Problematic

eating and its

association with
early childhood
caries among 4671-month-old
children using
Children's Eating
Behavior
Questionnaire
(CEBQ): a cross
sectional study.

Ankit Shah
1

ARTICLE
Anandakrishna L, Bhargav N, Hegde A, Chandra P,
Gaviappa D, Shetty AK.
Indian J Dent Res
2014
25(5)
602-6
2

ARTICLE
Follows IMRAD format
Year of publication is mentioned
Volume no. is mentioned
Page number is mentioned
Authors attachment mentioned
Designation is not mentioned.
3

TITLE
It indicates the focus of the study which is to
evaluate efficacy of chemomechanical caries
removal in reducing cariogenic microbiota.
The title is meaningful and complete.
It reflects the aim of the study .

ABSTRACT
Unstructured & Concise.
Informative
Gives the gist of the whole article.
Gives the idea of the study
Information given matches the detailed text
Key words are mentioned & are appropriate
5

INTRODUCTION
Early childhood caries (ECC) is defined as the presence of
one or more decayed (noncavitated or cavitated lesions),
missing (due to caries), or filled teeth in children under 71
months of age.
Rapidly destroy the primary dentition of toddlers and
small children, and if left untreated, can lead to pain,
acute infection, nutritional insufficiencies, and learning
and speech problems.
Risk factors involved are high intake of fermentable
carbohydrates, poor oral hygiene, prolonged breast
feeding and transmission of S. mutans from mothers to
infants
6

 Low fluoride in drinking water, poor saliva buffering

capacity and behavioral factors are other causes hence it
is regarded as multifactorial.
Eating behavior in childhood may vary on a continuum
ranging from picky eating, irregular eating, overeating,
and food refusal, negativistic behavior during eating, slow
eating and tantruming during mealtimes.
The fact that the effects of problematic eating behavior
including slowness in eating, pouching of food over a long
period of time and selective eating has been relatively
unexplored in the causation of ECC & has to be
considered.
7

 CEBQ is one of the most comprehensive instruments

in assessing childrens behavior. Used for different
research purposes like body mass index, to compare
appetite preferences in children of lean and obese
parents, to discover continuity and stability in
childrens eating behavior across time.
The relationship between such eating disorders and
ECC has never been established.

AIM
To determine whether the problematic
eating and feeding behavior is
associated with ECC in 4671monthold children in Bengaluru
city, India using CEBQ.

INTRODUCTION
Seminar approach
Built on the existing literature
Need of the study is mentioned
Aim of the study is mentioned

10

MATERIALS & METHODS

Crosssectional study was carried out in schools of
Bengaluru city, Karnataka, India.
City was divided into north and south zone.
From each zone, private and government schools were
randomly selected
Sampling method used was Stratified Random Sampling.
All school going children from preschool to first standard
from the selected schools were included in the study.
11

MATERIALS & METHODS

Ethical clearance was obtained from Institutional review
board of Nitte University.
Permission from the school authorities and informed consent
from the parents was obtained to carry out dental
examination and also to collect data by questionnaire from
the parents.
Selected children were clinically examined for dental caries
by a pediatric dentist
Examination was carried out using mouth mirrors,
community periodontal index probe under natural light/torch
12

 The decayed missing filled primary tooth surfaces

decayed, missing, filled surfaces Index, as given by
Gruebbel A.O. in 1944 was used.
Childs eating behavior was assessed by using CEBQ
Detailed eating behavioral history was recorded from
the parents that included food responsiveness,
enjoyment of food, food fussiness, and satiety
responsiveness, emotional under eating (EUE), desire
to drink (DD) and slowness in eating on a
dichotomous scale to probe for the presence or
absence of each item.
13

MATERIALS & METHODS

Study design is mentioned.

Study setting mentioned.
Sampling is mentioned.
Time period is not mentioned.
Inclusion criteria mentioned.
Exclusion criteria is not mentioned.
Calibration and training of examiners is done
Ethical approval is taken and informed consent of
participants mentioned.
Blinding is not mentioned
Sample size justification is not mentioned
14

STATISTICAL ANALYSIS
The collected data
Chisquare test.

was

analyzed

by

using

15

RESULTS

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18

RESULTS
Results are presented but not comprehensively.
Important results are mentioned in tables.
Tables are numbered properly.
Results are based on aims & objectives of the study.

19

DISCUSSION
Dietary patterns among children have shifted. Milk
consumption has decreased, while consumption of
soft drinks and juices and drinks has increased. Some
meals, such as breakfast, often are skipped
altogether.
Teenagers who miss breakfast are more likely to
snack during the day and snacks have the highest
sugar content.
Children who reject certain types of foods and/or
groups of food that parents think are appropriate may
be perceived as picky eaters.
20

 Literature on oral aspects of these disorders occurring

in children has been largely empirical and
undocumented. Hence, this was an initial attempt to
know whether there was any association between
such eating behavior in children and its relationship
with dental caries.
This was the first time CEBQ was used to assess
association with dental caries.
A total of 250 children aged between 46 and 71
months attending both private and government
schools were assessed for the study.
21

 Near equal distribution of gender achieved with 124 boys

and 126 girls
Prevalence of ECC was around 34% [Table 2], which is
within the range of 19.2-44% reported in other parts of
South India.
Satiety responsiveness represents the ability of a child to
reduce food intake after eating to regulate its energy
intake.
Slow eating is a consequence of lack of enjoyment and
interest in food & one of the most frequent problems
reported by mothers.
22

 In response to Factor 1 (satiety responsiveness/slowness

in eating) 74.4% of the parents responded that their
children did not eat a meal if they have had a snack just
before and 69.6% of the parents also reported that their
children eat slowly. However 65% of these children were
without ECC. No statistical difference was observed
between children with or without ECC.
Food fussiness is characterized by a lack of interest in
food and slowness in eating. In response to factor 2
(fussiness) highest ECC prevalence of 64.9% was found
among the children who were difficult to please with the
meals. No statistical significant difference was found
between children who had ECC and those without ECC.
23

 Children do not have a tendency to keep food in

their mouth all the time had significantly lesser ECC
as compared to those who had this tendency. This
difference was statistically significant (P = 0.001).
The
reason
for
this
could
be
increased
demineralization due to increased exposure to food
substances.
It was also observed that those children who did not
have a tendency to eat too much had significantly
less ECC compared to those who ate too much.

24

 Emotional overeating was not observed in the

sample population. This was in contrast with other
studies where most of the children had a tendency
to eat more during stress.
It was observed that prevalence of ECC was
significantly high in children who ate more when
they had nothing else to do compared to those who
did not eat more (P = 0.008).

25

 Prevalence of ECC was highest (41.6%) in children

who ate more when they had nothing else to do
(52.6%). Also, approximately 84.8% of the children
did not have a tendency to eat more when they had
nothing to do and 69.3% of these children were
caries free. This difference was found to be
statistically significant (P = 0.008).

26

DISCUSSION
Meaningful.
Highlight important findings.
Enough explanations for significant findings are
given.
Authors have compared the current findings with
ones already reported with similar studies.

27

CONCLUSION
Problematic eating behavior in children
observed as early as 46 months of age.

was

ECC was more prevalent in children who had the

tendency to keep food in their mouth all the time,
who ate excessively and who ate more when they
had nothing else to do.

28

CONCLUSION
Meaningful.
Given separately.
Based on the aim & objective of the study.
They are well supported by the results.

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REFERENCES
Vancouver Style

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