A Systematic Review and Meta-Analyses on Early-Childhood-Caries Global Data

Abstract

Abstract The present study systematically reviewed and provided a meta-analysis on early childhood caries (ECC) global prevalence and its association with socioeconomic indicators, both geographical and regarding unemployment rate, national income as well as income inequalities. Studies published from 2011 to 2022 from PubMed, Scopus and Embase were retrieved by ad hoc prepared search strings. Cross-sectional and cohort studies reporting the prevalence and experience of early childhood caries in children under 71 months in urban or rural communities were included. Primary outcomes of the included studies were the prevalence and experience of ECC. The meta-analyses were conducted for both overall ECC prevalence and experience stratified by country of publication as well as measures of socioeconomic indicators (geographical area, gross national income (GNI), wealth inequality within a nation index (Gini), unemployment rate) using a random effects model using STATA 17®. One hundred publications reporting ECC data from 49 countries (published from 2011–2022) were included and summarized by meta-analysis. The lowest prevalence was reported in Japan (20.6%) and Greece (19.3%). The global estimated random-effect pooled prevalence of ECC was 59.05%, while the estimated overall pooled caries experience (mean dmft) was 3.41 ± 2.40, ECC prevalence was 22.11%, 14.14%, 15.37%, 20.27% and 28.10% for countries with GNI < 5.000USD, > 5.000 < 10.000USD, > 10.000 < 20.000USD, > 20.000 < 40.000 and > 40.000 respectively. For the four different categories of life expectancy (53–70, > 70–75, > 75–80, > 80), the highest pooled prevalence of ECC was in the age category > 75–80 (39.41%) and for the unemployment rate, it was in the category of medium unemployment rate (60.38%). Within the limitations of this study, results from 49 different countries reported a wide range of ECC prevalence. These reports indicated persisting high worldwide distribution of the disease. Both ECC prevalence and experience were associated with geographical areas and GNI.