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Wang X, Ghanbarzadegan A, Sohn W, Taylor E, Gao J, Christian B. Inequalities in dental caries among Indigenous and non-Indigenous children in Australia: A literature review. Aust Dent J 2024; 69:73-81. [PMID: 38197608 DOI: 10.1111/adj.13005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
Dental caries constitutes one of the most ubiquitous diseases in Australia, with Indigenous children presenting a notably higher prevalence than their non-Indigenous peers. This literature review aims to update the knowledge base developed by Christian and Blinkhorn in 2012, with a particular focus on the contemporary disparities in dental caries between Indigenous and non-Indigenous children. Our research strategy involved a thorough exploration of the Medline, PubMed, and Scopus databases to identify pertinent studies published between 2009 and 2022. Supplementary resources included various government websites and citation searches. We prioritised studies that focused on children aged 5-6 or 12 years-reflecting the World Health Organization's index ages for oral health-and that reported dental caries prevalence and experience indicators. Our review methodology was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The updated search, spanning 2009 to 2023, retrieved studies that reported caries estimates exclusively from 2009 to 2014. Within this period, the prevalence of dental caries in Indigenous children's primary teeth ranged between 52% and 77%, while the prevalence in permanent teeth varied from 36% to 60%. This updated review indicated that Indigenous children continue to experience caries at an approximately twice higher rate than non-Indigenous children, sustaining the persisting disparity in caries estimates. The findings from this review show that no discernible improvement in dental caries rates among Australian Indigenous children has been observed in comparison to the previous review; and that Indigenous children continue to experience both higher prevalence and severity of dental caries compared to non-Indigenous children.
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Affiliation(s)
- X Wang
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A Ghanbarzadegan
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - W Sohn
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - E Taylor
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - J Gao
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - B Christian
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
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Hedges J, Poirier B, Soares G, Haag D, Sethi S, Santiago PR, Cachagee M, Jamieson L. Journeying towards decolonising Aboriginal and Torres Strait Islander oral health re-search. Community Dent Oral Epidemiol 2023; 51:1232-1240. [PMID: 37294001 DOI: 10.1111/cdoe.12881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Arguably, the deficit narrative of oral health inequities, perpetuated by colonial re-search agendas, media and sociopolitical discourse, contributes to oral disease burden and fatalism among Aboriginal and Torres Strait Islander Peoples. There remains a need to evolve the way oral health is understood, in a manner that reflects the lived experiences of Aboriginal and Torres Strait Islander Peoples. METHODS This paper proposes decolonising methodologies as a strategy to ensure oral health re-search creates more equitable oral health outcomes and realities for Aboriginal and Torres Strait Islander Communities. Anchored by a critical reflection of the failure of dominant oral health inequity re-search practices to address Indigenous oral health, both in Australia and internationally, we propose five explicit pathways for decolonising Aboriginal and Torres Strait Islander oral health re-search. RESULTS We argue the need for (1) positionality statements in all re-search endeavours, (2) studies that honour reciprocal relationships through the development of proposals that ask questions and follow models based on Traditional Knowledges, (3) the development of culturally secure and strengths-based data capturing tools, (4) frameworks that address the intersection of multiple axes of oppression in creating inequitable conditions and (5) decolonising knowledge translation techniques. CONCLUSION Importantly, we recognize that re-search will never be entirely 'decolonised' due to the colonial foundations upheld by academic institutions and society more broadly; however, as oral health re-searchers, we ascertain that there is an ethical compulsion to drive decolonising re-search pursuits that produce equitable oral health outcomes for Aboriginal and Torres Strait Islander Communities.
