The association between maternal knowledge, stunting severity, and dental caries among stunted children: a cross-sectional study

Ika Kurnia Dewi Supli, Mita Juliawati, Sri Ratna Laksmiastuti, Balqis Istiqomah Gusbela

Abstract


Introduction: Stunting remains a significant public health problem in Indonesia, including in Banyuasin Regency, South Sumatra, where the prevalence is 24.8%, exceeding the national average. Maternal knowledge may influence children's dietary practices, oral hygiene, and preventive care, thereby affecting the risk of dental caries. Stunting may also impair oral development and increase the risk of dental caries in children. This study aimed to analyze the association between maternal knowledge, stunting severity, and dental caries among stunted children Methods: This observational analytical study used a cross-sectional design. A total of 65 stunted toddlers were included using total sampling at Mariana Community Health Center, South Sumatra, between August and December 2025. Data were obtained from community health center records, and maternal knowledge regarding stunting was assessed using a questionnaire. Dental caries was measured using the def-t index. The associations between maternal knowledge regarding stunting, stunting severity and dental caries was analyzed using the Chi-square test. Results: Among the stunted children, 60.0% (n=39) were moderately stunted and 40.0% (n=26) were severely stunted. Most mothers had poor knowledge regarding stunting, with 58 respondents (89.23%) categorized as having poor knowledge (score <55). No significant association was found between maternal knowledge and stunting severity (p=0.073), while stunting severity was significantly associated with dental caries (p = 0.037). Conclusion: Maternal knowledge was not associated with stunting severity, whereas stunting severity was significantly associated with dental caries. Oral health assessment may be considered as a component of the comprehensive management of children with stunting.


Keywords


Stunting, dental caries, def-t index, maternal knowledge

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References


World Health Organization. Reducing stunting in children: equity considerations for achieving the global targets 2025. Geneva: World Health Organization; 2018. 32 p. Available from: https://www.who.int/publications/i/item/9789241513647

Jalaludin MY, Fauzi MD, Sidiartha IGL, John C, Aviella S, Novery E, et al. Addressing stunting in children under five: insights and opportunities from Nepal, Bangladesh, and Vietnam—a review of literature. Children (Basel). 2025;12(5):641. https://doi.org/10.3390/children12050641

Azriani D, Agustian D, Zuhairini Y, Yulita IN, Dhamayanti M. Prediction models for stunting at 2-years-old from Indonesian newborn population. BMC Pediatr. 2025;25:718. https://doi.org/10.1186/s12887-025-06096-4

Siramaneerat I, Astutik E, Agushybana F, Bhumkittipich P, Lamprom W. Examining determinants of stunting in urban and rural Indonesian: a multilevel analysis using the population-based Indonesian Family Life Survey (IFLS). BMC Public Health. 2024;24:1371. https://doi.org/10.1186/s12889-024-18824-z

Andriani H, Friska E, Arsyi M, Sutrisno AE, Waits A, Rahmawati ND, et al. A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys. BMC Public Health. 2023;23:1836. https://doi.org/10.1186/s12889-023-16728-y

National Population and Family Planning Board of South Sumatra Province. Performance report of the National Population and Family Planning Board of South Sumatra Province 2023. Palembang: National Population and Family Planning Board of South Sumatra Province; 2023.

Hamalaw SJ, Salih HA, Ali DA, Fattah AO, Muhamad NO, Noori AJ. Maternal knowledge and oral health status in relation to the oral health status of children. BMC Oral Health. 2026;26:304. https://doi.org/10.1186/s12903-025-07631-6

Abdulaziz R, Suryanti N, Setiawan AS. A review on maternal parenting, child's growth stunting, and oral health. Eur J Dent. 2024;18(1):26-40. https://doi.org/10.1055/s-0043-1764428

Mistry SK, Hossain MB, Arora A. Maternal nutrition counselling is associated with reduced stunting prevalence and improved feeding practices in early childhood: a post-program comparison study. Nutr J. 2019;18:47. https://doi.org/10.1186/s12937-019-0473-z

Aulia RN, Indriyanti R, Setiawan AS. The bi-directional relationship between growth stunting and early childhood caries: a rapid review. Front Public Health. 2023;11:1234893. https://doi.org/10.3389/fpubh.2023.1234893

Sadida ZJ, Indriyanti R, Setiawan AS. Does growth stunting correlate with oral health in children?: a systematic review. Eur J Dent. 2022;16(1):32-40. https://doi.org/10.1055/s-0041-1731887

Dimaisip-Nabuab J, Duijster D, Benzian H, Heinrich-Weltzien R, Homsavath A, Monse B, et al. Nutritional status, dental caries and tooth eruption in children: a longitudinal study in Cambodia, Indonesia and Lao PDR. BMC Pediatr. 2018;18:300. https://doi.org/10.1186/s12887-018-1277-6

Folayan MO, El Tantawi M, Oginni AB, Alade M, Adeniyi A, Finlayson TL. Malnutrition, enamel defects, and early childhood caries in preschool children in a sub-urban Nigeria population. PLoS One. 2020;15(7):e0232998. https://doi.org/10.1371/journal.pone.0232998

