3 - Pediatric Nutritional Drink Supplement Consumption and Early Childhood Caries

Abstract:
Title: Pediatric Nutritional Drink Supplement Consumption and Early Childhood Caries

Purpose: Dental decay has multifactorial etiology, and research has shown that caries is associated with sugar consumption. While there is clear evidence on the cariogenic effects of sugar sweetened beverages such as juice and soda, there is none specifically investigating pediatric nutritional drink supplements. Nutritional drink supplements (NDSs) provide nutrients for individuals with undernutrition and growth faltering and generally have high carbohydrate content. The purpose of this study is to determine whether there is an association between pediatric NDSs and dental caries.

Methods: This study is a retrospective chart review of Boston Medical Center patients ages 6 or younger who had a dental exam between June 2015 and June 2023.  Cases were identified as patients who consume any formulation of “Pediasure”, “Ensure”, or “Boost”, while controls were identified as patients who did not have these items on their record. Demographic and medical information was collected.

Results: This sample included 255 cases and 439 controls. The average age of starting NDS consumption was 2.3 years. 35.6% of the sample were female. Of the total sample, 41.9% were diagnosed with Early Childhood Caries (ECC), and 26.2% were diagnosed with Severe Early Childhood Caries (S-ECC). Bivariate analysis showed that the rate of ECC and S-ECC in NDS users were 49.4% and 34.1% respectively, compared with 37.6% and 21.6% respectively in non-NDS users. These are statistically significant findings. The average age of onset of ECC for NDS users was 4.31 years, compared with 4.69 years for non-NDS users, a statistically significant result. The average age of onset of S-ECC for NDS users and non-users was not statistically significant. Figures 1 and 2 demonstrate the time of ECC and S-ECC relative to starting NDS usage.

Conclusion: The potential cariogenic effects of NDSs should be considered when recommending their use for nutritional supplementation among pediatric patients. Improved dental prevention efforts and patient education for children who utilize NSDs is warranted to mitigate dental caries risk among this group.