Nutritional status and its association with early childhood caries in Peruvian pre-schoolers aged 3–5 years: a cross-sectional study

López-Ramos R.P.; Vidigal E.; Jimenez-Hualpa B.R.; Cabrera L.; Saito M.; Gilman R.H.; Pajuelo M.J. · European Archives of Paediatric Dentistry (2026) · DOI: 10.1007/s40368-026-01295-8

Resumen

Purpose: This study aimed to evaluate the association between nutritional status, assessed through multiple anthropometric indicators, and early childhood caries (ECC) in Peruvian preschoolers. Methods: A cross-sectional study was conducted using data from 204 children aged 3–5 years enrolled in a birth cohort. Nutritional status was evaluated using anthropometric indicators from the World Health Organisation; data from the first 2 years of life were retrieved from the original birth cohort records, whilst subsequent assessments were conducted at the time of the study. ECC was assessed using the simplified International Caries Detection and Assessment System (ICDAS). A questionnaire was administered to mothers/caregivers regarding factors associated with ECC. Owing to COVID-19-related restrictions, data collection was carried out in two stages, 17 months apart, extending the originally planned data-collection period. Poisson regression with robust variance was performed to examine the associations between ECC and nutritional status, adjusting for confounding variables. Effect modification by COVID-19-related assessment period was assessed by including an interaction term in the Poisson model, with a Mantel–Haenszel stratified analysis as a sensitivity check. Results: ECC prevalence was 6.6% lower for each one-unit increase in BMI-for-age z score (95% CI: 0.1%, 12.8%). Poor oral hygiene (PR: 3.592; 95% CI: 1.889, 6.829) and frequent sweet consumption (PR: 1.200; 95% CI: 1.001, 1.439) were associated with ECC. There was no evidence of effect modification by assessment period. Conclusion: An association was observed between BMI-for-age and ECC, with a lower prevalence of ECC amongst children with higher BMI-for-age values. These findings highlight the complex relationship between nutritional status and oral health in preschool children. © The Author(s), under exclusive licence to European Academy of Paediatric Dentistry 2026.

Instituciones: Universidad Peruana Cayetano Heredia; Universidad Científica del Sur