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J Indian Soc Pedod Prev Dent. 2019 Jul-Sep;37(3):232-236. doi: 10.4103/JISPPD.JISPPD_68_19.

Influence of gratification behavior on early childhood caries and body mass index in preschool children.

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Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.



Early childhood caries (ECC) and obesity are becoming major public health problems in children. Apart from biological and social risk factors, gratification response, a psychological behavior, may also have a large influence on body mass index (BMI) and occurrence of ECC in preschool children.


The study aimed to ascertain the impact of delayed gratification as a behavioral risk factor for the occurrence of ECC and obesity in preschool children of age 5-6 years.

Settings and Design:

Comparative cross-sectional study.

Materials and Methods:

Fifty children with ECC (Group I) and 50 caries-free children (Group II) were included to participate in a task similar to the famous Stanford marshmallow experiment to assess their ability to delay gratification. BMI was calculated by obtaining the biometric measures of height and weight. Body weight status was determined using BMI for age percentile growth charts revised by the Indian Academy of Pediatrics, 2015. Children's caries experience and BMI status were associated with their gratification response.

Statistical Analysis:

Statistical analysis was performed using Fisher's exact test and Chi-square test.


Higher percentage of children with ECC delayed their gratification (54%) than caries free (40%). Children who exhibited instant gratification (37%) had a higher BMI when compared to those who delayed their gratification (25%).


Children with ECC were more self-controlled, and children with high BMI were more impulsive. Hence, delayed gratification for cariogenic reward is a behavioral risk factor for ECC, whereas instant gratification is an alarming risk factor for higher BMI in preschool children.


Body mass index; delayed gratification; early childhood caries; obesity

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