Association of Pulp Involvement, Ulceration, Fistula, Abscess and Body Mass Index among Primary School Children: A Case-Control Study.

Abstract

Aims and background: The aim of this study is to determine the relationship between nutrition as reflected by body mass index (BMI) and the prevalence and severity of untreated dental caries in children without prior dental treatment using pulp involvement, ulceration, fistula, abscess (PUFA) index. Dental caries is common among children worldwide, with prevalence linked to factors like income, location, and dental access, affecting 60-90% of school-age children depending on location. Untreated decay can lead to pain, school absence, and low self-esteem. This study examines the relationship between BMI and the PUFA index to assess untreated caries severity. Understanding diet, health, and oral health interactions may support multifaceted interventions for preventing caries in children.

Materials and methods: This case-control study involved 100 primary school children in Mysuru city, India. Cases were defined as children with untreated dental caries or clinical consequences of dental caries, while controls were children without untreated dental caries or with only initial or moderate caries. Dental examinations, PUFA index assessments, and weight and height measurements were conducted. Statistical analysis included descriptive statistics, t-tests, and logistic regression.

Results: No significant differences were found in age, weight, height, and BMI between cases and controls, but BMI was reported to be reduced in cases than the controls. However, cases showed significantly higher PUFA scores, particularly in pulpal involvement and abscesses. Socioeconomic status (SES), school type, and location significantly influenced anthropometric measurements but not dental health measures. Logistic regression revealed that higher BMI was associated with lower odds of PUFA category 1, while higher decayed, missing, filled teeth (DMFT) scores increased the odds. Mouthrinsing showed a strong protective effect against severe dental caries.

Conclusion: The study highlights the complex relationship between nutritional status, socioeconomic factors, and dental health in children. While anthropometric measures were similar between groups, significant differences in oral hygiene habits and dental health were observed. The results make it clear that different kinds of public health programs and focused interventions are needed to help children with poor oral health.

Clinical significance: This study explores the clinical link between BMI and the PUFA index in primary school children. Understanding this relationship is crucial, as higher PUFA scores reflect severe, untreated dental issues often found in children with lower BMI due to poor nutrition. Identifying such associations can guide interventions that target both oral health and nutritional support, helping reduce dental disease and promote overall health in children.

How to cite this article: Paramasivam K, Manjunathappa TH, Kumar BS, et al. Association of Pulp Involvement, Ulceration, Fistula, Abscess and Body Mass Index among Primary School Children: A Case-Control Study. Int J Clin Pediatr Dent 2025;18(8):930-939.