Non-Cochrane · aetiology · PM39514587
Systematic review of oral health in slums and non-slum urban settings of Low and Middle-Income Countries (LMICs): Disease prevalence, determinants, perception, and practices.
Osuh Mary E, Oke Gbemisola A, Lilford Richard J, et al. · PloS one · 2024 · PubMed · doi:10.1371/journal.pone.0309319
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
20
current version
GRADE rated
0
No studies
0
Included studies
23
linked below
No studies 0 · 0%Ungraded 20 · 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 | Adult residents (male and female) of slums and non-slum urban settings of LMICs | 23 included studies (n=23) across 15 LMIC countries; adult residents (13 studies Asia, 9 Africa, 1 South America) |
| Intervention | Slum setting (exposure) | Slum/urban-disadvantaged settings (6 studies on slums: 4 purely slum, 2 slum vs non-slum urban; 2 disadvantaged/low-SES) |
| Comparison | Non-slum urban setting | Non-slum urban/general-urban/national populations (2 general urban; 8 rural+urban; 3 national; 1 metropolis/municipal/district; 1 high vs low SES) |
| Outcomes | Oral disease prevalence/burden; determinants/risk factors; self-perceived oral health; oral hygiene practices; oral healthcare-seeking behaviour and dental service utilization | Caries prevalence 13-76%; periodontal disease 23-99%; mean DMFT 0.26-16.6; determinants (age, education, income, oral hygiene, setting, sex); mostly positive self-perception; predominant toothbrush/paste use; low, pain-driven service use (ever 17-71%, past-year 4-72%) |
| Study designs | Empirical studies of any design (quantitative, qualitative, mixed-methods); English; full-text; 2000-2023 | 22 quantitative (mostly cross-sectional surveys) + 1 qualitative (focus-group) study; appraised with MMAT |
| Timing | Publications from January 2000 to June 2023 | Studies published 2000-2023; cross-sectional |
Search date: June 2023 (Scopus and Web of Science searched March 2024). Databases: MEDLINE (Ovid); Embase (Ovid); PubMed; Scopus; Web of Science; CRD DARE; ELDIS; Essential Health Links; HINARI; African Index Medicus (AIM); Bioline International
Questions and results
Slum setting vs Non-slum urban setting
Population: Adults in LMIC urban and slum settings
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental service utilization Professional dental service utilization was generally low, episodic, and pain driven. Source: Results: Utilisation of dental services; Table 6 · same question in other reviews | no estimate extracted | 10 studies | Ungraded |
Dental caries experience (mean DMFT) Cross-sectional Population: Adult residents of slums and non-slum urban settings of LMICs Mean DMFT ranges from 0.26 to 16.6 across LMIC urban/slum populations; ungraded. Source: Results (Prevalence of oral diseases); Table 2 [refs 21-23,26,29-31,34,35,37,39,45] · same question in other reviews | Mean DMFT (usually reported at population level) ranged from 0.26 to 16.6 across studies; the Missing component was typically highest and the Filled component lowest, reflecting limited access to dental care. | 12 studies | Ungraded |
Dental trauma prevalence Cross-sectional · Urban vs rural; slum vs non-slum Population: Adult residents of slums and non-slum urban settings of LMICs Dental trauma appears more common in urban and disadvantaged settings; ungraded, few studies. Source: Results (Prevalence of oral diseases); Table 2 [refs 4,29/43] · same question in other reviews | Dental trauma was more prevalent in urban than rural settings and among disadvantaged groups; Osuh 2022 reported 32% (slum) vs 21% (non-slum); Tobin & Ajayi 2017 found 87.5% of trauma cases in urban vs rural areas… | NR | Ungraded |
Dental caries prevalence Cross-sectional Population: Adult residents of slums and non-slum urban settings of LMICs Dental caries prevalence in LMIC urban/slum populations ranges widely (13%-76%); not GRADE-rated (narrative synthesis). Source: Results (Prevalence of oral diseases); Table 2; Abstract · same question in other reviews | Prevalence of dental caries varied across age, gender and socioeconomic class, ranging from 13% (Nigeria) to 76% (Central India); prevalence >50% reported in India, Brazil, Malaysia and Rwanda; generally higher in… | 14 studies | Ungraded |
