The Big PictureSocioeconomic factors and caries
Section snippets
Background
Dental caries is the most prevalent disease in the world and affects billions of persons. Studies indicate that caries are not equally distributed among the various populations, but appear to be more common among persons who are disadvantaged in terms of socioeconomic status. As a result, socioeconomic position (SEP) may predict or cause caries, but the degree to which specific socioeconomic parameters are associated with caries lesions or experience is unknown. Some of these parameters deal
Methods
One hundred fifty-five studies involving 329,798 persons were reviewed. Various designs, SEP measures, and outcome parameters were employed in the many studies, with 122 cross-sectional studies, 9 case-control investigations, and 24 cohort studies. The geographic locales included highly developed countries (88 studies), developing countries (44 studies), and underdeveloped countries (22 studies), with a single study covering several countries. Quality tended to be low in 44 studies, moderate in
Results
In 83 studies, one or more caries parameters were significantly higher among low-SEP individuals compared to high-SEP persons. Three studies found these associations were reversed. Studies reporting the outcomes of having caries prevalence or experience used identical measures, but the cutoff values or measures for caries experience or severity and incidence differed widely.
Meta-analysis was performed on 92 studies in a quantitative analysis of the association between SEP and prevalence of
Discussion
Lower SEP was significantly associated with an increased risk for caries lesions or caries experience even among studies with various designs and measures for SEP and caries. Several factors may contribute to this association, such as educational background, which often dictates income and thus access to home or professional caries preventive measures; nonmaterial characteristics such as health literacy and healthy behavior patterns such as dietary habits and health care utilization; and social
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Schwendicke F, Dörfer CE, Schlattmann P, et al: Socioeconomic inequality and caries: A systematic review and meta-analysis. J Dent Res 94:10-18, 2015
Reprints available from F Schwendicke, Charité Ctr for Dental Medicine, Dept for Operative and Preventive Dentistry, Aßmannshauser Str 4-6, 14197 Berlin, Germany; e-mail: [email protected]