Vol. 15 No. 2 (2023): Arch Pub Health
Oral Health

Nutritional habits as risk factors for dental caries in children from rural and urban areas in Skopje

Aneta Lazarova
1Health Center, Department of Pediatric and Preventive Dentistry, Skopje, Republic of North Macedonia
Olga Kokoceva-Ivanovska
Department of Pediatric and Preventive Dentistry; Faculty of Dentistry, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

Published 2023-12-30


  • dental caries,
  • nutrition,
  • oral health,
  • children

How to Cite

Lazarova A, Kokoceva-Ivanovska O. Nutritional habits as risk factors for dental caries in children from rural and urban areas in Skopje. Arch Pub Health [Internet]. 2023 Dec. 30 [cited 2024 Mar. 2];15(2). Available from: https://id-press.eu/aph/article/view/6109


Proper nutrition is a long-term investment in one’s own health. Oral health as an integral part of general health is in bidirectional relationship with diet and nutrition. Globalization and urbanization have led to nutrition transition from a traditional agriculturally-based diet to consumption of processed foods that are high in sugar. Children have been particularly affected by this change. The aim of this study was to investigate the association between specific nutritional and hygiene habits and the development of caries in children from urban and rural areas. The study was conducted in December 2019 and comprised children aged 6 years. A survey was made and children’s dental status was tested. The results obtained showed a higher percentage of healthy deciduous (50%) and permanent (35%) teeth in children from rural areas than in children from urban area. Both groups had similar habits in terms of cariogenic and cariostatic food intake, but there were differences in children's hygiene habits.


Download data is not yet available.


  1. Pflipsen M, Zenchenko Y. Nutrition for oral health and oral manifestations of poor nutrition and unhealthy habits. Gen Dent 2017;65(6):36-43;PMID: 29099364
  2. Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31 Suppl 1:3-23;DOI: 10.1046/j..2003.com122.x
  3. Marcenes W, Kassebaum NJ, Bernabé E, et al. Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res 2013;92(7):592-597. doi:10.1177/0022034513490168
  4. Sheiham A. Oral health, general health and quality of life. Bulletin of the World Health Organization, September 2005, 83 (9);PMID: 16211151
  5. Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015;PMID: 25905159
  6. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83(9):661-669;PMID: 16211157
  7. WHO technical information note. Sugars and dental caries. October 2017;
  8. https://www.who.int/publications/i/item/WHO-NMH-NHD-17.12
  9. Moynihan P. Sugars and Dental Caries: Evidence for Setting a Recommended Threshold for Intake. Adv Nutr2016;7:149–156;PMID: 26773022
  10. Chi DL, Scott JM. Added Sugar and Dental Caries in Children: A Scientific Update and Future Steps. Dent Clin North Am 2019;63(1):17-33;PMID: 30447790
  11. Pitts NB, Zero DT, Marsh PD, et al. Dental caries. Nat Rev Dis Primers 2017;3:17030.PMID: 28540937
  12. Tinanoff N, Baez RJ, Diaz Guillory C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent 2019;29(3):238-248.PMID: 31099128
  13. Popkin BM. The nutrition transition in low-income countries; an emerging crisis. Nutr Rev 1994; 52(9): 285–298;PMID: 7984344
  14. Huffman SL, Piwoz EG, Vosti SA, Dewey KG. Babies, soft drinks and snacks: a concern in low- and middle-income countries? Matern Child Nutr 2014;10(4):562-574;PMID: 24847768
  15. Pries AM, Huffman SL, Champeny M, et al. Consumption of commercially produced snack foods and sugar-sweetened beverages during the complementary feeding period in four African and Asian urban contexts. Matern Child Nutr 2017;13 Suppl 2(Suppl 2):e12412;PMID: 29032629
  16. Fidler Mis N, Braegger C, Bronsky J, et al. Sugar in Infants, Children and Adolescents: A Position Paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017;65(6):681-696.PMID: 28922262
  17. Vos MB, Kaar JL, Welsh JA, et al. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement from the American Heart Association. Circulation. 2017;135(19):e1017-e1034;PMID: 27550974
  18. Marshall TA. Nomenclature, characteristics, and dietary intakes of sugars. J Am Dent Assoc2015; 146(1):61–64;PMID: 25569500
  19. Heyman MB, Abrams SA; Section on Gastroenterology, Hepatology, and Nutrition; Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics 2017;139(6) e20170967;PMID: 28562300
  20. Moynihan P. Foods and dietary factors that prevent dental caries. Quintessence Int2007;38 (4):320-324;PMID: 17432788
  21. Bradshaw DJ, Lynch RJ. Diet and the microbial etiology of dental caries: new paradigms. Int Dent J2013; 63 Suppl 2:64-72;PMID: 24283286
  22. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003;916:i-viii, 1-149, backcover;PMID: 12768890
  23. Levy SM, Warren JJ, Broffitt B, Hillis SL, Kanellis MJ. Fluoride, beverages and dental caries in the primary dentition. Caries Res 2003;37(3):157-165;PMID: 12740537
  24. Marshall TA, Levy SM, Broffitt B, et al. Dental caries and beverage consumption in young children. Pediatrics 2003;112(3 Pt 1):e184-e191. doi:10.1542/peds.112.3.e184
  25. ADA Policy on Diet and Nutrition. American Dental AssociationAdopted 2016 (2016:320).
  26. https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/nutrition-and-oral-health