Poor Nutrition in Haitian Children May Contribute to Gum Disease, Study Shows

BUFFALO, N.Y. -- Haiti's children, already burdened with poverty and malnutrition, may have a health problem related to these chronic conditions -- gum disease.

A study conducted by a University at Buffalo researcher has shown that Haitian children who were malnourished during the first five years of life had a higher occurrence of periodontal disease by adolescence than children who had sufficient nutrition during those years.

More specifically, participants who were in the poorest socioeconomic category and were the most poorly nourished as children had higher gum disease scores than children in the study who were not malnourished during their first five years.

Results of the study will be presented in a poster session at the International Association of Dental Research general session being held April 1-4 in Miami, Fla.

Germain Jean-Charles, D.D.S., a resident in maxillofacial pathology in UB's School of Dental Medicine, is first author.

"To our knowledge, this is the first study to investigate the relationship of Early Childhood Protein Energy Malnutrition (ECPEM) and the subsequent development of periodontal disease in the permanent teeth," said Jean-Charles.

"Results of this study indicate that ECPEM was significantly and directly related to an increased CPITN (Community Periodontal Index of Treatment Needs) score and may therefore predispose adolescents to periodontitis in their permanent teeth."

Jean-Charles and colleagues analyzed data collected from 96 people between the ages of 12 and 19 who had been participants in a nutritional study during their first five years. The initial study took place in the rural community of Jérémie, Haiti, from 1988-93.

Participants in the follow-up study underwent dental examinations based on the CPITN, an epidemiologic tool developed by the World Health Organization (WHO) to evaluation periodontal disease in populations.

The researchers compared mean CPITN scores of study participants who were found to be regularly or intermittently malnourished, with those who were not malnourished.

Findings showed that, in general, 50.5 percent of the participants had been shown to be malnourished as children, and 57.3 percent had a periodontal index score of 3 or greater in at least one of the six sections of permanent teeth examined at follow-up.

A total of 12 sites per participant were scored, ranging from 0, which signified healthy tissue, to a score of 4, which indicated a pathologic pocket, or gum/periodontal disease. The poorest and most poorly nourished children in the original examination were found to be at highest risk.

Jean-Charles is hoping to receive funding to train Haitian lay health workers to apply sealants to teeth of young children to prevent the development of dental decay and gum disease. Additional researchers on the study were Stefanie L. Russell and Walter Psoter from New York University; Samuel E. Prophete from State University of Haiti, and Betty J. Berbrian from the Haitian Health Foundation.

The study was supported by a grant from the National Institute for Dental and Craniofacial Research.

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. The School of Dental Medicine is one of five schools that constitute UB's Academic Health Center. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.