The effect of extracting badly decayed baby teeth from young underweight Filipino children on the children’s weight and height

Plain English summary of protocol

Background and study aims
In many low- and middle-income countries, the proportion of untreated dental decay of the baby teeth in young children is high. In a national study in the Philippines, dental decay was universal in 6-year-old children. On average they had over eight baby teeth that were either decayed, or had been extracted or filled because of decay. in over 84% of cases the decay was advanced and had reached the pulp causing infection or abscesses in bone and tissues outside the tooth - this is what ‘severely decayed teeth’ means. Poor oral health in children is linked to underweight and failure to thrive. In a previous Philippines National Oral Health Survey children needing multiple extractions of severely decayed teeth had significantly lower body weights than children with no decay. Complete dental rehabilitation of underweight children with severe dental decay has been shown to be linked to an increased rate of weight gain that may have been related to eliminating dental pain and infection that negatively affected children’s ability to eat and sleep. The objective of this study was to measure if extraction of severely decayed baby teeth affected weight and height in underweight preschool Filipino children, using a randomised controlled trial design (children were randomly allocated to one of two groups).

Who can participate?
All children included in the study were attending day care centres in villages in the Provinces of Cagayan de Oro and Misamis Oriental, Northern Mindanao, Philippines. Children aged between 4 years and 6 months to 5 years and 8 months participated. They were all underweight and had severe dental decay in one or more baby teeth. All children were tested for active tuberculosis infection. Children testing positively were not included, as were children with other medical conditions and infections.


What does the study involve?
Screening visit: All carers, in selected Barangays, were invited to bring their children to a screening session. Trained interviewers obtained basic information about the children such as date of birth, general health and oral problems using a structured interview. Children’s weight and height were measured and their mouths examined. Underweight children meeting the inclusion criteria were invited to join the study.

Treatment visit: Immediately prior to treatment weight and height were again recorded and a blood sample taken to test for anaemia. All severely decayed teeth were extracted using local anaesthesia and other less seriously decayed teeth were treated with silver-diamine-fluoride which slows progression of decay. The children’s carers were interviewed to provide information on the impact that dental problems had on their children’s daily lives.

Follow-up visit 1: Four months later Group B children received the identical treatment as Group A children had received four months earlier. Group A children had weight and height measured and their carers were interviewed.

Follow-up visit 2: All children had weight and height measured and their carers were interviewed as previously. Both Group A and Group B children also had a second blood sample taken to assess anaemia.

What are the possible benefits and risks in taking part?
The children benefit from receiving dental treatment that they would not otherwise be able to access. The children will have greatly reduced dental pain and be able to eat and sleep better. Carers too will enjoy improved peace-of-mind knowing that their children have greatly reduced pain, eat and sleep better.
The risks of high quality dental extractions in young children under local anaesthesia are rare and very minimal, should they occur. Many thousands of dental extractions are carried out around the world each year with very few complications. Complications are infrequent and easily dealt with, resulting in no lasting harm.

Where is the study run from?
Locally in Cagayan de Oro

When is the study and how long is it expected to run for?
The study started in May 2009 and ended in April 2010.

Who is funding the study?
This study was supported by a grant from FDI World Dental-Education.

Who is the main contact?
Professor Martin Hobdell
m.hobdell@ucl.ac.uk

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• England
• Philippines
• United Kingdom

Study participating centre

Sponsor information

World Dental Federation (Fédération Dentaire Internationale) (FDI) (Switzerland)
Research organisation

Tour De Cointrin
Avenue Louis Casai 84
Case Postale 3
Geneva
1216
Switzerland

Website	http://www.fdicongress.org/
"ROR"	https://ror.org/049htfh25

Funders

Funder type

Research organisation

Results and Publications

Study outputs