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Open Access Research article

Association between iron status, iron deficiency anaemia, and severe early childhood caries: a case–control study

Robert J Schroth123*, Jeremy Levi13, Eleonore Kliewer13, James Friel13 and Michael EK Moffatt234

Author Affiliations

1 Department of Preventive Dental Science, Faculty of Dentistry, University of Manitoba, 507-715 McDermot Avenue, Winnipeg, MB R3E 3P4, Canada

2 Department of Pediatrics & Child Health, Faculty of Medicine, University of Manitoba, 507-715 McDermot Avenue, Winnipeg, MB R3E 3P4, Canada

3 The Manitoba Institute of Child Health, 507 – 715 McDermot Avenue, Winnipeg, MB, R3E 3P4, Canada

4 Winnipeg Regional Health Authority, 4th Floor – 650 Main Street, Winnipeg, MB, R3B 1E2, Canada

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BMC Pediatrics 2013, 13:22  doi:10.1186/1471-2431-13-22

Published: 7 February 2013



Severe tooth decay is known to affect the health and well-being of young children. However, little is known about the influence of Severe Early Childhood Caries (S-ECC) on childhood nutritional status. The purpose of this study was to contrast ferritin and haemoglobin levels between preschoolers with S-ECC and caries-free controls.


Children were recruited as part of a larger case–control study examining differences in nutritional status between those with and without S-ECC. Preschoolers with S-ECC were recruited on the day of their dental surgery, while caries-free controls were recruited from the community. Parents completed a questionnaire and the child underwent venipuncture. The study was approved by the University’s Health Research Ethics Board. Statistics included descriptive, bivariate and logistic regression analyses. A p value ≤ .05 was significant. A total of 266 children were recruited; 144 with S-ECC and 122 caries-free.


The mean age was 40.8 ± 14.1 months. The mean ferritin concentration for all children was 29.6 ± 17.9 μg/L while the mean haemoglobin level was 115.1 ± 10.1 g/L. Children with S-ECC were significantly more likely to have low ferritin (p=.033) and low haemoglobin levels (p>.001). Logistic regression analyses revealed that children with S-ECC were nearly twice as likely to have low ferritin levels and were over six times more likely to have iron deficiency anaemia than caries-free controls.


Children with S-ECC appear to be at significantly greater odds of having low ferritin status compared with caries-free children and also appear to have significantly lower haemoglobin levels than the caries-free control group. Children with S-ECC also appear to be at significantly greater odds for iron deficiency anaemia than cavity-free children.

Early childhood caries; Iron; Iron deficiency; Anaemia; Preschool child