Assessment of the contextual effects on the prevalence of periodontitis: a systematic review

Abstract

This study reviews the influence of contextual factors on periodontitis based on a systematic search of studies recorded in the PubMed, Scopus, Web of Science, and EMBASE databases. Periodontitis was assessed by clinical attachment loss and probing depth for studies with data on the socioeconomic status (SES) of a specific area (area-level SES) or dental care service (service-level) in a catchment area among individuals aged 18 and over. Two independent reviewers performed study selection, data extraction, and assessment of methodological quality. Of the 646 articles identified, 13 were included in the systematic review, representing 101,362 individuals from five countries (USA, UK, Brazil, China, and Uruguay). A higher prevalence of periodontitis was described in lower SES neighborhoods, more deprived postcodes, and poorer provinces. Gini Index results were mixed and inconclusive. Three studies showed that higher coverage of primary dental care at the municipal level was associated with a lower prevalence of periodontitis. Contextual factors at the area-level SES and dental care service might influence periodontitis, but the existing evidence is unclear. The contextual effect is important for periodontal health and may contribute to the prevalence of periodontitis, independent of well-known risk factors and individual levels.

Association between socioeconomic contextual factor, dental care service availability, and prevalence of periodontitis in Brazil: a multilevel analysis

“…Secondly, the primary dental care findings were robust, and all three indicators showed higher prevalence in municipalities with higher coverage. These results disagree with a systematic review suggesting that higher coverage might be associated with a lower prevalence of periodontitis 11 . Although the relationship between secondary dental care and periodontitis had not been studied previously, the hypothesis that dental care service might be associated with a lower prevalence of periodontitis was not confirmed.…”

“…However, one study suggested that a preventive-oriented system may confer fewer dental caries 10 . Regarding periodontitis, a systematic review showed a poor association in the access to primary dental care at the municipal level 11 . Moreover, population-level periodontal services may not be effective in improving periodontal health as they focus only on those who seek help instead of the disease root causes, such as socioeconomic status, gender, or ethnicity 12,13 .…”

“…Studies analyzing oral care models have focused on process and structure 18,19 or on implementing a program or health policies 20 . Few studies have investigated the effect of periodontal services on periodontal disease 11,12 . Nevertheless, there is no consensus on the influence of periodontal care services on periodontitis, and the role of confounding factors and mediators must be clarified 11 .…”

“…Few studies have investigated the effect of periodontal services on periodontal disease 11,12 . Nevertheless, there is no consensus on the influence of periodontal care services on periodontitis, and the role of confounding factors and mediators must be clarified 11 . To fill this knowledge gap, this study investigated the relationship between dental care services and prevalence of periodontitis among adults in Brazilian municipalities.…”

Periodontoloji Kliniğine Başvuran Hastaların Periodontal Durumlarının, Sistemik Hastalıklarının ve Kişisel Alışkanlıklarının Değerlendirilmesi

“…4 ABD Hastalık Kontrol ve Önleme Merkezlerine göre, periodontal hastalık dünya çapında bir salgın olarak kabul edilir ve sakatlığa, konuşma bozukluğuna, düşük benlik saygısına ve yaşam kalitesinin düşmesine neden olur. 5 Periodontitis diyabet, kardiyovasküler hastalık, osteoporoz, akciğer hastalığı ve romatoid artrit gibi sistemik hastalıklarla da ilişkilidir. 6 Sistemik hastalıkların varlığı periodontal tedaviye cevabı ve yara iyileşme kapasitesini ve tedavinin başarısını etkileyen önemli faktörlerdendir.…”