Non-Cochrane · aetiology · PM31307444
Dental caries experience, care index and restorative index in children with learning disabilities and children without learning disabilities; a systematic review and meta-analysis.
Robertson Mark D, Schwendicke Falk, de Araujo Mariana Pinheiro, et al. · BMC oral health · 2019 · PubMed · doi:10.1186/s12903-019-0795-4
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
13
current version
GRADE rated
0
No studies
0
Included studies
44
linked below
No studies 0 · 0%Ungraded 13 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children with learning disabilities (with or without physical disabilities) compared with a similar group of children without learning disabilities | Children aged 1-18 years; 1819 CLD across 25 studies in 18 countries |
| Intervention | Presence of a learning disability (exposure) | Learning disability type: Down syndrome (11 studies), autism (8 studies), mixed/other learning disabilities (6 studies) |
| Comparison | Matched children without learning disabilities (CNLD) | 2157 CNLD (siblings, family members, or wider-population controls) |
| Outcomes | Caries experience (DMFT/dmft/deft); care index (CI); restorative index (RI) | Caries experience: DMFT permanent (16 studies meta-analyzed) and dmft/deft primary (8 studies meta-analyzed); care index (8 studies) and restorative index (9 studies) reported narratively only (no variance data, no meta-analysis); unmet dental need narrative (6 studies) |
| Study designs | Observational studies with caries data from clinical examination; comparative (CLD vs CNLD); studies comparing CLD only with general-population values excluded | 25 comparative cross-sectional studies |
| Timing | Not specified | Not specified (cross-sectional) |
Search date: Database inception to June 2017; search updated December 2018. Databases: MEDLINE (Ovid); PubMed; Scopus (Elsevier); Web of Science
Questions and results
Learning disability (CLD) vs No learning disability (CNLD)
Population: Children aged 1-18 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caries experience in primary teeth (dmft/deft) In primary teeth, meta-analysis found no evidence of a difference in caries experience (dmft/deft) between children with and without learning disabilities (SMD 0.41, 95% CI -0.14 to 0.96; 8 studies; certainty not graded). Source: Fig. 3 (forest plot, TOTAL diamond); Results 'Caries experience in the primary dentition for CLD compared to CNLD'; Tables 7-9 · same question in other reviews | SMD 0.41 [-0.14, 0.96] | 8 studies | Ungraded |
Caries experience in permanent teeth (DMFT) Across all learning disabilities, meta-analysis found no evidence of a difference in permanent-tooth caries experience (DMFT) between children with and without learning disabilities (SMD -0.43, 95% CI -0.91 to 0.05; 16 studies; certainty not graded). Source: Fig. 2 (forest plot, TOTAL diamond); Results 'Caries experience in the permanent teeth for CLD compared to CNLD'; Tables 3-5 · same question in other reviews | SMD -0.43 [-0.91, 0.05] | 16 studies | Ungraded |
Caries experience in permanent teeth (DMFT) Disability: mixed learning disabilities In children with mixed/other learning disabilities, permanent-tooth caries experience did not differ from children without learning disabilities (SMD 0.26, 95% CI -0.94 to 1.47; 2 studies; certainty not graded). Source: Fig. 2 (mixed subtotal); Results; Table 5 · same question in other reviews | SMD 0.26 [-0.94, 1.47] | 2 studies | Ungraded |
Care index (CI), permanent teeth The care index (met dental care need) for permanent teeth could not be meta-analyzed because no study reported variance; it was lower or equal in children with learning disabilities in 5 of 8 studies (certainty not graded). Source: Results 'Care, and restorative indices (permanent teeth)'; Table 2; Discussion · same question in other reviews | Mean care index CLD 0.12 (SD 0.12) vs CNLD 0.18 (SD 0.27) for permanent teeth; CI in CLD was less than or equal to CNLD in 5 of 8 studies. Not meta-analyzed (no variance data reported in any study). | 8 studies | Ungraded |
Caries experience in permanent teeth (DMFT) Disability: autism In children with autism, permanent-tooth caries experience did not differ from children without learning disabilities (SMD -0.28, 95% CI -1.31 to 0.75; 6 studies; certainty not graded). Source: Fig. 2 (autism subtotal); Results; Table 4 · same question in other reviews | SMD -0.28 [-1.31, 0.75] | 6 studies | Ungraded |
