# A common risk factor strategy for combating childhood oral diseases and malnutrition in Kalpetta, India

## TL;DR

A combined approach targeting oral health and nutrition improved child health in a tribal community in India.

## Contribution

Demonstrates the effectiveness of a common risk factor strategy in addressing childhood dental caries and malnutrition.

## Key findings

- Significant improvement in oral health and nutrition knowledge among children and caregivers.
- Mean number of decayed teeth decreased significantly after the intervention.
- Weight-for-age and weight-for-length Z-scores improved significantly in children under 5 years.

## Abstract

Childhood dental caries and malnutrition share a bi-directional relationship and represent significant public health challenges. This study aimed to evaluate the effectiveness of a Common Risk Factor Strategy-based intervention in improving childhood oral health and nutrition among preschool and primary school tribal children in Kerala, India.

This pre-post quasi-experimental study was conducted among tribal children and their caregivers. Baseline assessments included knowledge of oral health, childhood dental caries, and nutrition, along with evaluations of oral health and nutritional status using validated questionnaires and indices. The intervention comprised oral hygiene awareness, dietary counseling, caries prevention through fluoride varnish application, arrest of cavitated lesions using silver diamine fluoride (SDF), curative dental treatment, and the regular provision of toothpaste and toothbrushes. The effectiveness of these interventions was assessed after one year.

A total of 95 children (mean age: 4.47 ± 1.42 years) and their caregivers participated in the study. Post-intervention, there was a significant increase in mean KAP childhood caries assessed using 24 point scale [mean difference (MD): 14.52 ± 5.01] and nutrition knowledge assessed using 10 point scale (MD: 3.67 ± 3.42). The mean number of decayed teeth significantly decreased from 7.71 ± 3.59 to 1.43 ± 0.53, accompanied by notable improvements in oral hygiene and nutritional indicators. Among children under 5 years, weight-for-age and weight-for-length Z-scores improved significantly following the intervention (p < 0.05).

This study highlights the effectiveness of an integrated medical-dental approach in addressing childhood oral health and malnutrition. Strengthening early prevention strategies through the Common Risk Factor Approach can serve as a sustainable model to improve overall child health and well-being in vulnerable populations. Prioritizing such holistic interventions in public health policies can be a game-changer in reducing health inequities.