Abstract
BackgroundDental caries risk factors have been expanded to not only emphasize biology, dietary and oral habits but also broader social determinants such as socioeconomic factors and the utilization of health services. The aim was to review sociobehavioural/cultural and socioeconomic determinants of dental caries in children residing in the Middle East and North Africa (MENA) region.MethodsA search was conducted in the PubMed/Medline database and Google Scholar to identify studies published from 2000 to 2019 covering children using key search terms. In the initial stages, titles, abstracts and, if needed, full articles were screened for eligibility. In the final stage, all included articles were reassessed and read, and relevant data were extracted.ResultsOut of 600 initial articles, a total of 77 were included in this review, of which 74 were cross-sectional, 2 were longitudinal and one was a case–control study. The studies included a total of 94,491 participants in 14 countries across the MENA region. A majority used the World Health Organization scoring system to assess dental caries. The caries prevalence ranged between 17.2% and 88.8%, early childhood caries between 3% and 57% and decayed missing filled teeth (dmft) varied between 0.6 and 8.5 across the various age groups. Increased age, low maternal education, low overall socioeconomic status, decreased frequency of tooth brushing, low parental involvement, poor oral habits, infant feeding practices and sugar consumption were among the most prevalent determinants for increased risk of caries in the reviewed studies.ConclusionsDental caries was found to be high among children in many of the studies published from MENA. The key determinants of dental caries were found to include factors related to child characteristics, family background, oral hygiene and infant feeding and eating habits. The high dental caries prevalence emphasises the need to address the prevailing modifiable sociobehavioural and socioeconomic determinants by translating them into effective oral health prevention policies and programmes.
Highlights
Dental caries risk factors have been expanded to emphasize biology, dietary and oral habits and broader social determinants such as socioeconomic factors and the utilization of health services
It has been claimed that dental caries is decreasing in most industrialized countries due to improvements in prevention programmes and increased access to dental health services, but conflicting results have shown that dental caries is still prevalent among underprivileged groups in many of these countries [5, 7, 8]
Overall, 77 articles were included in this review from 14 countries: Egypt (n = 4) [18,19,20,21], Iran (n = 18) [22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39], Iraq (n = 2) [40, 41], Jordan (n = 4) [42,43,44,45], Kuwait (n = 3) [46,47,48], Lebanon (n = 1) [49], Libya (n = 2) [50, 51], Palestine (n = 2) [52, 53], Qatar (n = 2) [54, 55], Saudi Arabia (n = 14) [56,57,58,59,60,61,62,63,64,65,66,67,68,69], Syria (n = 4) [70,71,72,73], Turkey (n = 11) [74,75,76,77,78,79,80,81,82,83,84], UAE (n = 8) [85,86,87,88,89,90,91,92], and Yemen (n = 2) [93, 94]
Summary
Dental caries risk factors have been expanded to emphasize biology, dietary and oral habits and broader social determinants such as socioeconomic factors and the utilization of health services. In some MENA countries, political stability, economic growth and investments in healthcare systems have led to improvements in various health indicators, whereas some countries have been impacted by political unrest or war; subsequently, the region currently includes lowmiddle income, upper-middle income and high income countries [3, 4]. These societal changes have contributed to an increased rate of non-communicable diseases and persistence of some communicable diseases, such as dental caries, due to a marked shift in lifestyle, increased food availability and a notable nutritional transition among citizens [4]. Distinctions between dental caries experiences are present, with high rates of untreated caries in developing countries, which reflects the limited resources available and difficulties in accessibility and affordability to essential oral health care services [10, 11]
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