Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries

Madiha Yousaf, Tahir Aslam, Sidra Saeed, Azza Sarfraz, Zouina Sarfraz and Ivan Cherrez-Ojeda
Additional contact information
Madiha Yousaf: Research and Publications, Fatima Jinnah Medical University, Queen’s Road, Lahore 54000, Pakistan
Tahir Aslam: Research, Central Park Medical College, Lahore 54600, Pakistan
Sidra Saeed: Research, Gujranwala Medical College, Gujranwala 52250, Pakistan
Azza Sarfraz: Pediatrics and Child Health, Aga Khan University, Karachi 74000, Pakistan
Zouina Sarfraz: Research and Publications, Fatima Jinnah Medical University, Queen’s Road, Lahore 54000, Pakistan
Ivan Cherrez-Ojeda: Allergy and Pulmonology, Universidad Espíritu Santo, Km. 2.5 Vía La Puntilla, Samborondón 0901-952, Ecuador

IJERPH, 2022, vol. 19, issue 12, 1-26

Abstract: Introduction: Collective evidence on risk factors for dental caries remains elusive in low- and middle-income countries (LMICs). The objective was to conduct a systematic review and meta-analysis on risk factors for dental caries in deciduous or permanent teeth in LMICs. Methods: Studies were identified electronically through databases, including Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, PubMed/MEDLINE, and CINAHL, using “prevalence, dental caries, child, family, socioeconomic, and LMIC” as the keywords. A total of 11 studies fit the inclusion criteria. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale (NOS). The MedCalc software and Review Manager 5.4.1 were used. Results: From 11,115 participants, 38.7% (95% CI: 28.4–49.5%) had caries and 49.68% were female. Among those with caries, 69.74% consumed sugary drinks/sweets (95% CI: 47.84–87.73%) and 56.87% (95% CI: 35.39–77.08%) had good brushing habits. Sugary drinks had a two times higher likelihood of leading to caries (OR: 2.04, p < 0.001). Good oral hygiene reduced the risk of caries by 35% (OR: 0.65, p < 0.001). Concerning maternal education, only secondary education reduced the likelihood of caries (OR: 0.96), but primary education incurred 25% higher risks (OR: 1.25, p = 0.03). A 65% reduction was computed when caregivers helped children with tooth brushing (OR: 0.35, p = 0.04). Most families had a low socioeconomic status (SES) (35.9%, 95% CI: 16.73–57.79), which increased the odds of caries by 52% (OR: 1.52, p < 0.001); a high SES had a 3% higher chance of caries. In the entire sample, 44.44% (95% CI: 27.73–61.82%) of individuals had access to dental services or had visited a dental service provider. Conclusion: Our findings demonstrate that high sugar consumption, low maternal education, and low and high socioeconomic status (SES) increased the risk of dental caries in LMICs. Good brushing habits, higher maternal education, help with tooth brushing, and middle SES provided protection against caries across LMIC children. Limiting sugars, improving oral health education, incorporating national fluoride exposure programs, and accounting for sociodemographic limitations are essential for reducing the prevalence of dental caries in these settings.

Keywords: dental caries; risk factors; breastfeeding; bottle-feeding; fluoride; socioeconomic status; education; low- and middle-income countries (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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