Food Security Status, WIC Participation, and Early Childhood Caries in a Nationally Representative Sample of Children

Abstract

Background: Despite the potential role of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in mitigating the adverse effects of food insecurity on oral health, to our knowledge, no study has examined whether WIC participation could modify the association between food insecurity with caries in young children.

Objective: Our aim was to investigate the impact of WIC participation in modifying the association between food insecurity and early childhood caries.

Design: This was a cross-sectional study.

Participants/setting: Using 2011-2018 National Health and Nutrition Examination Survey data, children aged 2 through 5 years; with household income ≤185% of the Federal Poverty Level; and with data on WIC participation, food security, and dental examinations were included (n = 1,921).

Study exposures: Food-security status and WIC participation were the study exposures.

Main outcome measures: Total and untreated dental caries were the main outcome measures.

Statistical analyses: Logistic regression examined associations of food security (household-level and child-level) and WIC participation with odds of caries. Interactions between food security and WIC participation were examined using multiplicative interaction terms.

Results: Marginal child food security was significantly related to higher odds of total caries in income-eligible WIC nonparticipants (odds ratio 1.92; 95% CI 1.07 to 3.46); however, this relationship was not observed in WIC participants. Furthermore, food insecurity was significantly associated with greater odds of untreated caries only among income-eligible WIC nonparticipants (odds ratio 1.79; 95% CI 1.12 to 2.85).

Conclusions: In this sample of preschool-aged children, the relationship of food insecurity with caries differed by WIC participation status. Findings suggest that WIC participation could improve the oral health of income-eligible children with lower levels of food security.

Keywords: Dental caries; Early childhood; Food security; NHANES; WIC participation.