93 - School Meal Cariogenicity Associated to Caries Prevalence in South Florida

Purpose: This study investigated whether the cariogenicity level of school lunch menus is associated with caries experience.

Methods: Cariogenicity levels of school-provided meals from 6 South Florida schools (3 public and 3 charter) were evaluated using Evans Index and compared to dental morbidity among schoolchildren attending these schools, as assessed through the Basic Screening Survey (BSS). BSS identifies untreated and treated caries, sealants, and scored treatment urgency.



Results: A total 267 elementary school students 3-14 years (mean age=8.2 years) were included. The mean cariogenicity level of lunch menus served at charter schools was significantly higher than that of public schools in 2022 (P=.004). Logistic regression analysis of the BSS components taken between 2023-2025 revealed rising meal cariogenicity levels increase the chances of untreated caries (OR=10.0, P< .001). Dental screenings revealed inequities in morbidity levels and services provided to students from different school systems. Charter school students had more existing dental sealants (P=.007), less extensive tooth damage measured by the number of full-coverage restorations per child (P=.047) and received fewer preventive services (prophylaxis, fluoride applications, exam) from the mobile unit performing the screening. These charter schools serve populations with higher poverty scores (P < .001), potentially qualifying their schoolchildren for increased access to Medicaid dental benefits that could have mitigated disease severity.

Conclusion: School meal cariogenicity associates with dental morbidity. Therefore, adopting healthy menus has the potential to decrease dental disease while positively impacting overall health among school children. Nevertheless, access to care remains a mitigating factor critical to communities at risk.