Non-Cochrane · aetiology · PM35742362
Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries.
Yousaf Madiha, Aslam Tahir, Saeed Sidra, et al. · International journal of environmental research and public health · 2022 · PubMed · doi:10.3390/ijerph19127114
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
22
current version
GRADE rated
0
No studies
0
Included studies
11
linked below
No studies 0 · 0%Ungraded 22 · 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 deciduous and/or permanent dentition, no age limit, residing in low- and middle-income countries (World Bank definition) | 11 studies; 11,115 children from six LMICs (Brazil, Nigeria, Cambodia, Tanzania, Mexico, Ethiopia); data from 2001 to 2022 |
| Intervention | Child-, family-, and socioeconomic-level factors (exposures/risk factors) reported as prevalence: e.g., gender, feeding, diet/sugary intake, oral hygiene/brushing, maternal age and education, caregiver help with brushing, fluoride toothpaste, SES, setting, access to dental services | Factors meta-analyzed (n varies per analysis): sugary drinks/sweets, good brushing habits, maternal education (no formal/primary/secondary+), caregiver help with tooth brushing, fluoride toothpaste, SES (low/middle/high), access to dental services, female sex |
| Comparison | Children with versus without dental caries (association/odds-ratio analyses); none for single-group prevalence estimates | Children without dental caries (association analyses); single-group proportions among children with caries (prevalence analyses) |
| Outcomes | Dental caries (presence/absence in primary or permanent dentition; dmft/DMFT, or ICDAS II) | Caries prevalence 38.7% (95% CI 28.4-49.5%; 11 studies). Associations with caries: sugary drinks OR 2.04 (1.59-2.60); good brushing OR 0.65 (0.46-0.92); primary maternal education OR 1.25 (1.02-1.54); secondary+ education OR 0.96 (0.64-1.44); no formal education OR 1.34 (0.76-2.36); caregiver help OR 0.35 (0.13-0.93); low SES OR 1.52 (1.22-1.89); middle SES OR 0.80 (0.59-1.10); high SES OR 1.03 (0.81-1.31) |
| Study designs | Observational studies (primary or secondary observational data; 'best available evidence'); abstracts and unpublished studies excluded | 11 observational studies (7 cross-sectional, 3 cross-sectional data of prospective cohorts, 1 prospective cohort); NOS quality scores 4-8 (inter-reader kappa 0.88) |
| Timing | No restriction (children of any age; deciduous and/or permanent dentition) | Studies published 2001-2022; cohort follow-up 0-12 years; most cross-sectional |
Search date: March 2022 (all databases searched 11 March 2022; MEDLINE 1946 to 11 March 2022; CINAHL 1937 to 11 March 2022). Databases: Cochrane Oral Health Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed/MEDLINE); CINAHL via EBSCO (plus hand-searching of citation lists and expert consultation)
Questions and results
Dental caries assessment (dmft/DMFT index; ICDAS II in one study) vs None (descriptive prevalence; random-effects pooled proportion)
Population: Children (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caries prevalence (total population) About 39% of children in LMICs had dental caries (pooled prevalence 0.387, 95% CI 0.284 to 0.495; 11 studies; very high heterogeneity I2=99%; not GRADE-rated). Source: Results 3.1; Abstract; Figure 2A (forest plot); Supplementary Table S1 · same question in other reviews | Prevalence 0.387 [0.284, 0.495] | 11 studies · 11115 participants | Ungraded |
Female sex vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Female sex prevalence (among children with caries) Among children with caries in LMICs, about half were female (pooled prevalence 0.497, 95% CI 0.475 to 0.519; 6 studies; I2=0%; not GRADE-rated). Source: Results 3.2.1; Abstract; Figure 2B (forest plot); Supplementary Table S2 · same question in other reviews | Prevalence 0.4968 [0.4749, 0.5186] | 6 studies · 1999 participants | Ungraded |
Sugary drinks/sweets consumption vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Sugary drinks/sweets consumption prevalence (among children with caries) About 70% of children with caries in LMICs consumed sugary drinks/sweets (pooled prevalence 0.697, 95% CI 0.478 to 0.877; 7 studies; very high heterogeneity; not GRADE-rated). Source: Results 3.2.3; Abstract; Figure 2C (forest plot); Supplementary Table S3 · same question in other reviews | Prevalence 0.6974 [0.4784, 0.8773] | 7 studies | Ungraded |
Good brushing habits (>=2 daily tooth brushing) vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Good brushing habits prevalence (among children with caries) About 57% of children with caries in LMICs had good brushing habits (pooled prevalence 0.569, 95% CI 0.354 to 0.771; 7 studies; very high heterogeneity; not GRADE-rated). Source: Results 3.2.4; Abstract; Figure 2D (forest plot); Supplementary Table S4 · same question in other reviews | Prevalence 0.5687 [0.3539, 0.7708] | 7 studies | Ungraded |
