MALNUTRITION AND DEVELOPMENTAL DEFECTS OF ENAMEL IN 2 TO 6-YEAR-OLD SAUDI BOYS

Three hundred and ninety boys aged 2, 4 or 6 years from Riyadh, Saudi Arabia, took part in a survey in 1993/94. The main aims of the study w ere first, to identify factors related to malnutrition in young childr en since a study of older children from the same area 1 year before ha d shown malnutrition to be strongly related to prevalence of developme ntal defects of enamel (DDE) of permanent teeth and, second, to identi fy factors related to the prevalence of developmental defects of prima ry teeth. Enamel defects were recorded by clinical examination of the buccal surfaces of all primary teeth by 1 examiner using the DDE index . A questionnaire to parents provided information on socio-economic st atus, illness in the mother and child, infant feeding, trauma to teeth and toothbrushing. A 24-hour dietary record, to estimate water and mi lk intake, and a 24-hour urine collection were obtained for each child twice. Nutritional status was calculated from height for age using WH O methods. Multiple regression analyses revealed four variables relate d (p<0.05) to malnourished status: low birth-weight, low volume of wat er drunk, child stopped breast-and bottle-feeding before 1 year of age , and low class urban or rural area of residence. Birth-weight was its elf related to area of residence (p=0.02), parental education (p=0.02) and maternal illness during pregnancy (p=0.06). Malnutrition (p<0.001 ), low birth-weight (p<0.001), childhood illness (p<0.001), brushing o f child's teeth (p=0.003) and swallowing toothpaste (p<0.001) were rel ated to the prevalence of developmental defects of primary teeth. This study indicated several independent variables which may be related to the prevalence of enamel defects in primary and permanent teeth, but longitudinal studies are required to determine which are causes and wh ich are markers of these developmental defects.