ArticleBMC public health2026
Does stunting modify the impact of salivary factors and early childhood caries on oral health-related quality of life?
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStunting, a form of chronic malnutrition, is associated with impaired growth and potential changes in salivary function that may increase susceptibility to early childhood caries (ECC). These oral conditions may further influence a child's oral health-related quality of life (OHRQoL). However, the extent to which stunting modifies the impact of salivary factors and ECC on OHRQoL remains unclear.
methodsThis analytical cross-sectional study included 210 preschool children aged 24-59 months in Bandung, Indonesia, equally divided into stunted and non-stunted groups based on height-for-age z-scores (HAZ <-2 SD for stunted). Dental caries was assessed using the deft index, while salivary pH and buffering capacity were measured using the GC Saliva Check Buffer Test. OHRQoL was evaluated using a modified Early Childhood Oral Health Impact Scale (ECOHIS) with a dichotomous response format (never = 0, ever = 1) validated through pilot testing (Cronbach's α = 0.870). Statistical analyses included Mann-Whitney U, Chi-square, and t-tests, followed by logistic regression with interaction terms to examine effect modification by stunting.
resultsNon-stunted children had higher mean deft scores (6.50 ± 4.43) compared to stunted children (5.12 ± 4.38, p = 0.020). Acidic Saliva was more frequent among stunted children (11.4%) than non-stunted children (3.8%, p = 0.037). However, no significant differences were observed in ECOHIS total scores or in the impact of OHRQoL between groups (p > 0.05). Logistic regression revealed no significant interactions between stunting, ECC, salivary pH, or buffering capacity (all p > 0.05).
conclusionStunting did not affect the association between salivary factors, early childhood caries, and oral health-related quality of life in preschool children. Although children with stunted had slightly higher salivary acidity, these differences did not result in measurable differences in quality of life. Prevention should combine oral health education and nutritional interventions to comprehensively address the risk of stunting and dental caries.
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