Pocket money and the risk of dental caries and oral pain in children

Background

Tooth decay affects 40–90 % of children in low- and middle-income countries (LMICs), contributing to adverse consequences, including oral pain, difficulty focusing in school, lifelong dental problems, and overall lower quality of life. Few studies have examined the relationship between pocket money given to children, their purchase of sugary snacks and drinks with that money, and the risk for tooth decay.

Methods

This secondary cross-sectional analysis utilized data which were collected in 2014 as part of an oral health promotion program in rural El Salvador. A convenience sample of 279 children and their mothers who participated in the program were recruited to complete an interview with trained community health workers, and children received a dental examination from trained and licensed Salvadoran and U.S. dentists. Only children with teeth (primary, mixed, or permanent dentition) were included in this analysis; as such, children ranged in age from 6 months through 14 years. Descriptive, multivariate logistic regression, and Zero-Inflated Negative Binomial analyses were used to identify associations between pocket money given to children and three oral health outcomes: number of decayed, missing/extracted due to decay, and filled teeth (dmft for primary teeth and DMFT for permanent teeth); presence of deep decay; and occurrence of oral pain.

Results

Overall, almost two-thirds of children received daily pocket money with which over 70 % purchased unhealthy snacks/drinks; 83 % of children had tooth decay, with a mean dmft/DMFT of 6.0. After adjusting for covariates, receiving pocket money was associated with 0.18 (95 % CI: 0.05–0.54) times the odds of having zero-dmft/DMFT (i.e., being cavity-free) (p = 0.002). Among children with at least one decayed tooth, receiving pocket money was associated with 1.22 (95 % CI: 1.01–1.53) times the expected dmft/DMFT count (p = 0.04), 3.39 (95 % CI: 1.59–7.22) times the odds of deep decay (p < 0.001), and 2.66 (95 % CI: 1.24–5.70) times the odds of oral pain (p = 0.007) compared to children who did not receive pocket money.

Conclusion

Interventions to reduce the prevalence and severity of tooth decay should include nutrition and oral health education for children and families—including addressing pocket money and healthy vs. unhealthy purchases—in schools, communities, and primary health clinics; school programs to provide healthy foods and beverages for children; and enforcement of policies to prohibit the sale of ultra-processed foods and sugary drinks in and around schools.