Dental caries determinants in an adult Portuguese population and a comparison with Norwegian adults

Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies

This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I², and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger's test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies' heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]).

A systematic review of socioeconomic indicators and dental caries in adults

Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough review of the literature. Seven databases were systematically searched: Pubmed, Cochrane, Web of Science, Bireme, Controlled Trials, Clinical Trials and the National Institute for Health and Clinical Excellence. No restrictions were placed on the language or year of publication. The search yielded 41 studies for systematic review. Two independent reviewers screened the studies for inclusion, extracted data and evaluated quality using the Newcastle-Ottawa scale. The following socioeconomic indicators were found: educational level, income, occupation, socio-economic status and the community index. These indicators were significantly associated with a greater occurrence of dental caries: the subject's education, subject's income, subject's occupation and the Gini coefficient. A high degree of heterogeneity was found among the methods. Quality varied across studies. The criteria employed for socioeconomic indicators and dental caries should be standardized in future studies. The scientific evidence reveals that educational level, income, occupation and the Gini coefficient are associated with dental caries.

Dental caries risk studies revisited: causal approaches needed for future inquiries

Prediction of high-risk individuals and the multi-risk approach are common inquiries in caries risk epidemiology. These studies prepared the ground for future studies; specific hypotheses about causal patterns can now be formulated and tested applying advanced statistical methods designed for causal studies, such as structural equation modeling, path analysis and multilevel modeling. Causal studies should employ measurements, analyses and interpretation of findings, which are in accordance to causal aims. Examples of causal empirical studies from medical and oral research are presented.

Prevalence and determinants of periodontal disease in Portuguese adults: results from a multifactorial approach

The purpose of the present investigation was to study prevalence of periodontal disease among 30 to 39-years-old from Oporto in the north of Portugal. In addition, an attempt was made to elucidate possible periodontal disease determinants in this population. A random sample consisting of a total of 322 individuals was drawn based on electoral lists. The attendance rate was 61%. The CPITN index was used and the results indicate a high prevalence of periodontal disease and a substantial need for periodontal treatment in this population, with 41% of the individuals investigated having one or more sites with a CPITN score 4 (pockets deeper than 5.5 mm). Dental visiting habits, gender (lower CPITN scores for females) and oral hygiene were the determinants most significantly associated with variation in CPITN scores.