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Association of Undernutrition and Early Childhood Dental Caries. OBJECTIVE: To determine the association between early childhood caries and nutritional status in preschool children. METHODS: Cross-sectional study among preschool children (N=550, age 8-60 mo) were selected in tribal, rural and urban health care units of Kerala. An oral examination for early childhood caries status was done using Deft index. The anthropometric measurements were recorded. Multiple logistic regression with other covariates was used to determine the association between the early childhood caries and nutritional status. RESULTS: The mean (SD) Deft scores were 0.93 (1.73), 2.22 (2.92) and 3.40 (3.23) for children with normal nutritional status, borderline undernutrition and undernutrition, respectively. Children with borderline undernutrition (adjusted OR 2.05, 95% CI 1.20, 3.49) or undernutrition (adjusted OR 3.46, 95% CI 1.93, 6.29) had higher odds of dental caries in comparison to those with normal nutritional status. CONCLUSION: Undernutrition is associated with early childhood caries among preschool children.