Maternal education attainment vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary maternal education prevalence (among children with caries) Primary education About 42% of children with caries in LMICs had mothers with primary education (pooled prevalence 0.425, 95% CI 0.280 to 0.576; 7 studies; not GRADE-rated). Source: Results 3.3.2; Figure 3B (forest plot); Supplementary Table S6 · same question in other reviews | Prevalence 0.4246 [0.2799, 0.5763] | 7 studies · 3240 participants | Ungraded |
No formal maternal education prevalence (among children with caries) No formal education About 10% of children with caries in LMICs had mothers with no formal education (pooled prevalence 0.101, 95% CI 0.033 to 0.201; 3 studies; not GRADE-rated). Source: Results 3.3.2; Figure 3A (forest plot); Supplementary Table S5 · same question in other reviews | Prevalence 0.1014 [0.0334, 0.2007] | 3 studies · 1499 participants | Ungraded |
Secondary/higher maternal education prevalence (among children with caries) Secondary and higher education 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). Source: Results 3.3.2; Figure 3C (forest plot); Supplementary Table S7 · same question in other reviews | Prevalence 0.4496 [0.33, 0.5722] | 7 studies · 3240 participants | Ungraded |
Caregiver help with child tooth brushing vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caregiver help with tooth brushing prevalence (among children with caries) About 54% of children with caries in LMICs received caregiver help with tooth brushing (pooled prevalence 0.541, 95% CI 0.266 to 0.803; 3 studies; not GRADE-rated). Source: Results 3.3.3; Figure 4A (forest plot); Supplementary Table S8 · same question in other reviews | Prevalence 0.5408 [0.2663, 0.8025] | 3 studies · 830 participants | Ungraded |
Fluoride toothpaste use vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fluoride toothpaste use prevalence (among children with caries) 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). Source: Results 3.3.4; Figure 4B (forest plot); Supplementary Table S9 · same question in other reviews | Prevalence 0.391 [0.1658, 0.644] | 2 studies | Ungraded |
Socioeconomic status category vs None (descriptive single-group pooled prevalence)
Population: Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Low SES prevalence (among children with caries) Low SES 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). Source: Results 3.4.2; Abstract; Figure 4D (forest plot); Supplementary Table S10 · same question in other reviews | Prevalence 0.359 [0.1673, 0.5779] | 4 studies | Ungraded |
Middle SES prevalence (among children with caries) Middle SES About 35% of children with caries in LMICs were of middle SES (pooled prevalence 0.353, 95% CI 0.180 to 0.550; 7 studies; not GRADE-rated). Source: Results 3.4.2; Figure 4E (forest plot); Supplementary Table S11 · same question in other reviews | Prevalence 0.3534 [0.1804, 0.55] | 7 studies | Ungraded |
High SES prevalence (among children with caries) High SES About 25% of children with caries in LMICs were of high SES (pooled prevalence 0.245, 95% CI 0.162 to 0.339; 5 studies; not GRADE-rated). Source: Results 3.4.2; Figure 4F (forest plot); Supplementary Table S12 · same question in other reviews | Prevalence 0.2451 [0.1621, 0.339] | 5 studies | Ungraded |
Access to/visit to dental services vs None (descriptive single-group pooled prevalence)
Population: Children in low- and middle-income countries (both with and without dental caries)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Access to/visited dental services prevalence About 44% of children in LMICs had access to or had visited dental services (pooled prevalence 0.444, 95% CI 0.277 to 0.618; 5 studies; not GRADE-rated). Source: Results 3.4.4; Abstract; Figure 4C (forest plot); Supplementary Table S13 · same question in other reviews | Prevalence 0.4444 [0.2773, 0.6182] | 5 studies | Ungraded |
Sugary drinks/sweets consumption vs Children without dental caries
Population: Children (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries (association with sugary drinks/sweets consumption) Sugary drinks/sweets consumption was associated with about twice the odds of dental caries in LMIC children (OR 2.04, 95% CI 1.59 to 2.60; 7 studies; not GRADE-rated). Source: Results 3.2.3; Abstract; Figure 2E (OR forest plot) · same question in other reviews | OR 2.04 [1.59, 2.60] | 7 studies · 3653 participants | Ungraded |
Good brushing habits (>=2 daily tooth brushing) vs Children without dental caries
Population: Children (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries (association with good/>=2 daily brushing) Good brushing habits (>=2 daily) were associated with 35% lower odds of dental caries (OR 0.65, 95% CI 0.46 to 0.92; 7 studies; not GRADE-rated). Source: Results 3.2.4; Abstract; Figure 2F (OR forest plot) · same question in other reviews | OR 0.65 [0.46, 0.92] | 7 studies · 5446 participants | Ungraded |
Maternal education attainment vs Children without dental caries
