Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

114 questions · 197 findings · 18 reviews

No studies found 0 · 0%GRADE not reported 180 · 91.4%Very low 0 · 0%Low 5 · 2.5%Moderate 5 · 2.5%High 7 · 3.6%

Maternal education attainment vs Children without dental caries

Dental caries (association with secondary/higher maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Secondary/higher maternal education showed no significant association with dental caries (OR 0.96, 95% CI 0.64 to 1.44; 7 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Not applicable (single-group prevalence)

Secondary/higher maternal education prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 45% of children with caries in LMICs had mothers with secondary or higher education (pooled prevalence 0.450, 95% CI 0.330 to 0.572; 7 studies; not GRADE-rated).

1 finding from 1 review

Lower unemployment rate vs Higher unemployment rate (low <=5% / medium >5-10% / high >10%)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT tended to increase with unemployment rate (low 1.23, medium 2.08, high 2.38; ANOVA p<.05); descriptive country-level means only, not meta-analyzed or GRADE-rated.

3 findings from 1 review

Country-level income (World Bank income classification) vs Higher- vs lower-income country categories

Oral health-related quality of life · people aged 60 years and older living in the community

Community-dwelling older adults in higher-income countries had better OHRQoL than those in lower-income countries (77.9, 95% CI 70.2 to 85.6 vs 66.9, 95% CI 56.7 to 77.0); the difference by income was statistically significant (ungraded).

2 findings from 1 review

Country-level income inequality (Gini index) vs Lower vs higher income inequality categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in countries with relative income equality (low Gini index) had markedly higher OHRQoL (91.3, 95% CI 90.0 to 92.6) than those in less equal countries; the difference by Gini index was statistically significant (ungraded).

4 findings from 1 review
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Human Development Index (HDI) vs Higher vs lower HDI categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in higher-HDI countries had better OHRQoL (high 79.9, 95% CI 74.4 to 85.5; very high 78.4, 95% CI 71.1 to 85.8) than those in medium-HDI countries (63.5, 95% CI 54.3 to 72.7); the difference by HDI was statistically significant (ungraded).

3 findings from 1 review

Country-level unemployment rate vs Higher vs lower unemployment-rate categories

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly across country-level unemployment-rate categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Health expenditure per capita vs Higher vs lower per-capita health expenditure categories

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly across per-capita health-expenditure categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Out-of-pocket health expenditure vs Lower vs higher out-of-pocket expenditure categories

Oral health-related quality of life · people aged 60 years and older living in the community

Lower out-of-pocket health expenditure was associated with better OHRQoL (83.9, 95% CI 75.2 to 92.6 vs 67.5, 95% CI 58.5 to 76.5); the difference was statistically significant (ungraded).

2 findings from 1 review

Sociodemographic and behavioural factors (older age, lower education, lower income, poor oral hygiene/brushing, smoking, disadvantaged/slum residence, sex) vs Referent groups (younger, higher education/income, better oral hygiene, non-slum residence)

Determinants of oral diseases · Adult residents of slums and non-slum urban settings of LMICs

Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded.

1 finding from 1 review

Lower parental (maternal/paternal) education vs Higher parental education

Dental caries · Healthy children and adolescents in the United Arab Emirates

The association between parental education and caries was inconsistent; father's (but not consistently mother's) education was inversely associated with caries in some studies (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Lower family socioeconomic status / income vs Higher socioeconomic position

Dental caries · Healthy children and adolescents in the United Arab Emirates

Evidence on socioeconomic status/income and caries was inconsistent: some studies linked lower income to higher caries while others found no association (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Low maternal education (<=6 years of schooling) vs Higher maternal education (>6 years)

Poor oral health-related quality of life (OHRQoL) · Children aged 3-12 years

Lower maternal education was associated with poor OHRQoL (OR 1.12, 95% CI 1.00-1.23; 4 studies; high heterogeneity; CI lower bound at the null; ungraded).

1 finding from 1 review

Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with low socioeconomic status (>=22.4% of the population with low SES) vs Populations with higher socioeconomic status (<22.4% of the population with low SES)

Caries experience (mean DMFT) · Adults aged 19-60 years

Populations with a higher proportion of people with low socioeconomic status had higher caries experience (pooled DMFT 15.99 vs 5.50), and meta-regression associated low SES with higher DMFT (about 10.35 more DMFT per unit; p=0.050); ungraded observational evidence.

5 findings from 1 review
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Populations with a lower proportion of university-educated people (<33.78% with university level) vs Populations with a higher proportion of university-educated people (>=33.78% with university level)

Caries experience (mean DMFT) · Adults aged 19-60 years

The proportion of university-educated people was not associated with caries experience (DMFT); pooled DMFT was similar across subgroups and the meta-regression was non-significant; ungraded observational evidence.

5 findings from 1 review
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HDI (quantitative) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with a low level of schooling (>=33.60% of the population with low schooling) vs Populations with a higher level of schooling (<33.60% of the population with low schooling)

Caries experience (mean DMFT) · Adults aged 19-60 years

Population level of schooling was not significantly associated with caries experience (DMFT) in subgroup meta-analysis or meta-regression; ungraded observational evidence with very high heterogeneity.

5 findings from 1 review
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