March 2019 Volume LIV Number 2

 
 
 
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Ask the Policy Center

November 2016 Volume LI Number 6

Ask the Policy Center

The Role of Pediatric Dentistry in Preventing Childhood Obesity

Q. Is childhood obesity still increasing in the United States?

A. The good news: Childhood obesity has stabilized in recent years. The bad news: The incidence of obesity in children tripled during 1980–2010, rising from 6 percent to 18 percent of children ages 6–17 in just one generation.1 In 2011–2012, about 17 percent of children ages 2–18 were obese, 32 percent were either overweight or obese, and 8 percent of infants and toddlers had high weight for recumbent length.2

Q. Which of my patients are most likely to be affected?

A. The obesity epidemic in children is not an equal opportunity health concern. Although the prevalence of obesity is fairly similar between boys and girls, obesity rates tend to be higher among chil- dren in low-income households and among Hispanic and non-His- panic black children.3 In 2011–2012, 22 percent of Hispanic children and 20 percent of non-Hispanic black children were found to be obese compared with 17 percent of White, non-Hispanic children. 1

Q. What part does sugar consumption play in childhood obesity?

A. Numerous individual, social, economic and environmental forces—including diet, physical activity and technological advances – have contributed to the high prevalence of obesity in children. Within this broad picture, the trends toward increased obesity rates have been paralleled by an increase in sugar consumption.

In particular, sugared beverages are the single largest category of caloric intake in children ages 2–18, providing nearly one-quarter of empty calories in their average daily diet. For example, adolescents ages 14–18 drink an average of 260 calories a day of added sugars from sugar-sweetened beverages.4

Q. Is there a clear relationship between obesity and oral health in children?

A. You would think so, since many of the same foods and drinks can contribute to both tooth decay and obesity. But it’s complicated. Some studies have concluded that obese children have an increased caries risk, some have shown a decreased caries risk, and still other studies have found no relationship. That said, evidence suggests dental caries may be associated with both a high and low body mass index (BMI). Different factors may be involved in the caries develop- ment in children who are either underweight or overweight.5,6

Q. What are pediatric dentists doing to prevent obesity in their patients?

A. Many pediatric dentists offer nutritional education and coun- seling related to caries prevention, but few provide weight-related screening, information or counseling services. A national survey of pediatric dentists reported that about 50 percent of the respondents expressed an interest in offering obesity-related services, yet only six percent provided obesity-related interventions.7

Q. Why aren’t more pediatric dentists providing services related to healthy weight for their patients?

A. The majority of pediatric dentists agree that childhood obesity is a significant health problem and are willing to address it, but face perceived barriers in supplying obesity information and interventions to the parents of their patients. Major barriers mentioned in surveys of pediatric dentists included concerns about offending or appearing judgmental of the patient or parent, a lack of knowledge and training about obesity and/or weight-loss counseling, a lack of trained person- nel, insufficient time in the daily schedule, and concerns that state dental boards might consider such counseling as practicing medicine.8 These perceived barriers would need to be managed effectively to facilitate more weight-related interventions for child patients by pedi- atric dental professionals.

Q. Can pediatric dentists play a vital role in preventing childhood obesity?

A. In view of your frequent contact with pediatric patients, you and your team have an excellent opportunity to promote healthy weight in children. Because you have the educational foundation to address dietary habits and are adept at nutritional counseling for car- ies prevention, you can adapt these skills to intervene for early obesity prevention as well.

1Wallman KK. Federal Interagency Forum on Child and Family Statistics. America’s Children in Brief: Key National Indicators of Well-Being. 2015.
2Ogden CL, (US) NC for HS. Consumption of Sugar Drinks in the United States, 2005-2008. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics Hyattsville, MD, USA; 2011.
3Centers for Disease Control and Prevention. Disparities in oral health: Division of oral health.
4Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. Journal of the American Dietetic Association. 2010;110(10):1477-1484.
5Davidson K, Schroth R, Levi J, Yaffe A, Mittermuller B. Higher body mass index associated with severe early childhood caries. BMC Pediatrics. 2016;16(137).
6Hooley M, Skouteris H, Boganin C, Satur J, Kilpatrick N. Body mass index and dental caries in children and adolescents: a systematic review of literature published 2004 to 2011. System- atic reviews. 2012;1(1):1.
7Curran AE, Caplan DJ, Lee JY, et al. Dentists’ attitudes about their role in addressing obesity in patients: a national survey. The Journal of the American Dental Association. 2010;141(11):1307-1316.
8Lee JY, Caplan DJ, Gizlice Z, Ammerman A, Agans R, Curran AE. US Pediatric Dentists’ Counseling Practices in Addressing Childhood Obesity. Pediatric dentistry. 2012;34(3):245-250.

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