Periodontal disease prevalence Cross-sectional Population: Adult residents of slums and non-slum urban settings of LMICs Periodontal disease prevalence is high (23%-99%) across LMIC urban/slum populations; ungraded. Source: Results (Prevalence of oral diseases); Table 2 [refs 4,21,23,24,27,30,32,34,39] · same question in other reviews | Periodontal disease affected all ages, was more pronounced in older groups, and ranged from 23% to 99%, generally higher than dental caries; bleeding gum/gingivitis contributed the largest component. | 9 studies | Ungraded |
Oral disease burden, slum vs non-slum urban comparison Cross-sectional · Slum vs non-slum urban / general population Population: Adult residents of slums and non-slum urban settings of LMICs Where compared, oral disease burden is generally higher in slums than non-slum urban/national populations (5 studies; 1 found no difference); ungraded. Source: Results (Prevalence of oral diseases, para 3); Discussion; Table 2 [refs 4,20,22,39,40] · same question in other reviews | Five studies compared slum with non-slum urban or national populations: Airen 2014 (caries 76% slum vs 50-60% general), Patel 2017 and Osuh 2022 (higher oral disease prevalence in slum vs non-slum urban sites), Singh… | 5 studies | Ungraded |
Determinants of oral diseases Older age, lower education and income, poor oral hygiene, and disadvantaged residential setting were associated with oral diseases; directions varied across studies. Source: Results: Factors associated with oral diseases; Table 3 · same question in other reviews | no estimate extracted | 14 studies | Ungraded |
Oral disease prevalence Population: Adult residents of slum and non-slum urban settings in LMICs Oral disease prevalence was generally high and worse in slum settings where compared, but no meta-analysis was conducted. Source: Results: Prevalence of oral diseases; Table 2 · same question in other reviews | no estimate extracted | 18 studies | Ungraded |
Oral health practices Toothbrush and toothpaste use was common, but lower in disadvantaged or slum populations where compared. Source: Results: Oral health/hygiene practices; Table 5 · same question in other reviews | no estimate extracted | 11 studies | Ungraded |
Self-perceived oral health Most participants reported positive perceptions of oral health, despite observed disease burden. Source: Results: Attitudes, perception, and belief about oral health status; Table 4 · same question in other reviews | no estimate extracted | 6 studies | Ungraded |
Slum residence vs Non-slum urban residence
Population: Adult residents of slums and non-slum urban settings of LMICs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries (odds), slum vs non-slum residence Cross-sectional · Slum vs non-slum urban (Osuh 2022, Nigeria) Slum residents had non-significantly higher odds of caries than non-slum residents (OR 1.21, 95% CI 0.94-1.56; single study); ungraded. Source: Table 3 (Osuh et al. 2022, ref 4) · same question in other reviews | OR 1.21 [0.94, 1.56] | 1 study · 1357 participants | Ungraded |
Periodontal pocket (odds), slum vs non-slum residence Cross-sectional · Slum vs non-slum urban (Osuh 2022, Nigeria) Slum residents had significantly higher odds of periodontal pocketing than non-slum residents (OR 1.50, 95% CI 1.13-1.98; single study); ungraded. Source: Table 3 (Osuh et al. 2022, ref 4) · same question in other reviews | OR 1.50 [1.13, 1.98] | 1 study · 1357 participants | Ungraded |
Factors associated with oral diseases Cross-sectional Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded. Source: Results (Factors associated with oral diseases); Table 3 · same question in other reviews | Fourteen studies reported determinants: older age, less education, lower income, poor oral hygiene behaviour (brushing frequency, technique), infrequent dental visits and disadvantaged/slum residential setting were… | 14 studies | Ungraded |
Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population
