Impact of acculturation on oral health among immigrants and ethnic minorities: A systematic review

Abstract

Objective Cultural changes faced by immigrants and ethnic minorities after moving to a host country may have a detrimental or beneficial influence on their oral health and oral health-related behaviors. Therefore, this paper reviews the literature to see the impact of acculturation on immigrants and ethnic minorities’ oral health outcomes. Methods We searched seven electronic databases up to January 2018. All cross-sectional and longitudinal quantitative studies that examined associations between acculturation and oral health status and/or oral health behaviors among ethnic minority and immigrant population[s] were included. Study selection, data extraction, and risk of bias assessment were completed in duplicate. The Newcastle-Ottawa checklist was used to appraise the methodological quality of the quantitative studies. A meta-analytic approach was not feasible. Results A total of 42 quantitative studies were identified. The studies showed a positive association between acculturation and oral health status/behaviors. The most frequently used acculturation indicators were language spoken by immigrant and ethnic minorities and length of stay at the host country. High-acculturated immigrant and ethnic minority groups demonstrated better oral health outcomes, oral health behaviors, dental care utilization, and dental knowledge. Conclusions According to existing evidence, a positive effect of acculturation on oral health status and behaviors was found. Practical implications Dental practitioners should be culturally competent to provide the appropriate services and treatments to immigrant and ethnic minorities. Policymakers should also be sensitive to cultural diversities and properly address the unique needs of each group in order to maintain oral health equity.

La migración sur/sur como un determinante social de impacto en las desigualdades e inequidades en salud bucal en Latinoamérica

“…Otros estudios, muestran mejores indicadores en salud bucal en la población inmigrante, sustentada en una mayor aculturación (11) , teniendo en cuenta que se reconocen diferencias en los indicadores entre grupos poblacionales de inmigrantes. De acuerdo con ambas perspectivas (mejor o peor salud bucal en inmigrantes), no puede desconocerse el papel que juegan los estudios cualitativos, al investigar las percepciones sobre salud bucal, conocimientos, prácticas y creencias y que en gran medida pueden influir en una situación de salud buena, regular o mala, dependiendo del contexto social en el cual se encuentran, más allá de factores propios relacionados con hábitos y estilos de vida (27) .…”

“…Una búsqueda en PubMed (https://www.ncbi.nlm.nih.gov/ pubmed/), usando lenguaje libre mediante las palabras «immigrant OR migrant» AND «health», sin la aplicación de términos MeSH, da cuenta de 212 revisiones sistemáticas de diversos temas en salud en los últimos cinco años. De éstas, siete (3,3%) se ocupan de investigar temas relacionados con migración y salud bucal (10)(11)(12)(13)(14)(15)(16) . Esto da pie a la necesidad de analizar la situación de salud bucal desde un enfoque de los determinantes sociales que permita identificar las necesidades específicas en diferentes grupos sociales como la población migrante.…”

Acculturation and the oral health of a nationally representative sample of Hispanic children in the United States: an analysis of 2011–2012 National Survey of Children’s Health data

“…As immigrants become acculturated, their health status may improve or worsen depending on the health condition of interest, the new environments to which the immigrants are exposed, and the adoption of the host country's normative dietary, physical activity, and other health-related behaviors. Accordingly, changes in oral health are associated with acculturation [11]. A sizable body of research on Hispanic adults suggests that acculturation typically improves the oral health outcomes of this population [11].…”

“…Accordingly, changes in oral health are associated with acculturation [11]. A sizable body of research on Hispanic adults suggests that acculturation typically improves the oral health outcomes of this population [11]. Higher levels of acculturation in Hispanic adults in the US are generally associated with a decreased likelihood of orofacial pain [12], dental caries [13][14][15] and periodontal disease [13,14,[16][17][18], although findings related to oral health-related quality of life are inconsistent [19,20].…”

“…Conversely, there is limited research on the association between acculturation and oral health outcomes in Hispanic children in the US. A recent review of the literature on acculturation and oral health identified only four studies examining oral health outcomes in Hispanic children [11], and those studies had significant limitations. Three of the four were based on convenience samples [21][22][23], and none included children of all ages and dentition categories [24] nor were they nationally representative of Hispanic children from across the US [14,[21][22][23].…”