Prevalence of Periodontal Disease Among Indigenous and Non-indigenous Populations: Protocol for Systematic Review and Meta-analysis

Abstract

Background: Indigenous populations globally experience worse health than their non-Indigenous counterparts. This includes oral health inequities, especially periodontal disease. Globally, the occurrence of periodontal disease such as gingivitis and chronic periodontitis are high among Indigenous people. This population encounters various barriers to accessing dental care as well as social and economic disadvantages, which results in higher disease burden compared to the general population. The aim of this systematic review is to quantify at a global level, the prevalence of periodontal disease among Indigenous populations compared to non-Indigenous populations.Methods: An electronic search will be conducted using keywords and appropriate MeSH terms across several databases capturing both published and unpublished articles. The search will be conducted from the time of database inception to February 2021. After the initial search, duplicates will be removed, and remaining titles and abstracts will be assessed for eligibility. This review will consider studies that have reported prevalence of periodontal disease among Indigenous and compared against non-Indigenous populations. Studies that have no comparative population or lack of periodontal clinical assessment will be excluded. The full text of eligible studies will be assessed by two independent reviewers who will also complete the critical appraisals and data extraction. From the selected studies, we will conduct a random effects meta-analysis of observational data. Forest plots will be used for visualization of pooled prevalence of periodontitis. A subgroup analysis will be conducted based on definition of periodontitis, age, and geographical location. Heterogeneity among studies will be assessed by I2 and chi-square test. Egger’s test and funnel plots will be used to assess publication bias.Discussion: Our systematic review and meta-analysis will facilitate increased understanding of the magnitude of periodontal disease inequalities that exist globally for Indigenous populations through pooled prevalence estimates. The findings will be helpful to design selective targeted preventive and interventional strategies for periodontal disease for reducing oral health inequalities at a global level. Systematic review registration: PROSPERO CRD42020188531