Population: Adult residents of slums and non-slum urban settings of LMICs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Self-perceived (self-rated) oral health status Cross-sectional · By age, sex, socioeconomic class, employment Most participants perceive their oral health as satisfactory (one study 39%), more so among younger, male, higher-SES and employed people; ungraded. Source: Results (Attitudes, perception, and belief); Table 4 [refs 4,25,36,38,40,41] · same question in other reviews | Six studies (incl. 1 qualitative) reported perception; most participants rated their oral health as satisfactory/good (e.g., Olutola 76% good; Olusile 21% very good + 37% good; Osuh higher in slum than non-slum),… | 6 studies | Ungraded |
Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population
Population: Adult residents of slums and non-slum urban settings of LMICs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Use of toothbrush and toothpaste for mouth cleaning Cross-sectional · Slum/disadvantaged/rural vs non-slum/urban Toothbrush/paste is the commonest cleaning method but is used less in slum/disadvantaged/rural groups than urban/non-slum groups; ungraded. Source: Results (Oral health/hygiene practices); Table 5 · same question in other reviews | Eleven studies addressed practices; toothbrush and toothpaste were the commonest cleaning method but their use was lower among slum/disadvantaged/rural groups than non-slum/urban groups (e.g., Osuh 78% slum vs 94%… | 11 studies | Ungraded |
Frequency of mouth cleaning Cross-sectional · Slum/disadvantaged vs non-slum/urban Twice-daily cleaning (recommended) is uncommon; most clean once, in the morning; ungraded. Source: Results (Oral health/hygiene practices); Table 5 [refs 4,20,23,30,33,40] · same question in other reviews | Mouth cleaning was mostly once daily and in the mornings; only a small proportion cleaned at least twice daily (e.g., Osuh 24% slum vs 27% non-slum; Singh 3%; Habib 3.5%; Hewlett 69%). A similar slum/disadvantaged vs… | NR | Ungraded |
Use of alternative/indigenous mouth-cleaning implements Cross-sectional · Rural/slum vs urban Indigenous/alternative cleaning tools and home remedies are widely used, more so in rural/slum groups; ungraded. Source: Results (Oral health/hygiene practices); Table 5 [refs 30,33,37,41,46] · same question in other reviews | Alternative implements included toothpowder, chewing-stick, neem, charcoal, sand, snuff, salt, miswak, cotton wool and the fingers; native/indigenous tools were used more by rural and slum/disadvantaged residents than… | NR | Ungraded |
Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population
Population: Adult residents of slums and non-slum urban settings of LMICs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental service utilisation within the past year Past 12 months Past-year dental service use varies widely (4%-72%); ungraded. Source: Results (Utilisation of dental services); Table 6 [refs 4,25,27,36] · same question in other reviews | Utilisation within the preceding year ranged from 4% to 72% (e.g., Osuh 4%; Hewlett 10%; Rezaei 60% for treatment and 10% for check-ups; Olutola 72%). | NR | Ungraded |
Pattern of dental service utilisation and barriers Dental service use is low, episodic and pain-driven, with widespread self-care and cost/funding barriers; ungraded. Source: Results (Utilisation of dental services); Discussion; Table 6 [refs 4,23,25,31,33,40,41] · same question in other reviews | Utilisation was generally low, episodic and mostly problem/pain-driven (pain-driven visits ~70-99%); widespread self-care/home remedies were used as alternatives to professional care; lack of funds/cost, income, age,… | NR | Ungraded |
Ever utilised dental services Lifetime (ever) · Slum vs non-slum; urban vs rural; by sex Ever-use of dental services is low-to-moderate (17%-71%) and generally lower in slum/rural groups; ungraded. Source: Results (Utilisation of dental services); Table 6 · same question in other reviews | The 'ever utilised' rate ranged from 17% to 71% across studies (e.g., Osuh 17% slum vs 24% non-slum; Habib 14.6%; Hewlett 34%; Morgan 70.6%; Olusile 26%; Masalu 50% urban vs 37% rural; Singh 23% male vs 41% female). | 10 studies | Ungraded |
Included primary studies 23