Population: Children (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries (association with no formal maternal education) No formal education 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). Source: Results 3.3.2; Figure 3F (OR forest plot) · same question in other reviews | OR 1.34 [0.76, 2.36] | 3 studies · 3666 participants | Ungraded |
Dental caries (association with secondary/higher maternal education) Secondary and higher education 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). Source: Results 3.3.2; Figure 3D (OR forest plot) · same question in other reviews | OR 0.96 [0.64, 1.44] | 7 studies · 6529 participants | Ungraded |
Dental caries (association with primary maternal education) Primary education Primary maternal education was associated with 25% higher odds of dental caries (OR 1.25, 95% CI 1.02 to 1.54; 7 studies; not GRADE-rated). Source: Results 3.3.2; Figure 3E (OR forest plot) · same question in other reviews | OR 1.25 [1.02, 1.54] | 7 studies · 6529 participants | Ungraded |
Caregiver help with child tooth brushing vs Children without dental caries
Population: Children (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries (association with caregiver help with tooth brushing) Caregiver help with tooth brushing was associated with 65% lower odds of dental caries (OR 0.35, 95% CI 0.13 to 0.93; 3 studies; very high heterogeneity; not GRADE-rated). Source: Results 3.3.3; Abstract; Figure 5A (OR forest plot) · same question in other reviews | OR 0.35 [0.13, 0.93] | 3 studies · 2016 participants | Ungraded |
Socioeconomic status category vs Children without dental caries
Population: Children (deciduous and/or permanent dentition) in low- and middle-income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries (association with middle SES) Middle SES Middle SES showed no significant association with dental caries (OR 0.80, 95% CI 0.59 to 1.10; 7 studies; not GRADE-rated). Source: Results 3.4.2; Figure 5C (OR forest plot) · same question in other reviews | OR 0.80 [0.59, 1.10] | 7 studies · 7175 participants | Ungraded |
Dental caries (association with high SES) High SES High SES showed no significant association with dental caries (OR 1.03, 95% CI 0.81 to 1.31; 5 studies; not GRADE-rated). Source: Results 3.4.2; Abstract; Figure 5D (OR forest plot) · same question in other reviews | OR 1.03 [0.81, 1.31] | 5 studies · 4340 participants | Ungraded |
Dental caries (association with low SES) Low SES Low SES was associated with 52% higher odds of dental caries (OR 1.52, 95% CI 1.22 to 1.89; 7 studies; not GRADE-rated). Source: Results 3.4.2; Abstract; Figure 5B (OR forest plot) · same question in other reviews | OR 1.52 [1.22, 1.89] | 7 studies · 7175 participants | Ungraded |
Included primary studies 11
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Ayele 2013 Predictors of dental caries among children 7-14 years old in Northwest Ethiopia: a community based cross-sectional study. PMID:23331467 | 1 other review | not stated | not extracted yet | not extracted yet |
| Folayan 2019 Association between early childhood caries and malnutrition in a sub-urban population in Nigeria. PMID:31722683 | 1 other review | not stated | not extracted yet | not extracted yet |
| Renggli 2021 Stunting Malnutrition Associated with Severe Tooth Decay in Cambodian Toddlers. PMID:33498508 | 1 other review | not stated | not extracted yet | not extracted yet |
| Saraiva 2007 Are intrauterine growth restriction and preterm birth associated with dental caries? DOI:10.1111/j.1600-0528.2006.00345.x | 1 other review | not stated | not extracted yet | not extracted yet |
| Adeniyi 2016 Improved survival in patients with poor-prognosis malignant melanoma treated with adjuvant levamisole: a phase III study by the National… PMID:2016615 | this review only | not stated | not extracted yet | not extracted yet |
| Borges 2012 Socio-behavioral factors influence prevalence and severity of dental caries in children with primary dentition DOI:10.1590/s1806-83242012000600013 | this review only | not stated | not extracted yet | not extracted yet |
| Fraiz 2001 Study of the factors associated with dental caries in children who receive early dental care DOI:10.1590/s1517-74912001000300005 | this review only | not stated | not extracted yet | not extracted yet |
| Moura 2006 Dental caries in children that participated in a dental program providing mother and child care. PMID:19089031 | this review only | not stated | not extracted yet | not extracted yet |
| Ndekero 2021 Prevalence of early childhood caries, risk factors and nutritional status among 3-5-year-old preschool children in Kisarawe, Tanzania. PMID:33630949 | this review only | not stated | not extracted yet | not extracted yet |
| Peres 2005 Social and biological early life influences on severity of dental caries in children aged 6 years DOI:10.1111/j.1600-0528.2004.00197.x | this review only | not stated | not extracted yet | not extracted yet |
| Perez 2021 Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren. PMID:34160434 | 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).