Weight Status

Nutritional status assessment Category

Percentile Range

Student name: ------------- Group------------- Less than the 5th

Underweight
percentile
Patient name: ---------------
Age --------------Class----------- 5th percentile to less than
Healthy weight
the 85th percentile
Gender------------------------
At risk of 85th to less than the 95th
Height (m) ---------------------------
overweight percentile
Weight (kg) --------------------
Equal to or greater than
BMI ------------------------------------- (kg/m2) Overweight
the 95th percentile
Weight Status Category ------------------------------
Dietary analysis (24-hour recall)

‫نوع الغذاء‬ ‫الوقت‬

‫الفطور‬

‫بعد الفطور‬

‫الغذاء‬

‫بعد الغذاء‬

‫العشاء‬

‫بعد العشاء‬

‫وقت النوم‬

Plaque forming sweet

Frequency of eaten sweet (----------------) × 20 = (--------------) minutes

(--------------) hours
Food group evaluation
Type of food No of serving Suggested no of Adequate inadequate
per day serving per day

Milk group 2-3

Starchy food 5 or more

and bread
Fruit 2-4

Vegetables 3 or more

Meat,poultry, 2-3
fish,egg, peans

Sweet evaluation chart

Form of sweet Frequency of intake Points
per day

Liquid ×5=

Solid and sticky ×10=

Slowly dissolved ×15=

Sweet score Sum=

5 or less excellent
10 good
15 or more watch out zone

The time between last eaten sweet and go to bed equal to

(---------------) minutes

(---------------) hours
Nutritional status assessment using Body Mass Index (BMI)
What is BMI?
Body Mass Index (BMI) is a number calculated from a child's weight and
height. For children BMI is used to screen for overweight, at risk of overweight,
or under weight. It's easy to perform method screening for weight categories that
may lead to health problems. For Children an teens, BMI is age- and gender-
specific and is often referred to as BMI-for-age.
What is a BMI percentile?

After BMI is calculated for children and teens, the BMI number is plotted
on the CDC BMI-for-age growth charts (for either girls or boys) to obtain a
percentile ranking. Percentiles are the most commonly used indicator to assess
the size and growth patterns of individual children. The percentile indicates the
relative position of the child’s BMI number among children of the same gender
and age. The growth charts show the weight status categories used with children
and teens (underweight, healthy weight, at risk of overweight, and overweight).

How is BMI calculated and interpreted for children and teens?

Calculating and interpreting BMI using the BMI Percentile Calculator involves
the following steps:

1. Before calculating BMI, obtain accurate height and weight measurements

2. Calculate the BMI and percentile using the Child and Teen BMI Calculator.
The BMI number is calculated using standard formulas. weight (kg) / height 2

3. Review the calculated BMI-for-age percentile and results. The BMI-for-age

percentile is used to interpret the BMI number because BMI is both age-and
gender-specific for children and teens. These criteria are different from those
used to interpret BMI for adults — which do not take into account age or geder.

Age and gender are considered for children and teens for two reasons:

 The amount of body fat changes with age. (BMI for children and teens is
often referred to as BMI-for-age.)
 The amount of body fat differs between girls and boys.
The CDC BMI-for-age growth charts for girls and boys take into account these
differences and allow translation of a BMI number into a percentile for a child’s
or teen’s gender and age.

4. Find the weight status category for the calculated BMI-for-age percentile as
shown in the following table.

Weight Status Category Percentile Range

Underweight Less than the 5th percentile

Healthy weight 5th percentile to less than the 85th percentile

At risk of overweight 85th to less than the 95th percentile

Overweight Equal to or greater than the 95th percentile

Two children have the same BMI values, but one is considered overweight and
the other is not. Why is that?

The interpretation of BMI-for-age varies by age and gender so if the children are
not exactly the same age and of the same gender, the BMI numbers have
different meanings. Calculating BMI-for-age for children of different ages and
gender may yield the same numeric result, but that number will fall at a different
percentile for each child for one or both of the following reasons:

 The normal BMI-related changes that take place as children age and as
growth occurs.
 The normal BMI-related differences between gender.