Unmet dental treatment need Narrative reports from 6 studies suggested greater unmet dental treatment need in children with learning disabilities (5 of 6 studies), but no quantitative data were available (certainty not graded). Source: Results 'Narrative reports of unmet dental need'; Table 10 · same question in other reviews | Six studies gave narrative reports of unmet dental need (Table 10); 5 of 6 reported greater unmet treatment need in CLD than CNLD, with no supporting numerical data. | 6 studies | Ungraded |
Restorative index (RI), permanent teeth The restorative index for permanent teeth could not be meta-analyzed (no variance data); it was lower or equal in children with learning disabilities in 4 of 9 studies, and the pattern suggested more extraction- than restoration-based care in CLD (certainty not graded). Source: Results 'Care, and restorative indices (permanent teeth)'; Table 2; Discussion · same question in other reviews | Mean restorative index CLD 0.15 (SD 0.14) vs CNLD 0.28 (SD 0.33) for permanent teeth; RI in CLD was less than or equal to CNLD in 4 of 9 studies. Not meta-analyzed (no variance data). In CLD the RI tended to exceed the… | 9 studies | Ungraded |
Caries experience in permanent teeth (DMFT) Disability: Down syndrome In children with Down syndrome, permanent-tooth caries experience was lower than in children without learning disabilities (SMD -0.73, 95% CI -1.28 to -0.18; 8 studies; certainty not graded). Source: Fig. 2 (Down syndrome subtotal); Results; Table 3 · same question in other reviews | SMD -0.73 [-1.28, -0.18] | 8 studies | Ungraded |
Caries experience in primary teeth (dmft/deft) Disability: autism In children with autism, primary-tooth caries experience did not differ from children without learning disabilities (SMD 0.43, 95% CI -0.53 to 1.39; 4 studies; certainty not graded). Source: Fig. 3 (autism subtotal); Results; Table 8 · same question in other reviews | SMD 0.43 [-0.53, 1.39] | 4 studies | Ungraded |
Caries experience in primary teeth (dmft/deft) Disability: Down syndrome In children with Down syndrome, primary-tooth caries experience did not differ from children without learning disabilities (SMD 0.55, 95% CI -0.40 to 1.52; 3 studies; certainty not graded). Source: Fig. 3 (Down syndrome subtotal); Results; Table 7 · same question in other reviews | SMD 0.55 [-0.40, 1.52] | 3 studies | Ungraded |
Caries experience in primary teeth (dmft/deft) Disability: mixed learning disabilities For mixed/other learning disabilities, the single primary-teeth estimate showed no difference in caries experience (SMD -0.10, 95% CI -0.34 to 0.14; 1 study; certainty not graded). Source: Fig. 3 (mixed subtotal); Results; Table 9 · same question in other reviews | SMD -0.10 [-0.34, 0.14] | 1 study | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Restorative index, primary teeth | no estimate extracted | 2 studies | Ungraded |
Care index, primary teeth Disability: autism | no estimate extracted | 2 studies | Ungraded |
Included primary studies 44
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Al Habashneh 2012 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Al Habashneh et al. 2012 Oral health status and reasons for not attending dental care among 12‐ to 16‐year‐old children with Down syndrome in special needs centres… DOI:10.1111/j.1601-5037.2012.00545.x | 1 other review | not stated | not extracted yet | not extracted yet |
| Cogulu 2006 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Mathias 2011 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Subramaniam 2014 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Subramaniam et al. 2014 Assessment of salivary total antioxidant levels and oral health status in children with Down syndrome DOI:10.1111/scd.12054 | 1 other review | not stated | not extracted yet | not extracted yet |
| Al-Maweri 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Al-Maweri et al. 2014 Oral lesions and dental status of autistic children in Yemen: A case-control study. PMID:25625079 | this review only | not stated | not extracted yet | not extracted yet |
| AlSarheed 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| AlSarheed 2015 A comparative study of oral health amongst trisomy 21 children living in Riyadh, Saudi Arabia: Part 1 caries, malocclusion, trauma. PMID:26644758 | this review only | not stated | not extracted yet | not extracted yet |
| Areias et al. 2013 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bakry & Alaki 2012 Risk Factors Associated with Caries Experience in Children and Adolescents with Intellectual Disabilities DOI:10.17796/jcpd.36.3.d716250117827056 | this review only | not stated | not extracted yet | not extracted yet |
