|Year : 2020 | Volume
| Issue : 3 | Page : 258-261
Influence of food pouching habit during television and multimedia device viewing on dental caries: A cross-sectional study
Abhishek Das, Payel Agarwala, Sudipta Kar, Gautam Kumar Kundu
Department of Pedodontics and Preventive Dentistry, Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India
|Date of Submission||01-Nov-2019|
|Date of Decision||16-Dec-2019|
|Date of Acceptance||30-Apr-2020|
|Date of Web Publication||28-Jul-2020|
Dr. Abhishek Das
Department of Pedodontics and Preventive Dentistry, Guru Nanak Institute of Dental Sciences and Research, Panihati, Sodpur, Kolkata, West Bengal
Source of Support: None, Conflict of Interest: None
BACKGROUND: Television and multimedia device viewing has been implicated as a possible risk factor for dental caries.
AIMS: The aim was to find out the correlation of dental caries with increased duration of food chewing habits during screen viewing.
MATERIALS AND METHODS: Closed-ended, validated questionnaires were asked from parents of children, followed by an oral examination and calculation of the dmft values of children. Settings and Design: A cross-sectional study was carried out in various schools of Kolkata, where 3–6-year-old 419 participants were selected by a simple random sampling method. Statistical Analysis Used: The statistical software IBM SPSS statistics 20.0 (IBM Corporation, Armonk, NY, USA) was used for the analyses of the data.
RESULTS: Children who watch screens during mealtime and snack time, obtained dmft score was 5.91 ± 4.224 compared to those who do not watch screens, the dmft score was 2.47 ± 2.551. The dmft score among the children who watch various screens for <30 min (N = 242), 30–60 min (N = 143), and >60 min (N = 34) were 3.38 ± 3.228, 6.49 ± 4.182, and 9.53 ± 3.768, respectively. The P value was <0.001 in all of the comparisons (statistically highly significant result).
CONCLUSIONS: This study shows that prolonged eating time during screen usage is detrimental for oral health and the cause of increased dmft.
Keywords: Dental caries, screen time, television viewing
|How to cite this article:|
Das A, Agarwala P, Kar S, Kundu GK. Influence of food pouching habit during television and multimedia device viewing on dental caries: A cross-sectional study. Int J Health Allied Sci 2020;9:258-61
|How to cite this URL:|
Das A, Agarwala P, Kar S, Kundu GK. Influence of food pouching habit during television and multimedia device viewing on dental caries: A cross-sectional study. Int J Health Allied Sci [serial online] 2020 [cited 2020 Sep 28];9:258-61. Available from: http://www.ijhas.in/text.asp?2020/9/3/258/290724
| Introduction|| |
Getting a child to eat the food they are served is not the easiest task in the world. Children are often quite fussy when it comes to eating, and parents constantly find it difficult to make healthy food seem enticing to them. Parents' hand them a smartphone to fidget with or switch on the television while eating to insist them to gobble up their food in modern days. Not only that but most parents also love having some “quiet freedom” from children's constant noisiness at the table, at home, or in a restaurant. Parents do this without realizing the long-term impact on their children. Handing over a screen, even if it's just during mealtime, can be a huge mistake. Because what starts as showing the child YouTube rhymes or cartoon shows while eating will slowly turn into a habit that the child finds hard to break away from, and once this habit forms, the child would not even want to try to escape from it. This is how screen addiction develops. Various studies have found an association between dental caries and television viewing, which mainly focused that television advertising promotes the intake of cariogenic food, which causes dental caries.,, Longer screen viewing time during mealtime also compromises the oral clearance of food, which is also a predisposing factor for dental caries. Hence, this study was aimed to find out the relationship between compromised oral clearance due to longer screen viewing time while eating and the occurrence of dental caries among children.
| Subjects and Methods|| |
A total of 419 children (age: 3–6 years) were included for the study as study samples. Children attending the Outpatient Department of the Department of Guru Nanak Institute of Dental Sciences and Research were chosen randomly as the study sample as per the inclusion and exclusion criteria. Children from different schools of Kolkata were also taken as the study sample. Children with special health-care needs, children/parents who are not willing to participate, and children with diagnosed cases of the developmental anomaly of teeth were excluded from the study.
