Early Childhood Caries Advocacy Group, Winnipeg, Canada.
Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
BMC Oral Health. 2024 Sep 3;24(1):1029. doi: 10.1186/s12903-024-04790-w.
Poverty is a well-known risk factor for poor health. This scoping review (ScR) mapped research linking early childhood caries (ECC) and poverty using the targets and indicators of the Sustainable Development Goal 1 (SDG1).
We searched PubMed, Web of Science, and Scopus in December 2023 using search terms derived from SDG1. Studies were included if they addressed clinically assessed or reported ECC, used indicators of monetary or multidimensional poverty or both, and were published in English with no date restriction. We excluded books and studies where data of children under 6 years of age could not be extracted. We charted the publication year, study location (categorized into income levels and continents), children age, sample size, study design, measures of ECC, types and levels of poverty indicators and adjusted analysis. The publications were also classified based on how the relation between poverty and ECC was conceptualized.
In total, 193 publications were included with 3.4 million children. The studies were published from 1989 to 2023. Europe and North America produced the highest number of publications, predominantly from the UK and the US, respectively. Age-wise, 3-5-year-olds were the most studied (62.2%). Primary studies (83.9%) were the majority, primarily of cross-sectional design (69.8%). Non-primary studies (16.1%) included reviews and systematic reviews. ECC was mainly measured using the dmf indices (79.3%), while poverty indicators varied, with the most common used indicator being income (46.1%). Most studies measured poverty at family (48.7%) and individual (30.1%) levels. The greatest percentage of publications addressed poverty as an exposure or confounder (53.4%), with some studies using poverty to describe groups (11.9%) or report policies or programs addressing ECC in disadvantaged communities (11.4%). In addition, 24.1% of studies requiring adjusted analysis lacked it. Only 13% of publications aligned with SDG1 indicators and targets.
The ScR highlight the need for studies to use indicators that provide a comprehensive understanding of poverty and thoroughly examine the social, political, and economic determinants and impact of ECC. More studies in low and middle-income countries and country-level studies may help design interventions that are setting- and economic context-relevant.
贫困是健康状况不佳的一个已知危险因素。本范围界定综述（ScR）利用可持续发展目标 1（SDG1）的目标和指标，绘制了将早期儿童龋（ECC）与贫困联系起来的研究。
我们于 2023 年 12 月在 PubMed、Web of Science 和 Scopus 中使用源自 SDG1 的搜索词进行了搜索。如果研究涉及临床评估或报告的 ECC、使用货币或多维贫困指标或两者兼用且以英文发表且无日期限制，则将其纳入研究。我们排除了无法提取 6 岁以下儿童数据的书籍和研究。我们绘制了出版物年份、研究地点（分为收入水平和大陆）、儿童年龄、样本量、研究设计、ECC 测量、贫困指标类型和水平以及调整分析。还根据贫困与 ECC 之间的关系概念化方式对出版物进行了分类。
共纳入 193 篇出版物，涉及 340 万儿童。研究发表于 1989 年至 2023 年。欧洲和北美发表的论文数量最多，分别主要来自英国和美国。按年龄划分，3-5 岁的儿童研究最多（62.2%）。主要是初级研究（83.9%），主要是横断面设计（69.8%）。非初级研究（16.1%）包括综述和系统综述。ECC 主要使用 dmf 指数进行测量（79.3%），而贫困指标各不相同，最常用的指标是收入（46.1%）。大多数研究在家庭（48.7%）和个人（30.1%）层面上衡量贫困。最大比例的出版物将贫困视为暴露或混杂因素（53.4%），有些研究使用贫困来描述群体（11.9%）或报告弱势社区中解决 ECC 的政策或计划（11.4%）。此外，24.1%需要调整分析的研究缺乏分析。只有 13%的出版物符合 SDG1 指标和目标。
ScR 强调需要研究使用能全面了解贫困的指标，并彻底研究 ECC 的社会、政治和经济决定因素及其影响。在低收入和中等收入国家以及国家层面开展更多研究可能有助于设计符合具体环境和经济背景的干预措施。
