Two decades of socioeconomic inequalities in the prevalence of untreated dental caries in early childhood: Results from three birth cohorts in southern Brazil

Karam, Sarah Arangurem; Costa, Francine dos Santos; Peres, Karen Glazer; Peres, Marco A; Barros, Fernando C.; Bertoldi, Andréa Dâmaso; Santos, Iná da Silva dos; Tovo‐Rodrigues, Luciana; Matijasevich, Alícia; Menezes, Ana Maria Baptista; Gonçalves, Helen; Corrêa, Marcos Britto; Demarco, Flávio Fernando

doi:10.1111/cdoe.12747

Cited by 14 publications

(12 citation statements)

References 40 publications

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“…But poor oral health status was explained strongly and consistently by structural determinants more than by intermediate determinants. Similar studies concluded that the former are better at explaining the health differences between individuals than the latter [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Do [3] explained that the differences between oral health status are best illustrated by countries' social and macro-economic policies, while the differences within a country are defined by socioeconomic position like the Chilean situation from our findings.…”

Section: Candy Consumptionsupporting

confidence: 71%

“…Despite the fact that Social Determinants of Health (SDH) studies in Latin-American children are more limited, some reports have suggested that oral health differences are strongly associated with family socioeconomic level, caregivers' educational level, family income and access to fluoridated water [15][16][17][18]. However, the evidence is not yet conclusive, since most studies analyze the structural and intermediate social determinants separately and there are relevant differences between economic development and culture between countries in the region.…”

Section: Introductionmentioning

confidence: 99%

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Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region

et al. 2023

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Objective To estimate the association between Social Determinants of Health (structural and intermediate) and caries indicators in Chile's Metropolitan Region preschool children. Methods A multilevel cross-sectional study of Social Determinants of Health (SDH) and caries in children aged 1 to 6 years in Chile's Metropolitan Region was conducted in 2014–2015, with three levels: district, school and child. Caries were assessed by the dmft-index and the prevalence of untreated caries. The structural determinants analyzed were Community Human Development Index (CHDI), urban/rural location, school type, caregiver's education and family income. Poisson multilevel regression models were fit. Results The sample size was 2,275 children from 40 schools in 13 districts. While the highest CHDI district had an untreated caries prevalence of 17.1% (12.3–22.7%), in the most disadvantaged district it was 53.9% (95% CI 46.0–61.6%). As family income increased, the probability of untreated caries prevalence decreased (PR = 0.9 95% CI 0.8–1.0). Rural districts had an average dmft-index of 7.3 (95% CI 7.2–7.4), while in urban districts, it was 4.4 (95% CI 4.3–4.5). Higher probabilities of untreated caries prevalence (PR = 3.0 95% CI 2.3–3.9) were observed in rural children. Greater probabilities of untreated caries prevalence (PR = 1.3 95% CI 1.1–1.6) and prevalence of caries experience (PR = 1.3 95% CI 1.1–1.5) were observed in children whose caregivers had a secondary educational level. Conclusions A strong association was observed between the social determinants of health, specifically the structural ones, and the caries indicators studied in children of the Metropolitan Region of Chile. There were notable differences in caries between districts according to social advantage. Rurality and caregiver's education were the most consistent predictors.

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Section: Candy Consumptionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region

et al. 2023

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“…Among children, dental caries is the most prevalent chronic condition, affecting 60-90% of children globally [11]. For children in low-and middle-income countries (LMIC), and low-income populations in high-income countries, the high prevalence of dental caries and limited access to dental care has left much tooth decay untreated [12][13][14]. Untreated caries can contribute to a poorer quality of life, malnutrition, daily performance, and difficulty sleeping and eating due to mouth pain [4,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Fewer Children in Families Associated with Lower Odds of Early Childhood Caries: A Sample from Three Countries