Before starting the study, ethical clearance was obtained from the institutional ethical committee, and Informed consent was taken from parents. An approval from the concerned school authorities was taken by explaining the entire study procedure. Parents were also asked to present on the day of examination along with their children during camp organized by the researcher at school. Prevalidated closed-ended questions from a prepared questionnaire were asked from parents of children. All the study participants were examined by a single examiner (researcher himself) to avoid intraexaminer biases, and the decayed missing filled teeth index (DMFT) index was calculated.
| Results|| |
The statistical software IBM SPSS statistics 20.0 (IBM Corporation, Armonk, NY, USA) was used for the analyses of the data, and Microsoft Word and Excel were used to generate tables.
The total study population in the present study was 419. [Table 1] shows that 71.8% (N = 301) of children watch various types of screens while eating meals and 28.2% (N = 118) do not. 37.9% (N = 159) watches screens during snack times and 62.1% (N = 260) does not. 51.8% (N = 217) of children are addicted to TV and multimedia while eating, and 48.2% (N = 202) were not addicted. Food chewing completion time <30 min was for 57.8% (N = 242), 30–60 min was for 34.1% (N = 143), and >60 min was for 8.1% children (N = 34).
Mann–Whitney U-test was used to compare dmft values among those who watch (N = 301) and those who do not watch (N = 118) TV or any multimedia while eating meals. The children who watch screens dmft score was 5.91 ± 4.224, and those who do not watch screens dmft score was 2.47 ± 2.551. The Z-value was 7.925, and the P value was <0.001, which was a statistically highly significant result [Table 2].
|Table 2: Comparison of the decayed, missing, and filled teeth values in terms of mean (standard deviation) among those who watch and those who do not watch TV or any multimedia while eating meals using Mann–Whitney U-test|
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Mann–Whitney U-test was used to compare decayed, missing, and filled teeth (DMFT) and dmft values among those who watch (N = 159) and those who do not watch (N = 260) TV or any multimedia while eating snacks. The children who watch screens dmft score was 5.91 ± 4.209, and those who do not watch screens dmft score was 4.35 ± 3.966. The Z-value was 3.910, and the P value was <0.001, which was a statistically highly significant result [Table 3].
|Table 3: Comparison of the decayed, missing, and filled teeth values in terms of mean (standard deviation) among those who watch and those who do not watch TV or any multimedia while eating snacks using Mann–Whitney U-test|
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Mann–Whitney U-test was used to compare DMFT and dmft values among those who are addicted to TV or other multimedia devices (N = 217), and those who are not addicted (N = 202) while eating. The children who are addicted to screens during eating dmft score was 6.09 ± 4.222, and those who are not addicted to screens during eating dmft score were 3.70 ± 3.641. The Z-value was 6.158, and the P value was <0.001, which was a statistically highly significant result [Table 4].
|Table 4: Comparison of the decayed, missing, and filled teeth values in terms of mean (standard deviation) among those who are addicted and those who are not addicted to TV or any multimedia devices while eating using Mann–Whitney U-test|
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Kruskal–Wallis test was used to compare the DMFT values in terms of mean ± standard deviation among those with different food chewing completion time while using TV/multimedia devices. The dmft score among the children who watch various screens for <30 min (N = 242), 30–60 min (N = 143), and >60 min (N = 34) was 3.38 ± 3.228, 6.49 ± 4.182, and 9.53 ± 3.768, respectively. The Chi-square value was 89.732, and the P value was < 0.001, which was a highly significant result [Table 5].
|Table 5: Comparison of the decayed, missing, and filled teeth values in terms of mean (standard deviation) among those with different food chewing completion time while using TV/multimedia using Kruskal–Wallis test|
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| Discussion|| |
The mechanisms linking TV or multimedia viewing with the prevalence of dental caries have not been fully examined and are not, as yet, fully understood. Anand et al. observed that children who watched more TV had worse oral hygiene and consumed larger amounts of soft drinks compared with children who watched less. This study correlated the food chewing completion time while watching TV or multimedia devices with the caries status of that population.
