Food insecurity and dental caries in schoolchildren: a cross‐sectional survey in the western Brazilian Amazon

We analyzed the association between food insecurity and dental caries in 7‐ to 9‐yr‐old schoolchildren. We performed a cross‐sectional survey nested in a population‐based cohort study of 203 schoolchildren. The participants lived in the urban area of a small town within the western Brazilian Amazon. Dental examinations were performed according to criteria recommended by the World Health Organization. The number of decayed deciduous and permanent teeth as a count variable was the outcome measure. Socio–economic status, food security, behavioral variables, and child nutritional status, measured by Z‐score for body mass index (BMI), were investigated, and robust Poisson regression models were used. The results showed a mean (SD) of 3.63 (3.26) teeth affected by untreated caries. Approximately 80% of schoolchildren had at least one untreated decayed tooth, and nearly 60% lived in food‐insecure households. Sex, household wealth index, mother's education level, and food‐insecurity scores were associated with dental caries in the crude analysis. Dental caries was 1.5 times more likely to be associated with high food‐insecurity scores after adjusting for socio–economic status and sex. A significant dose–response relationship was observed. In conclusion, food insecurity is highly associated with dental caries in 7‐ to 9‐yr‐old children and may be seen as a risk factor. These findings suggest that food‐security policies could reduce dental caries.