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Affiliation(s)
- Joanne Hedges
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Brianna Poirier
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Gustavo Soares
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Dandara Haag
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Sneha Sethi
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Pedro Ribeiro Santiago
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Madison Cachagee
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
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Zhao Y, Raymond K, Chondur R, Sharp W, Gadd E, Bailie R, Skinner J, Burgess P. Costs and benefits of community water fluoridation in remote Aboriginal communities of the Northern Territory. Aust J Rural Health 2023; 31:1017-1026. [PMID: 37706591 DOI: 10.1111/ajr.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/20/2023] [Accepted: 08/22/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVE To undertake an economic evaluation of community water fluoridation (CWF) in remote communities of the Northern Territory (NT). DESIGN Dental caries experiences were compared between CWF and non-CWF communities before and after intervention. Costs and benefits of CWF are ascertained from the health sector perspective using water quality, accounting, oral health, dental care and hospitalisation datasets. SETTING AND PARTICIPANTS Remote Aboriginal population in the NT between 1 January 2008 and 31 December 2020. INTERVENTION CWF. MAIN OUTCOME MEASURES Potential economic benefits were estimated by changes in caries scores valued at the NT average dental service costs. RESULTS Given the total 20-year life span of a fluoridation plant ($1.77 million), the net present benefit of introducing CWF in a typical community of 300-499 population was $3.79 million. For each $1 invested in CWF by government, the estimated long-term economic value of savings to health services ranged from $1.1 (population ≤300) to $16 (population ≥2000) due to reductions in treating dental caries and associated hospitalisations. The payback period ranged from 15 years (population ≤300) to 2.2 years (population ≥2000). CONCLUSIONS The economic benefits of expanding CWF in remote Aboriginal communities of NT outweigh the costs of installation, operation and maintenance of fluoridation plants over the lifespan of CWF infrastructure for population of 300 or more.
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Affiliation(s)
- Yuejen Zhao
- Department of Health, Northern Territory, Casuarina, Northern Territory, Australia
| | - Kate Raymond
- Department of Health, Northern Territory, Casuarina, Northern Territory, Australia
| | - Ramakrishna Chondur
- Department of Health, Northern Territory, Casuarina, Northern Territory, Australia
| | - Wayne Sharp
- Power and Water Corporation, Northern Territory, Darwin, Northern Territory, Australia
| | - Elizabeth Gadd
- Power and Water Corporation, Northern Territory, Darwin, Northern Territory, Australia
| | - Ross Bailie
- The University of Sydney, Sydney, New South Wales, Australia
| | - John Skinner
- Macquarie University, Sydney, New South Wales, Australia
| | - Paul Burgess
- Department of Health, Northern Territory, Casuarina, Northern Territory, Australia
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Verma A, Priyank H, P R, Kumari M, Sayed Abdul N, Shivakumar S. A Systematic Review and Meta-Analysis on Oral Health Disparities Among the Indigenous Paediatric Population. Cureus 2023; 15:e41673. [PMID: 37575701 PMCID: PMC10412898 DOI: 10.7759/cureus.41673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
There is a knowledge gap in the literature regarding oral health disparities (OHD) in minority and indigenous (IG) paediatric cohorts that needs to be addressed. Disparities in oral health among children are a pressing concern, highlighting inequities in access to dental care and meeting needs. The current systematic review aims to provide a comprehensive synthesis of the prevailing understanding of OHD in the minority and IG strata. A meticulous search strategy was formulated by a team of reviewers to identify pertinent studies from databases of PubMed, MEDLINE, Scopus, Google Scholar and EMBASE. Data extraction and article selection strictly adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Newcastle-Ottawa Scale (NOS) was employed to evaluate the methodological quality of the studies included. Review Manager version 5.4 was used to synthesise quantitative data. A total of five cross-sectional studies were included in the final analysis. The findings consistently demonstrated the existence of racial and socioeconomic disparities in oral health across varying age groups and geographical locations in the defined population. Significant disparities in oral health outcomes were observed between IG and non-IG populations, with IG and minority groups exhibiting a heightened vulnerability to oral health challenges. Through a meta-analysis of the compiled data, a statistically significant association was established between children (being a member of a minority group) and unmet oral health needs. Socioeconomic status (SES) and maternal education were factors that showed a significant impact on oral health disparity. All studies were graded to be of the low-risk category based on the NOS risk of bias tool. This review successfully identified several influential factors contributing to oral health disparities, such as cultural practices, dietary patterns and access to oral healthcare services. Additionally, discernible differences in oral health status were evident between IG and non-IG children, with IG children enduring a greater burden of oral health difficulties. These findings underscore the imperative for targeted interventions and policy measures aimed at addressing the specific oral health needs of minority and IG paediatric populations, with the overarching goal of mitigating the existing disparities.
