Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

61 questions · 95 findings · 11 reviews

No studies found 0 · 0%GRADE not reported 88 · 92.6%Very low 7 · 7.4%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Low income vs High income

Prevalence of untreated decay (% DT > 0) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Australia, low versus high income differed by 11.90 percentage points in prevalence of untreated decay.

5 findings from 1 review
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Low income vs High income

Mean number of decayed teeth (mean DT) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

Across four countries, low versus high income differed by 0.44 decayed teeth in mean number of decayed teeth (random-effects meta-analysis; I2=76.4%).

5 findings from 1 review
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Low income vs High income

Prevalence of fair/poor self-rated oral health · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

Across four countries, low versus high income differed by 15.77 percentage points in prevalence of fair/poor self-rated oral health (random-effects meta-analysis; I2=13.4%).

5 findings from 1 review
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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 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

Socioeconomic status category vs Children without dental caries

Dental caries · Children (deciduous and/or permanent dentition) in low- and middle-income countries

High SES showed no significant association with dental caries (OR 1.03, 95% CI 0.81 to 1.31; 5 studies; not GRADE-rated).

2 findings from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

Low SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 36% of children with caries in LMICs were of low SES (pooled prevalence 0.359, 95% CI 0.167 to 0.578; 4 studies; not GRADE-rated).

1 finding from 1 review

Sociodemographic / socioeconomic factors (single-parent family, low parental education, family income, socioeconomic status) vs Absence of the factor / reference socioeconomic category

Caries increment in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Evidence on the association between sociodemographic/socioeconomic factors and permanent-teeth caries is weak and inconsistent (3 studies; could not be pooled; not GRADE-rated).

1 finding from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

Odds of higher caries (DMFT) category · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Higher national income was strongly associated with lower odds of poor oral health (OR 0.10, 95% CI 0.03 to 0.37; about 90% lower odds); not GRADE-rated.

1 finding from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

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

Mean DMFT in 12-year-olds rises as national income falls: 0.90 (very high income), 2.38 (high income), 3.30 (middle income) (Figure 2); not GRADE-rated.

3 findings from 1 review

Higher family income / socioeconomic status vs Lower income / worse socioeconomic status

Oral health-related quality of life · Adolescents (10-19 years)

Higher family income / better socioeconomic status is associated with better OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Adolescents from families with higher incomes and higher levels of maternal education have better OHRQoL scores [34]. Worse oral health status, older age, female sex and worse socioeconomic status were significantly…
    Studies not reported
    GRADE not reported

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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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

Fluoride toothpaste vs Not applicable (single-group prevalence)

Fluoride toothpaste use prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 39% of children with caries in LMICs used fluoride toothpaste (pooled prevalence 0.391, 95% CI 0.166 to 0.644; 2 studies; not GRADE-rated).

1 finding from 1 review

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

Maternal education attainment vs Children without dental caries

Dental caries (association with no formal maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

No formal maternal education showed a non-significant trend toward higher odds of dental caries (OR 1.34, 95% CI 0.76 to 2.36; 3 studies; not GRADE-rated).

1 finding from 1 review