| Bakry 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bhandary & Hari 2017 Salivary biomarker levels and oral health status of children with autistic spectrum disorders: a comparative study DOI:10.1007/s40368-017-0275-y | this review only | not stated | not extracted yet | not extracted yet |
| Bhandary 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Cogulu et al. 2006 Evaluation of the relationship between caries indices and salivary secretory IgA, salivary pH, buffering capacity and flow rate in… DOI:10.1016/j.archoralbio.2005.06.001 | this review only | not stated | not extracted yet | not extracted yet |
| Cornejo et al. 1996 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Davidovich 2010 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Davidovich et al. 2010 A comparison of the sialochemistry, oral pH, and oral health status of down syndrome children to healthy children DOI:10.1111/j.1365-263x.2010.01045.x | this review only | not stated | not extracted yet | not extracted yet |
| Du et al. 2014 Oral health among preschool children with autism spectrum disorders: A case-control study DOI:10.1177/1362361314553439 | this review only | not stated | not extracted yet | not extracted yet |
| El Khatib 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| El Khatib et al. 2014 Oral health status and behaviours of children with Autism Spectrum Disorder: a case–control study DOI:10.1111/ipd.12067 | this review only | not stated | not extracted yet | not extracted yet |
| Fakroon 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Fakroon et al. 2014 Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder DOI:10.1007/s40368-014-0156-6 | this review only | not stated | not extracted yet | not extracted yet |
| Forsberg et al. 1985 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Hashizume 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Hashizume et al. 2017 Salivary secretory IgA concentration and dental caries in children with Down syndrome DOI:10.1111/scd.12222 | this review only | not stated | not extracted yet | not extracted yet |
| Jaber 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Jaber 2011 Dental caries experience, oral health status and treatment needs of dental patients with autism. PMID:21625735 | this review only | not stated | not extracted yet | not extracted yet |
| Jokic et al. 2007 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Lee et al. 2004 Dental caries and salivary immunoglobulin A in Down syndrome children DOI:10.1111/j.1440-1754.2004.00457.x | this review only | not stated | not extracted yet | not extracted yet |
| Mathias et al. 2011 Assessment of time taken to treat dental trauma in Nigerian children DOI:10.1007/bf03262777 | this review only | not stated | not extracted yet | not extracted yet |
| Moreira 2012 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Moreira et al. 2012 Does intellectual disability affect the development of dental caries in patients with cerebral palsy? DOI:10.1016/j.ridd.2012.03.026 | this review only | not stated | not extracted yet | not extracted yet |
| Namal 2007 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Namal et al. 2007 Do autistic children have higher levels of caries? A cross-sectional study in Turkish children DOI:10.4103/0970-4388.33457 | this review only | not stated | not extracted yet | not extracted yet |
| Palin 1982 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Palin et al. 1982 Dental health of 9–10‐year‐old mentally retarded children in Eastern Finland DOI:10.1111/j.1600-0528.1982.tb00369.x | this review only | not stated | not extracted yet | not extracted yet |
| Pope & Curzon 1991 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Pope 1991 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Stabholz 1991 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Stabholz et al. 1991 Caries experience, periodontal treatment needs, salivary pH, and <i>Streptococcus mutans</i> counts in a preadolescent Down syndrome… DOI:10.1111/j.1754-4505.1991.tb01732.x | this review only | not stated | not extracted yet | not extracted yet |
| Yashoda & Puranik 2014 Oral health status and parental perception of child oral health related quality-of-life of children with autism in Bangalore, India DOI:10.4103/0970-4388.130967 | this review only | not stated | not extracted yet | not extracted yet |
| Yashoda 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Association between Dental Caries and Down Syndrome: A Systematic Review and Meta-Analysis. (2015) | 6 | 0.11 |