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Affiliation(s)
- Ankita Verma
- Department of Pedodontics and Preventive Dentistry, Hazaribag College of Dental Sciences and Hospital, Ranchi, IND
| | - Harsh Priyank
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Renuka P
- Department of Pedodontics and Preventive Dentistry, Government Dental College, Dibrugarh, IND
| | - Minti Kumari
- Department of Public Health Dentistry, Patna Dental College and Hospital, Patna, IND
| | - Nishath Sayed Abdul
- Department of Oral Pathology, College of Dentistry, Oral Diagnostic Sciences, Riyadh Elm University, Riyadh, SAU
| | - Sahana Shivakumar
- Department of Public Health Dentistry, People's College of Dental Science and Research Center, Bhopal, IND
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Toh JR, Wooi N, Tan SN, Wong K, Lopez-Silva C, Zafar S. Association between lack of dental service utilisation and caregiver-reported caries in Australian Indigenous children: A national survey. J Paediatr Child Health 2022; 58:2218-2224. [PMID: 36082587 PMCID: PMC10087467 DOI: 10.1111/jpc.16192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/06/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
AIM To investigate the association between the lack of dental service utilisation and dental caries in Australian Indigenous children. METHODS Data from the Longitudinal Study of Indigenous Children, which is a longitudinal population-based cross-sectional study in Australia were analysed. A total of 1258 children were included, consisting of the baby cohort and the child cohort at Wave 7. Logistic regression analysis was conducted to examine the association between caregiver-reported child dental caries and dental service utilisation. Multiple imputation using the fully conditional specifications approach was used to account for missing data. RESULTS Around one tenth (12.3%) of Indigenous children did not see a dentist when required. Lack of dental service utilisation was associated with an increased likelihood of caregiver-reported dental caries (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.5-3.8) and teeth removed due to dental caries (OR 2.3; 95% CI 1.1-4.7). These associations remained after adjusting for confounders (caregiver-reported dental caries OR 2.3; 95% CI 1.3-3.8; teeth removed due to dental caries OR 2.1; 95% CI 1.0-4.4). The reasons reported for not utilising dental services when required were the lack of an available dentist (31.4%), difficulties with physical access (19.8%), long waiting times (13.9%), financial issues with cost (5.8%) and feeling that 'they could cope' (4.6%). CONCLUSIONS Lack of dental service utilisation was associated with dental caries and extraction due to caries in Australian Indigenous children.
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Affiliation(s)
- Jia R Toh
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Nadine Wooi
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Si N Tan
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Kingsley Wong
- Child Disability, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Claudia Lopez-Silva
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Sobia Zafar
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
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Campus G, Cocco F, Strohmenger L, Wolf TG, Balian A, Arghittu A, Cagetti MG. Inequalities in caries among pre-school Italian children with different background. BMC Pediatr 2022; 22:443. [PMID: 35869462 PMCID: PMC9308358 DOI: 10.1186/s12887-022-03470-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/14/2022] [Indexed: 11/28/2022] Open
Abstract
Background The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient. Methods The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence. Results Overall, 54.4% (95%CI 46.7–58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents’ occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background. Conclusions Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03470-4.