Juliawati M, Arbianti K, Juslily M, Anggraini W, Gusbela BI, Astoeti TE. Patient safety culture and identify factors associated with positive attitudes in private dental hospitals using the Indonesian Safety Attitude Questionnaire (SAQ-Indo): a cross-sectional study. Padjadjaran J Dent. 2025;37(3):300-309. https://doi.org/10.24198/pjd.vol37no3.64738

Putri NA, Setiawan AS, Setiawan AS. Oral health attitude with the socioeconomic conditions of mothers with growth stunting children. Eur J Dent. 2023;17(4):1051-5. https://doi.org/10.1055/s-0042-1757213

Jalaludin MY, Fauzi MD, Sidiartha IGL, John C, Aviella S, Novery E, et al. Addressing stunting in children under five: insights and opportunities from Nepal, Bangladesh, and Vietnam—a review of literature. Children (Basel). 2025;12(5):641. https://doi.org/10.3390/children12050641

Rezaeizadeh G, Mansournia MA, Keshtkar A, Farahani Z, Zarepour F, Sharafkhah M, et al. Maternal education and its influence on child growth and nutritional status during the first two years of life: a systematic review and meta-analysis. EClinicalMedicine. 2024;71:102574. https://doi.org/10.1016/j.eclinm.2024.102574

Althubaiti A. Sample size determination: a practical guide for health researchers. J Gen Fam Med. 2023;24:72-78. https://doi.org/10.1002/jgf2.600

Ntumi S, Agbenyo S, Bulala T. Estimating the psychometric properties (item difficulty, discrimination and reliability indices) of test items using Kuder-Richardson approach (KR-20). Shanlax Int J Educ. 2023;11(3):18-28. https://doi.org/10.34293/education.v11i3.6081

Ahmad M, Sechi C, Vismara L. Advanced maternal age: a scoping review about the psychological impact on mothers, infants, and their relationship. Behav Sci (Basel). 2024;14(3):147. https://doi.org/10.3390/bs14030147

Walters CN, Rakotomanana H, Komakech JJ, Stoecker BJ. Maternal determinants of optimal breastfeeding and complementary feeding and their association with child undernutrition in Malawi (2015-2016). BMC Public Health. 2019;19:1503. https://doi.org/10.1186/s12889-019-7877-8

Laksmiastuti SR, Wijaya H, Astoeti TE. Assessing mother's general and oral health awareness on COVID-19 pandemic in family: a study in Indonesia. J Int Dent Med Res. 2023;16(2):785-789.

Yani RWE, Kiswaluyo, Dwiatmoko S. Dental caries of stunting and underweight toddlers aged 3-5 years old among Pandhalungan community. Braz Dent Sci. 2023;26(4):e3833. https://doi.org/10.4322/bds.2023.e3833

Jethi A, Pradhan D, Tiwari S, Dhimole A, Saini N, Yadav A, et al. Assessment of chronic malnutrition and its correlation with oral health status in children aged three to six years in Jabalpur District, India: an epidemiological study. Cureus. 2024;16(8):e67838. https://doi.org/10.7759/cureus.67838

Vieira KA, Rosa-Júnior LS, Souza MAV, Santos NB, Florêncio TMMT, Bussadori SK. Chronic malnutrition and oral health status in children aged 1 to 5 years: an observational study. Medicine (Baltimore). 2020;99(18):e19595. https://doi.org/10.1097/MD.0000000000019595

Azriani D, Masita, Qinthara NS, Yulita IN, Agustian D, Zuhairini Y, et al. Risk factors associated with stunting incidence in under five children in Southeast Asia: a scoping review. J Health Popul Nutr. 2024;43(1):174. https://doi.org/10.1186/s41043-024-00656-7

Alristina AD, Laili RD, Nagy É, Feith HJ. The importance of socioeconomic factors associated with maternal nutrition knowledge and undernutrition among children under five. Nutrients. 2025;17(21):3355. https://doi.org/10.3390/nu17213355

Hamudeng AM, Fajriani, Nurhaeda, Yasa QA, Permatasari AS. Analysis of the relationship between stunting and dental caries patterns in children aged 6-12 years. J Dentomaxillofac Sci. 2025;10(4):220-223. https://doi.org/10.15562/jdmfs.v10i4.1973

Wang D, Wang X, Zhao C, Ma S, Zhang Y, Shi H. Study on the association between malnutrition, early childhood caries and caries activity among children aged 3-5 years. BMC Oral Health. 2024;24(1):1035. https://doi.org/10.1186/s12903-024-04802-9

Abdat M, Usman S, Chairunas, Suhaila H. Relationship between stunting with dental and oral status in toddlers. J Dentomaxillofac Sci. 2020;5(2):114-119. https://doi.org/10.15562/jdmfs.v5i2.1064

Renggli EP, Turton B, Sokal-Gutierrez K, Hondru G, Chher T, Hak S, et al. Stunting malnutrition associated with severe tooth decay in Cambodian toddlers. Nutrients. 2021;13(2):290. https://doi.org/10.3390/nu13020290

Setijanto D, Hemadi AS, Dewanto I, Adiatman M, Wulan KA, Ningrum V, et al. The updated trend of association between dental caries and stunting in all age groups: a systematic review. Iran J Public Health. 2025;54(2):265-272. https://doi.org/10.18502/ijph.v54i2.17898




DOI: https://doi.org/10.24198/pjd.vol38no2.70164

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