Dental News - Study suggests school food environments strongly influence caries in kids

Dental Tribune International

Mon. 6. November 2017

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QUEBEC CITY, Canada: The occurrence of dental caries may depend in part on school-based environmental or policy-related factors, but few researchers have explored this subject. Now, a Canadian study has identified types of oral health-promoting school environments and found an association with lower two-year dental caries incidence among Quebecois children attending these schools.

Food choices in and around schools vary greatly and affect the general health of children. It is an environment often carefully observed to understand its impact on obesity prevalence, but rarely in relation to cavities. In Quebec, there has been no impact study on oral health promotion since provincial guidelines were published in 2005. For the current study, a team of Montreal researchers, including Dr. Tracie Barnett of the Institut national de la recherche scientifique (INRS), investigated schools in Greater Montreal to see how oral health was being promoted and the effect this had on cavity rates in children.

This study used data from two visits completed in 2008 and 2011 as part of the Quebec Adipose and Lifestyle Investigation in Youth, which recruited white children at risk of obesity and their families from Greater Montreal schools. Measures included school and neighborhood characteristics, and decayed, missing or filled surfaces index scores. The data was evaluated using principal component and cluster analysis and generalized estimating equations.

Over a period of two years, the INRS research team analyzed various factors affecting 330 students at 200 schools, including socioeconomic factors, school food environments and cavity prevention programs. The authors identified three distinct school environment types. Type 1 and 2 schools had strong healthy eating programs, whereas Type 3 had weak programs. Type 1 schools had favorable neighborhood food environments, whereas Types 2 and 3 had unfavorable ones. After adjusting for potential confounders, the researchers found that children attending Type 1 and 2 schools had a 21 percent and 6 percent lower two-year incidence of dental caries, respectively, compared with those at Type 3 schools.

Because cavities remain a public health concern, the researchers recommended making this component part of health promotion programs alongside obesity. Policies promoting healthy eating environments could have a greater impact on children’s oral health than school programs run in isolation to encourage kids to take good care of their teeth.

The study, titled “Oral health–promoting school environments and dental caries in Québec children,” was published in the November issue of the American Journal of Preventive Medicine.