Transactional Evaluation of the Influence of Diet Consistency on Transverse Maxillary Deficiency, Plaque Index and Dental Caries in Pediatric Patients: A Cross-Sectional Study

Abstract: Objectives: This study examines the association between a predominantly softtextured diet and clinical signs of maxillary bone hypoplasia, such as maxillary constriction and related malocclusions like crossbite. A secondary aim is to assess whether this diet correlates with dental caries and higher plaque index in children with early mixed dentition. Methods: A total of 106 pediatric patients (4–12 years) were enrolled during routine visits (June 2022–February 2024), divided into 53 “cases” (maxillary hypoplasia and malocclusions) and 53 “controls” (normal maxillary development, no malocclusions). Patients with congenital craniofacial malformations were excluded. Dietary habits were assessed using a food questionnaire categorizing foods into four consistencies (“Semi-Liquid”, “Creamy”, “Soft”, and “Solid”). The DMFT index was calculated, considering only missing teeth due to caries. The plaque index (PI) was recorded at the first visit to evaluate the relationship between food texture and plaque accumulation. Statistical analyses included Student’s t-test, Z-test, Chi-square test, and Fisher’s exact test. Results: Mixed breastfeeding was common in both groups with no significant difference. However, natural breastfeeding was significantly more frequent in the non-crossbite group. A high-arched palate was more prevalent in the crossbite group (p = 0.042 *). Soft food consumption was significantly higher in the crossbite group compared to controls (p = 0.032 *). A statistically significant association was found between caries prevalence (DMFT > 0) and posterior crossbite (p = 0.04). Furthermore, the relationship between the dental plaque index and food consistency demonstrated a statistically significant result. In particular, there was a correlation between soft food and semi-solid foods and the plaque index (χ2 = 3.55, p = 0.04). Conclusions: Posterior crossbite is associated with increased consumption of soft foods, potentially reducing the mechanical stimulation essential for maxillary growth. Conversely, noncrossbite subjects consume more hard foods and are more frequently breastfed naturally, reinforcing their role in craniofacial development. Additionally, posterior crossbite is associated with higher caries prevalence, indicating a potential connection between occlusion and oral health. Dietary texture also influences oral hygiene, with soft and semi-solid foods correlating with increased plaque accumulation, while no association was found with solid or hard foods.