**5. Nutrition and growth**

Food consumption has a tremendous influence on human lives and is essential to life itself. Eating appropriate amounts of a wide variety of foods helps to maintain optimal health. Prolonged periods of poor food choices may cause impaired health. People need approximately 50 nutrients for growth and maintenance of health. These nutrients are present in a wide variety of different types of foods. Carbohydrates, lipids and proteins are energy nutrients which give the human body the energy it needs for moving and doing work, as well as for such vital activity as breathing and pumping blood. Minerals, a category made up of more than 20 nutrients perform a variety of functions, although they are not sources of energy. Vitamins are regulatory substances needed in even smaller amounts than minerals. At present, 13 vitamins are recognized as essential nutrients. Every person, (whether a child or mature adult), needs good nutrition in order to maintain good health and this can be supplied by a well-balanced healthy diet taken in regular meals and in appropriate surroundings (Wright, 2000).

The evidence in the World Health Organization (WHO) Global Database on Child Growth (De Onis et al, 2000) and Malnutrition gives a description of the magnitude and geographical distribution of childhood under- and over-nutrition worldwide. Analyses based on the database's information confirm that child under-nutrition remains a major public health problem in many countries, and can hamper children's physical growth and mental development. Indeed, it may even be a major threat to their survival. Despite an overall decrease in poor growth in developing countries, in some, poor growth is increasing in prevalence and in many others the incidence of growth faltering remains disturbingly high(De Onis et al, 2000, 1993 ). An important observation which has been made, is that the pattern of growth faltering in developing countries, not only within a region but also globally, are remarkably similar even though different instruments and measuring methods were used in the surveys. This suggests that interventions during the earliest periods of life

Effect of Dental Caries on Children Growth 383

pattern in young children. This behavior may influence both the appetite and dental health of children. In a study in 1991 Holt showed that between-meal snacking was prevalent in 4 year-old children (Holt, 1991). Small children may be over-whelmed by a large plate of food. Small portions, of colorful, attractively presented food are more tempting (Harrise & Booth,

Toddler behavior is strongly influenced by past experience. Any negative experience with food might result in future food refusal. Transient food refusal may occur after birth of a sibling or other event, in an attempt to redirect attention to themselves (Harrise & Booth, 1992). Refusal to chew due to failure to introduce texture and lumps before 6-7 months of

One of the most important indicators of suitable and adequate nutrition is normal growth. Therefore, prolonged food refusal, even due to non-organic causes can result in impaired growth. Regular weight and height measurement is therefore necessary. Taking a detailed diet history is also an important part of growth assessment (HMSO, 1992). Diet questions should include a food diary describing all food and drink consumed, with details of meal pattern, location of eating time and supervision received(HMSO, 1992). There are different types of diaries available. Food frequency tables are one type which includes information about frequency of consumption as well as the type of foods usually eaten. Details of nutrient intake can be made by analysis of the type and amount of reported foods, but

Dental caries is a complex, multi-factorial disease and is a significant health and social problem which affects people of all ages and is responsible for a vast amount of pain, misery and economic loss. It is a major problem in young children. Caries of the primary teeth "Early Childhood Caries" or ECC is one of the most prevalent health problems in infants and toddlers (Mayanagi et al, 1995). It can be considered an epidemic in lower-income families and in under developed parts of the world (Ismail & Sohn 1999). ECC is one of the major causes of hospitalization in young children, who often need to receive general

Despite improvements in the oral health of children in recent decades, early childhood caries (ECC) remains a serious threat to child welfare. ECC is manifested by severe decay of primary teeth. This can be a debilitating condition that can not only affect the children but also their families and the communities in which they live. Toothache leads to school absence, which is a ready indicator of children's health. In the USA, where caries is lower than elsewhere, visits or dental problems accounted for 117 000 hours of school lost per 100 000 children (Gift et al, 1992). Because most school dental services work mainly during school hours, loss of schooling among the poor, who have higher caries rates, is high. Other manifestations of ECC include pain, infection, abscesses, chewing difficulty, malnutrition,

age can result in children rejecting lumpy food later (K & R Minde, 1986).

**8. Assessment of diet, nutrition and feeding problems** 

reporting problems can make such analysis unreliable.

anaesthesia for extraction or tooth restoration (Sheller et al, 1996).

**10. Public health aspects of dental caries** 

**9. Early Childhood Caries (ECC)** 

1992).

are likely to have the greatest impact in promoting good nutrition and preventing poor growth and development in children.