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Prevalence of Common Diseases in Indigenous People in Colombia. Trop Med Infect Dis 2022; 7:tropicalmed7060109. [PMID: 35736987 PMCID: PMC9231329 DOI: 10.3390/tropicalmed7060109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/30/2022] Open
Abstract
The Indigenous tribe called the Wiwa lives retracted in the Sierra Nevada de Santa Marta, Colombia. Little is known about their health status and whether the health care system in place covers their needs. In 2017 and 2018, a permanent physician was in charge for the Wiwa. Diseases and complaints were registered, ranked, and classified with the ICD-10 coding. Datasets from the Indigenous health care provider Dusakawi, collected from local health points and health brigades travelling sporadically into the fields for short visits, were compared. Furthermore, a list of provided medication was evaluated regarding the recorded needs. The most common complaints found were respiratory, infectious and parasitic, and digestive diseases. The top ten diagnoses collected in the health points and in the health brigade datasets were similar, although with a different ranking. The available medication showed a basic coverage only, with a critical lack of treatment for many severe, chronic, and life-threatening diseases. Most of the detected diseases in the Indigenous population are avoidable by an improvement in health care access, an expansion of the provided medication, and an increase in knowledge, hygiene, and life standards.
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Fernando S, Tadakamadla S, Kroon J, Lalloo R, Johnson NW. Predicting dental caries increment using salivary biomarkers in a remote Indigenous Australian child population. BMC Oral Health 2021; 21:372. [PMID: 34301228 PMCID: PMC8305904 DOI: 10.1186/s12903-021-01702-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/20/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The burden of childhood dental caries amongst Indigenous Australians is higher than in other Australians. Because of differences in lifestyle and the evolutionary history of the oral microbiota, associated risk indicators may differ. Here, we evaluate associations between caries increment, salivary biomarkers and baseline caries among children aged 5-17 years residing in a remote rural Indigenous community. METHODS This study was part of a trial assessing cost-effectiveness of an intervention to prevent dental caries among children. Baseline epidemiology and application of topical caries-preventive measures was conducted in 2015, followed-up in 2016 and 2017. Children who did not consent or failed to attend the prevention visits but did attend for follow-up epidemiology constituted a natural comparison group for evaluating the intervention. Saliva flow, pH, buffering and bacterial loads were measured at all visits. Caries was scored by the International Caries Detection and Assessment system. Outcome was caries increment. Explanatory variables were sex, being in experimental or comparison group, baseline caries, saliva flowrate and buffering, pH, and salivary loads of mutans streptococci (MS), Lactobacilli (LB), and yeast. Chi Square tests compared caries incidence in relation to explanatory variables and Generalised Linear Models explored associations between explanatory and outcome variables. RESULTS Of 408 participants at baseline, only 208 presented at 2-year follow-up. Of caries-free children at baseline, significantly fewer had incipient (p = 0.01) and advanced (p = 0.04) caries after two years. Children in the experimental group experienced fewer tooth surfaces with advanced caries (p = 0.02) than comparison children. Having caries at baseline (p = 0.02) and low salivary flow-rates (p < 0.001) saw a significant increase in advanced caries after two years. Children with high salivary loads of MS (p = 0.03) and LB (p = 0.004) experienced more advanced carious surfaces. Multivariable analysis revealed 58% reduction (p = 0.001) in advanced caries among children with high salivary flow rates. Caries increment was 61% (p = 0.03) more for incipient and 121% (p = 0.007) more for advanced caries among children who harboured higher loads of MS. CONCLUSION As with other ethnicities, children with low salivary flow and those with high MS had higher incipient and advanced caries increments after two years. Such risk assessments facilitate targeted preventive interventions for such communities. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), No: ACTRN12615000693527: 3 July 2015.
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Affiliation(s)
- Surani Fernando
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Santosh Tadakamadla
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jeroen Kroon
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, St Lucia, Australia
| | - Newell W Johnson
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia.
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
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Nath S, Poirier BF, Ju X, Kapellas K, Haag DG, Ribeiro Santiago PH, Jamieson LM. Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis. Caries Res 2021; 55:268-287. [PMID: 34107490 PMCID: PMC8491513 DOI: 10.1159/000516137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined.
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Affiliation(s)
- Sonia Nath
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
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