Arikan and Bekar  also reported that more than half of the children (58.2%) ate while watching TV, and 34.4% of these children ate once a day while watching TV and 31.2% always ate while watching TV. This study also demonstrated that 71.8% of children watch various types of screens while eating meals and 37.9% watches during snack time. It was also found that 51.8% of children were addicted to screens while eating. The mean dmft score was higher among children who watch screens during both mealtime and snack time than those who do not watch. The score was also higher among children who are addicted to screens during eating. The difference was statistically highly significant (P < 0.001) in all cases. The dmft score among the children who watch various screens for a longer duration has higher scores with statistically highly significant results (P < 0.001).
Stevenson and Allaire  suggested in their study that the younger the child, the lower the oral motor development, and therefore, the less control of the tongue and cheek, which are important auxiliaries for digestion and elimination of food in the oral cavity, are more susceptible to dental caries. They also suggested that most adhesive food determines greater permanence in the oral cavity, expanding their cariogenic effect. High starch-containing foods remain longer on the teeth than high sucrose- or low starch-containing foods., The retention of high starch-containing foods may give rise to compromised oral clearance and prolonged periods of acid production, which may promote tooth decay.
The increased oral clearance times of foods have been identified as a cause of dental caries in elderly patients, in patients with myotonic dystrophy  and rheumatic patients with dry mouths  and cleft patients.
Longer screen viewing time also compromises oral clearance of food and increased retention of food within the oral cavity. According to the result of this study, this food pouching habit within the mouth during screen viewing act as a predisposing factor for dental caries.
| Conclusion|| |
With consideration of its strength and limitation, this study has provided a high level of evidence of the detrimental effect TV and other multimedia device usage during mealtime and snack time on oral health in growing children in the study area. It should be remembered that TV and Multimedia devices should not be the center of attraction all the time especially during eating. Exploring the links among screen viewing time and dental caries not only promotes a more complex association with oral health, but it also provides the opportunity to identify interventions to curtail the adverse consequences of dental caries.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ravishankar TL, Malik A, Tirth A, Tandon V. Association of dental caries and obesity with television viewing practices among school children of Moradabad city. J Clin Diagn Res 2016;4:124.
Rodd HD, Patel V. Content analysis of children's television advertising in relation to dental health. Br Dent J 2005;199:710-2.
Zeng X, Sheiham A, Sabbah W. The association between dental caries and television viewing among Chinese adolescents in Guangxi, China. BMC Oral Health 2014;14:138.
Veiga KA, Porto AN, Costenaro AP, Borges AH, Soares AM, Bandéca MC, et al
. Time of eliminating foods with different degrees of adhesion by preschool children. World J Dent 2017;8:430-3.
Anand N, Suresh M, Chandrasekaran SC. Effect of obesity and lifestyle on the oral health of pre adolescent children. J Clin Diagn Res 2014;8:196-8.
Arikan D, Bekar P. Children's eating habits and obesity while watching television. Iran J Pediatr 2017;27:1-6.
Stevenson RD, Allaire JH. The development of normal feeding and swallowing. Pediatr Clin North Am 1991;38:1439-53.
Edgar WM, Bibby BG, Mundorff S, Rowley J. Acid production in plaques after eating snacks: Modifying factors in foods. J Am Dent Assoc 1975;90:418-25.
Linke HA, Birkenfeld LH. Clearance and metabolism of starch foods in the oral cavity. Ann Nutr Metab 1999;43:131-9.
Kashket S, Yaskell T, Murphy JE. Delayed effect of wheat starch in foods on the intraoral demineralization of enamel. Caries Res 1994;28:291-6.
Lundgren M, Birkhed D, Steen G, Emilson CG, Osterberg T, Steen B. Oral glucose clearance in nonagenarians in relation to functional capacity, medication and oral variables. Gerodontology 1997;14:17-27.
Engvall M, Birkhed D. Oral sugar clearance and other caries-related factors in patients with myotonic dystrophy. Acta Odontol Scand 1997;55:111-5.
Risheim H, Arneberg P, Birkhed D. Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms. Caries Res 1992;26:439-44.
Lin YT, Tsai CL. Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan. Cleft Palate Craniofac J 1999;36:522-6.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]