Tooth Loss and Nutritional Status in 120,994 Children Aged 6-9 Years in Mongolia: A Population-Based Study

Background: Tooth loss in childhood reflects cumulative oral disease and may impair dietary intake, potentially influencing nutritional status. Evidence on the association between tooth loss and anthropometric indicators in school-aged children remains limited. Methods: This population-based cross-sectional study used data from a nationwide health screening conducted by the Ministry of Health of Mongolia in 2023-2024. A total of 120,994 children aged 6-9 years were included. Tooth loss was categorized as 0, 1-2, or ≥3 extracted teeth. Nutritional status was assessed using weight-for-height (WHZ), weight-for-age (WAZ), height-for-age (HAZ) Z-scores, and body mass index (BMI). Associations between tooth loss and anthropometric indicators were examined using unadjusted and multivariable linear regression models adjusting for age and sex. Results: Overall, 12.5% of children had experienced tooth loss. Mean WHZ and WAZ decreased progressively with increasing tooth loss. In adjusted analyses, children with 1-2 extracted teeth had lower WHZ (β = -0.025; 95% CI: -0.047 to -0.004), and those with ≥3 extracted teeth had substantially lower WHZ (β = -0.058; 95% CI: -0.084 to -0.032), compared with children without tooth loss. Similar associations were observed for WAZ. No significant associations were found between tooth loss and BMI or HAZ. No interactions with age or sex were detected. Conclusions: Tooth loss was independently associated with lower indicators of current nutritional status among children aged 6-9 years. These findings underscore the importance of integrating oral health and nutrition strategies in childhood health programs.