Park

Kulchar

Susarla

et al. 2023

IJERPH

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Childhood caries experience is influenced by family characteristics and oral health practices in the context of many social-commercial determinants. The aim of this study was to explore the relationship between families’ number of children, oral health practices and child caries experience in a convenience sample of 1374 children aged 6 months through 6 years and their families from Ecuador, Nepal, and Vietnam. Data were collected by mother interviews and child dental exams. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between number of children, oral health practices and decayed, missing or filled teeth (dmft). Families had a mean of 2.2 children (range 1–12); 72% of children had tooth decay, with mean dmft of 5.4. Adjusting for child age, sex, and urban/rural location, a greater number of children in the family was associated with significantly less likelihood of unhealthy bottle feeding practices, having a toothbrush/toothpaste and parent helping child brush, and being cavity-free; higher number of dmft, and greater likelihood of having a dental visit. Early childhood oral health promotion should include focus on oral hygiene and healthy feeding—particularly breastfeeding and healthy bottle feeding practices—as well as access to family planning services and support for childcare.

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“…Moreover, only fragmentary knowledge exists about the correlation to factors such as wealth inequality within a nation index 13,14 (Gini coe cient) and/or gross national income per capita/year (GNI) of several countries. The numbers of ECC do not fall as rapidly as anticipated especially among socioeconomically deprived children 15 , therefore, it is critical to investigate the association between background social and economic factors and ECC prevalence/experience worldwide. Starting from these premises, this systematic review and meta-analysis were aimed to synthesize existing research ndings regarding ECC prevalence and experience globally over the last ten years and to describe its distribution by country as well as its links to various socio-economic indicators.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-Analyses on Early-Childhood-Caries Global Data

Maklennan

Esteves‐Oliveira

Weirichs

et al. 2023

Preprint

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The present study systematically reviewed and provided a meta-analysis on early childhood caries (ECC) global prevalence and its association with socioeconomic indicators, both geographical and regarding unemployment rate, national income as well as income inequalities. Studies published from 2011 to 2022 from PubMed, Scopus and Embase were retrieved by ad hoc prepared search strings. Cross-sectional and cohort studies reporting the prevalence and experience of early childhood caries in children under 71 months in urban or rural communities were included. Primary outcomes of the included studies were the prevalence and experience of ECC. The meta-analyses were conducted for both overall ECC prevalence and experience stratified by country of publication as well as measures of socioeconomic indicators (geographical area, gross national income (GNI), wealth inequality within a nation index (Gini), unemployment rate) using a random effects model using STATA 17®. One hundred publications reporting ECC data from 49 countries (published from 2011–2022) were included and summarized by meta-analysis. The lowest prevalence was reported in Japan (20.6%) and Greece (19.3%). The global estimated random-effect pooled prevalence of ECC was 59.05%, while the estimated overall pooled caries experience (mean dmft) was 3.41 ± 2.40, ECC prevalence was 22.11%, 14.14%, 15.37%, 20.27% and 28.10% for countries with GNI < 5.000USD, > 5.000 < 10.000USD, > 10.000 < 20.000USD, > 20.000 < 40.000 and > 40.000 respectively. For the four different categories of life expectancy (53–70, > 70–75, > 75–80, > 80), the highest pooled prevalence of ECC was in the age category > 75–80 (39.41%) and for the unemployment rate, it was in the category of medium unemployment rate (60.38%). Within the limitations of this study, results from 49 different countries reported a wide range of ECC prevalence. These reports indicated persisting high worldwide distribution of the disease. Both ECC prevalence and experience were associated with geographical areas and GNI.

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Two decades of socioeconomic inequalities in the prevalence of untreated dental caries in early childhood: Results from three birth cohorts in southern Brazil

Cited by 14 publications

References 40 publications

Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region

Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region

Fewer Children in Families Associated with Lower Odds of Early Childhood Caries: A Sample from Three Countries

A Systematic Review and Meta-Analyses on Early-Childhood-Caries Global Data

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