See the following graphic for an example for a 10-year-old boy and a 15-year-
old boy who both have a BMI-for-age of 23. (Note that two children of different
ages are plotted on the same growth chart to illustrate a point. Normally the
measurement for only one child is plotted on a growth chart.)
Diet analysis
Parents have a pivotal role in the nutrition of their children during school year;
they provide guidance for healthy eating habit and attitude. Therefore, good and
bad dietary habit tends to be passed from them to their child.
The method commonly used to assess dietary intake is:
24 Hour Recall:
This method is widely used to assess dietary intake, the respondent is
asked to remember and repeat all the food in the preceding 24 hour or in the
preceding day, the respondent able to recall most of their dietary intake because
of the immediacy of the recall period, however, in this method the individual
may not report their food consumption accurately for reasons related to memory
and the interview situation.
General direction
1- Encourage use a typical day, uncomplicated by illness, dieting, holidays,
or other unusual events
2- Be accurate in determining the amount eaten using household
measurement
3- Record food preparation methods
4- Record all fluid including water
5- The time of bed should be entered
6- Record time and type of tooth cleaning methods (oral hygiene measure)
The recall typically is conducted by personal interview, using paper and
pencil form. A quality control system to minimize error and increase reliability
of interviewing and coding is essential.
Interviewing
The purpose of an interview is to obtain information and to give help,
comfortable relaxed atmosphere are important, the interview should not take
place in chair side in the dental operator for reason that this is a threaten
atmosphere that may engender fear. Therefore using a private counseling
room will indicate that you respect the patients feeling
How to interview a patient
1- The interviewer should be relaxed and should help the patient to relax
2- Its important to allow the patient to talk freely, thus leads for additional
questions
3- An important advantages of listening before speaking is that the patient
may reveal answers to many question without being asked. Allowing the
patient to speak first may change the interviewers view about the cause of
the problem and may reveal the causes of dental decay from the patients
points of view
4- In general question that require extend answers are preferable to question
that can be answered yes or no, when closing an interview it is usually a
good plan to end by recapitulating what the patient has learned and the
future action that you have agreed on
With this work sheet, the diet can be qualitatively evaluated for its adequacy and
the amount of sugar-sweetened food with their cariogenic potential can be
clearly shown by the following evaluation:
Evaluation of general diet adequacy (food group evaluation ):
The examiner examines how well the patient fare in relation to the major
food groups. When the 24 hour recall is completed , an analysis of the patient
diet is made.
1- Using a green pencil to circle the acceptable food that fall within the various
compartment of food group.
2- In second step, using table of food group evaluation. Each item circled in
green on 24 hour recall is assigned to the appropriate food group and a chit
mark made in the column for that group.
3- At the end the number of chit mark for each group is totaled to total number
of daily serving this serving is compared with daily recommended average for
the food groups
4- The plus or minus differences between the intake and the recommended
number of serving is recorded in the column marked adequacy

ِِ
Assessment of cariogenic potential
The frequency of intake and consistency of refined carbohydrate are key factors
in the initiation and continuation of caries process. To evaluate the amount and
type of food sweetened with sugar and the frequency of eating them the
examiner is asked to do the following
1- Circle in red all food listed in the 24 h recall that are sweetened with sugar to
identify types of cariogenic food, it should be looked at this from a public health
view point not purely biochemical viewpoint, even a bread contain sugars but
overall, bread is not a threat to teeth and is valuable food, look for food which
clearly contain a significant proportion of non milk sugars such as
confectionery, sugar-containing soft drink, sugar in tea and coffee, biscuits and
cakes and so (see below)
2- Classify each sweet into liquid, solid and sticky, or slowly dissolved this
determine the consistency of cariogenic food relate to probable length of time
food might remain on the tooth surface (food have an overtly sweet taste). The
major goal is to try to wean the patient from the readily detectable sweet flavor.
Dried fruits such as figs, dares, prunes apricots, and raisins should be circled
because they are highly concentrated sweets. However fresh fruit with high
water and fiber content such as apple, orange, or pears are not

Liquid soft drink Sugar and honey in beverage, ice cream

Solid and sticky Cakes, sweet roll, ,pastry, canned fruit, chocolate
candy, toffee, dried fruit, jelly, jam, custard

Slowly dissolved Hard candies, sugared chewing gum

 3-The frequency is more relevant than quantity, therefore for each time a
sweet was eaten, either at the end of a meal or between meals(at least 20
minutes a part) place a check in the frequency column
4-In each group added up the number of sweet eaten and multiply by the
number provided, write down the number of points
3- added up all the points for the for the total score
5 or less excellent
10 good
15 or more "watch out" zone

Evaluation by the patient

Plaque forming sweet
The total number of exposure of the teeth to the sweet, the form of the sweet
(solid or liquid), and when they were eaten (at meal or between meals) are
determined.
1- On the plaque forming sweet chart, the patient classifies the food circled
in red in the 24 hour recall according to their physical nature and how
frequently they were eaten
2- The significance of the total number of check marks become clear if the
patient multiplies that number by a factor of ( 20 ). The factor 20
represent approximately the number of minutes that the plkaque remain at
the tooth demineralization potential when concentrated sweet in liquid
form come into contact with dental plaque if the sweet are retained,
3- The number of acid production may be doubled with hard candies, toffee,
cookies.
4- After that the patient has calculated the number of hours each day that the
teeth have been exposed to acid demineralization.
Was sugar- containing food eaten within one hour of bed.
Salivary flow virtually ceases during sleep. Saliva is very important in clearing
sugar from the mouth and especially at raising pH in dental plaque. Plaque pH
changes following sugar eating usually last about 30-60 minutes, and if the
patient go to sleep within this period, the pH of the plaque is likely to stay low
for many hours, this may be especially harmful.