this study, although there are other studies revealing that the mean DMFT in girls is higher [3, 21], it was determined in some studies that oral and dental health indicators were similar by gender [7, 16, 22]. It is stated that the prevalence of caries may be higher due to the earlier ages for dentition in girls and the emergence of periodontal problems due to hormonal changes in puberty period.
Since dental caries has a multifaceted etiology including general health, nutrition, plaque, saliva secretion, type and amount of microorganism, sensitivity of host, oral hygiene habits, use of fluoride, social and behavioral factors, any relationship between oral and dental hygiene practices and caries is difficult to be detected . In this study, it was found that the indicators for milk teeth of those who have higher tooth brushing time and frequency are better (p < 0.05) (Table 3). Proper oral and dental hygiene is also effective in preventing many diseases that are not associated with caries. The most common diseases such as caries and periodontal diseases are caused by poor oral hygiene practices as well as other factors , and children are important to be educated in subjects such as brushing style, duration, and frequency.
Dietary habits play an important role in general health status and oral health . In one study, the predominant factor in caries risk profile was shown to be diet . In this study, the mean DMFT\dmft values of the children consuming foods with high cariogenic potential were determined likely to be high (Table 4). In a study conducted to examine the effect of backward dietary habits of children on dental health, those who consumed foods increasing the risk of dental caries more than three times a day at the age of one and those who consumed candy more than once a week at the age of 3 were found to have higher number of decayed and filled teeth at the age of 15 . The negative relationship between nutritional status and caries is explained by main meals and snacks. Main meals are stated to contain higher protein and fat and lower sugar than snacks so that snacks are associated with caries. While being exposed to sugary and starchy foods during meals reduces the risk of caries, it was revealed that high sugar consumption with snacks increase such risk.
Dental caries, obesity, and malnutrition are global diseases with adverse effects on health [27, 28]. As there are common risk factors for these diseases, the relationship between body weight and tooth decay has been the subject of many studies [29,30,31,32]. People who have an unbalanced diet with low nutritional value and high sugar and energy content are often affected by both malnutrition and caries. In addition, it is stated that there is a positive relationship between obesity and dental caries with increasing food and refined food consumption and consumption frequency. Therefore, it was investigated whether there is a causal relationship between dental diseases and anthropometric measurements or whether they share the same risk factors . In this study, a negative relationship was found between anthropometric measurements and oral and dental health indicators (Table 5). Contradictory results were found in both research and review studies on body weight and oral health in children. Some studies showed a positive correlation between body weight and tooth decay [26, 33,34,35], some of them revealed a negative relationship [3, 6, 36], and others found no relationship between them [16, 37,38,39]. Besides, different results were reached according to different age groups [19, 40]. A negative relationship between anthropometric measurements and tooth decay may be caused by the risk of a weak immune system and dietary habits based on foods with low nutritional values and high energy foods in children with low body weight. The difficulty in studying the relationship between dental caries and obesity is due to the fact that many factors need to be measured at the same time in a standard way.