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Costa et al. 2012 The severity of dental caries in adults aged 35 to 44 years residing in the metropolitan area of a large city in Brazil: a cross-sectional… PMID:22849537 | 1 other review | not stated | not extracted yet | not extracted yet |
| Msyamboza et al. 2016 Magnitude of dental caries, missing and filled teeth in Malawi: National Oral Health Survey. PMID:26956884 | 1 other review | not stated | not extracted yet | not extracted yet |
| Patel et al. 2017 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Airen et al. 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chakraborty et al. 2023 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Gholami et al. 2012 Common Perceptions of Periodontal Health and Illness among Adults: A Qualitative Study. PMID:23029620 | this review only | not stated | not extracted yet | not extracted yet |
| Habib et al. 2022 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Handa et al. 2016 Oral Health Status of Rural and Urban Population of Gurgaon Block, Gurgaon District Using WHO Assessment Form through Multistage Sampling… PMID:27437359 | this review only | not stated | not extracted yet | not extracted yet |
| Hannan et al. 2014 Prevalence of Gingivitis, Plaque accumulation and Decayed, Missing and Filled Teeth among slum population in Bangladesh. PMID:26415339 | this review only | not stated | not extracted yet | not extracted yet |
| Hessari et al. 2007 Oral health among 35- to 44-year-old Iranians. PMID:17541293 | this review only | not stated | not extracted yet | not extracted yet |
| Hewlett et al. 2022 Assessment of oral health status in a Ghanaian population: rationale, methods, and population characteristics. PMID:35279167 | this review only | not stated | not extracted yet | not extracted yet |
| Jaafar et al. 2014 Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence? PMID:25438162 | this review only | not stated | not extracted yet | not extracted yet |
| Masalu et al. 2009 Oral health related behaviors among adult Tanzanians: a national pathfinder survey. PMID:19751519 | this review only | not stated | not extracted yet | not extracted yet |
| Morgan et al. 2018 Building oral health research infrastructure: the first national oral health survey of Rwanda. PMID:29860930 | this review only | not stated | not extracted yet | not extracted yet |
| Olusile et al. 2014 Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians. PMID:25427860 | this review only | not stated | not extracted yet | not extracted yet |
| Olutola & Ayo-Yusuf 2012 Socio-environmental factors associated with self-rated oral health in South Africa: a multilevel effects model. PMID:23202757 | this review only | not stated | not extracted yet | not extracted yet |
| Osuh et al. 2022 Prevalence and determinants of oral health conditions and treatment needs among slum and non-slum urban residents: Evidence from Nigeria. PMID:36962169 | this review only | not stated | not extracted yet | not extracted yet |
| Rezaei et al. 2018 Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study. PMID:29171015 | this review only | not stated | not extracted yet | not extracted yet |
| Singh et al. 2020 Assessment of oral health status and treatment needs among people of Foklyan area, Dharan, Nepal. PMID:33176772 | this review only | not stated | not extracted yet | not extracted yet |
| Sun et al. 2018 The Prevalence and Associated Factors of Periodontal Disease among 35 to 44-year-old Chinese Adults in the 4th National Oral Health Survey. PMID:30264040 | this review only | not stated | not extracted yet | not extracted yet |
| Tobin & Ajayi 2017 Common oral conditions and correlates: an oral health survey in Kwara State Nigeria. PMID:29115979 | this review only | not stated | not extracted yet | not extracted yet |
| Varenne et al. 2004 Oral health status of children and adults in urban and rural areas of Burkina Faso, Africa. PMID:15119798 | this review only | not stated | not extracted yet | not extracted yet |
| Wang et al. 2002 The second national survey of oral health status of children and adults in China. PMID:12212817 | 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).