Dental caries prevention strategies among children and adolescents with immigrant - or low socioeconomic backgrounds- do they work? A systematic review

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Abstract

Background

This systematic review was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds.

Methods

According to pre-determined inclusion and exclusion criteria, relevant articles focusing on underprivileged groups were electronically selected between January1995 and October 2015. The literature search was conducted in five databases; PubMed, Embase, CINAHL, SweMed+ and Cochrane Library. Accepted languages for included articles were English, German and Scandinavian languages. Abstracts and selected articles in full text were read and assessed independently by two review authors. Systematic reviews and meta-analyses were not included. Also articles with topics of water fluoridation and fluoride toothpaste were excluded, this due to all existing evidence of anti-caries effect for disadvantaged groups. The key data about the main characteristics of the study were compiled in tables and a quality grading was performed.

Results

Thirty-seven articles were selected for further evaluation. Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups. Also a child/mother approach, targeting nutrition and broad oral health education of mothers showed effectiveness. For older children, a slow-release fluoride device and application of acidulated phosphate fluoride (APF) gel showed to be effective.

Conclusion

On the basis of this review, we maintain that in addition to studies of water fluoridation and fluoride toothpaste, there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic backgrounds.

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Most cited references 73

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The Common Risk Factor Approach: a rational basis for promoting oral health

Aubrey Sheiham, Richard Geddie Watt (2000)

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Risk factors for dental caries in young children: a systematic review of the literature.

Rebecca Harris, Alison D Nicoll, Pauline Adair … (2004)

To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries. Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design. 1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries. There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Muttans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non-cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of 'good' habits by way of maintaining good plaque control and 'bad' habits by way of having a cariogenic diet, the development of caries may be controlled.

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An overview of clinical research: the lay of the land.

Thomas K F Schulz, D. Jay Grimes (2002)

Many clinicians report that they cannot read the medical literature critically. To address this difficulty, we provide a primer of clinical research for clinicians and researchers alike. Clinical research falls into two general categories: experimental and observational, based on whether the investigator assigns the exposures or not. Experimental trials can also be subdivided into two: randomised and non-randomised. Observational studies can be either analytical or descriptive. Analytical studies feature a comparison (control) group, whereas descriptive studies do not. Within analytical studies, cohort studies track people forward in time from exposure to outcome. By contrast, case-control studies work in reverse, tracing back from outcome to exposure. Cross-sectional studies are like a snapshot, which measures both exposure and outcome at one time point. Descriptive studies, such as case-series reports, do not have a comparison group. Thus, in this type of study, investigators cannot examine associations, a fact often forgotten or ignored. Measures of association, such as relative risk or odds ratio, are the preferred way of expressing results of dichotomous outcomes-eg, sick versus healthy. Confidence intervals around these measures indicate the precision of these results. Measures of association with confidence intervals reveal the strength, direction, and a plausible range of an effect as well as the likelihood of chance occurrence. By contrast, p values address only chance. Testing null hypotheses at a p value of 0.05 has no basis in medicine and should be discouraged.

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Author and article information

Contributors

Marit S. Skeie: +47 55586576 , marit.skeie@uib.no

Kristin S. Klock: +47 55586596 , kristin.klock@uib.no

Journal

Journal ID (nlm-ta): BMC Oral Health

Journal ID (iso-abbrev): BMC Oral Health

Title: BMC Oral Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6831

Publication date (Electronic): 7 February 2018

Publication date PMC-release: 7 February 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 20

Affiliations

[1 ]ISNI 0000 0004 1936 7443, GRID grid.7914.b, Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, , University of Bergen, ; Aarstadveien 19, N-5009 Bergen, Norway

[2 ]ISNI 0000 0004 1936 7443, GRID grid.7914.b, Department of Clinical Dentistry, Community Dentistry, The Faculty of Medicine, , University of Bergen, ; Aarstadveien 19, N-5009 Bergen, Norway

Article

Publisher ID: 478

DOI: 10.1186/s12903-018-0478-6

PMC ID: 5803902

PubMed ID: 29415706

SO-VID: cec1a5ab-568d-4215-a714-05d577857b38

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 2 March 2017

Date accepted : 24 January 2018

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: dental caries,socioeconomy,children,immigrants,prevention,systematic literature review

Data availability:

ScienceOpen disciplines: Dentistry

Keywords: dental caries, socioeconomy, children, immigrants, prevention, systematic literature review

Dental caries prevention strategies among children and adolescents with immigrant - or low socioeconomic backgrounds- do they work? A systematic review

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Abstract

Background

Methods

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Conclusion

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International Journal of Medicine and Medical Research

Most cited references 73

The Common Risk Factor Approach: a rational basis for promoting oral health

Risk factors for dental caries in young children: a systematic review of the literature.

An overview of clinical research: the lay of the land.

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