• academic performance;
  • schools;
  • oral health;
  • dental caries;
  • dental decay



Although recent literature indicated an association between dental caries and poor academic performance, previous work relied on self-reported measures. This analysis sought to determine the association between academic performance and untreated dental caries (tooth decay) using objective measures, controlling for school-level characteristics.


School-level untreated caries prevalence was estimated from a 2009-2010 oral health survey of Ohio third-graders. Prevalence estimates were combined with school-level academic performance and other school characteristics obtained from the Ohio Department of Education. Linear regression models were developed as a result of bivariate testing, and final models were stratified based upon the presence of a school-based dental sealant program (SBSP).


Preliminary bivariate analysis indicated a significant relationship between untreated caries and academic performance, which was more pronounced at schools with an SBSP. After controlling for other school characteristics, the prevalence of untreated caries was found to be a significant predictor of academic performance at schools without an SBSP (P = 0.001) but not at schools with an SBSP (P = 0.833).


The results suggest the association between untreated caries and academic performance may be affected by the presence of a school-based oral health program. Further research focused on oral health and academic performance should consider the presence and/or availability of these programs.