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Dental cavities: A nearly forgotten cause of stunting in Indonesia
One thing that I have observed as a pediatric dentist is how dental cavities can lead to malnutrition.
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A person undergoes a dental procedure at Syiah Kuala University’s dental and oral hospital in Banda Aceh on Feb. 6, 2024. (Antara/Irwansyah Putra)
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tunting is a condition when a child’s height is more than two standard deviations below the WHO’s median child growth standard. According to the Health Ministry’s Nutritional Status Study report, the prevalence of stunting in Indonesia fell from 27.7 percent in 2019 to 24.4 percent in 2021 to 21.6 percent in 2022, with the majority of cases occurring in children aged 3 to 4.
Stunting is a complex phenomenon caused by inadequate nutrition and is associated with environmental, economic and educational status. Maternal education level was associated with stunting among children under 2 years in Indonesia. The lower a mother’s education level, the more likely it is for her to have stunted children under 2 years old.
One thing that I have observed as a pediatric dentist is how dental cavities can lead to malnutrition.
A study from 2018 explained how severe untreated dental caries may be associated with children being underweight and experiencing poor growth. Untreated caries can cause pain and discomfort, negatively affecting children’s eating and sleeping ability. A limited eating ability can lead to poor appetite and reduced nutritional intake, while sleep disturbance can impair the secretion of growth hormones. Indirectly, chronic inflammation resulting from severe caries with pulpitis could affect growth via immune and metabolic response.
Dental caries lead to the destruction of tooth tissue. In my almost 12 years of experience as a dentist, I have found an identical problem in most Indonesian parents: They think baby teeth are not important to take care of because permanent teeth will replace them one day. Whether I am practicing in a social clinic in rural West Java, an NGO clinic in a remote area in West Kalimantan or a private small clinic or private hospital, the problem is always the same.
First, parents forget that the mouth is the gate where food comes into our body. We process food by chewing with our teeth. Of course, dental cavities, whether on baby teeth or permanent teeth, disturb the chewing process because they can cause discomfort or pain.
Secondly, parents forget that building healthy habits such as brushing our teeth is easier when we start at an early age and have healthy eating habits because sugar overconsumption can lead to cavities.
