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A Global Perspective of Racial-Ethnic Inequities in Dental Caries: Protocol of Systematic Review.

ABSTRACT: Though current evidence suggests that racial-ethnic inequities in dental caries persist over time and across space, their magnitude is currently unknown from a global perspective. This systematic review aims to quantify the magnitude of racial/ethnic inequities in dental caries and to deconstruct the different taxonomies/concepts/methods used for racial/ethnic categorization across different populations/nations. This review has been registered in PROSPERO; CRD42021282771. An electronic search of all relevant databases will be conducted until December 2021 for both published and unpublished literature. Studies will be eligible if they include data on the prevalence or severity of dental caries assessed by the decayed, missing, filled teeth index (DMFT), according to indicators of race-ethnicity. A narrative synthesis of included studies and a random-effects meta-analysis will be conducted. Forest plots will be constructed to assess the difference in effect size for the occurrence of dental caries. Study quality will be determined via the Newcastle-Ottawa Scale and the GRADE approach will be used for assessing the quality of evidence. This systematic review will enhance knowledge of the magnitude of racial/ethnic inequities in dental caries globally by providing important benchmark data on which to base interventions to mitigate the problem and to visualize the effects of racism on oral health.

SUBMITTER: Nath S

PROVIDER: S-EPMC8835154 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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A Global Perspective of Racial-Ethnic Inequities in Dental Caries: Protocol of Systematic Review.

Nath Sonia S Sethi Sneha S Bastos João L JL Constante Helena M HM Kapellas Kostas K Haag Dandara D Jamieson Lisa M LM

International journal of environmental research and public health 20220126 3

Though current evidence suggests that racial-ethnic inequities in dental caries persist over time and across space, their magnitude is currently unknown from a global perspective. This systematic review aims to quantify the magnitude of racial/ethnic inequities in dental caries and to deconstruct the different taxonomies/concepts/methods used for racial/ethnic categorization across different populations/nations. This review has been registered in PROSPERO; CRD42021282771. An electronic search of ...[more]

PMID: 35162411

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Project description:ObjectiveTo assess the effectiveness of lasers (at sub-ablative parameters) in reducing caries incidence compared with traditional prophylactic interventions (TPIs) when used alone or together with other TPIs such as pits and fissures sealant or fluoride gels or varnishes.DesignA systematic review. Data sources include Medline (via PubMed), Embase, Web of Science and the Cochrane Library (December 2019).Eligibility criteriaOnly randomised trials (RCTs) and controlled clinical trials (CCTs) dealing with prophylactic lasers use (vs TPI or untreated teeth) were considered as eligible. We excluded in vitro and ex vivo studies.Data extractionEligible studies were selected and data extracted independently by two reviewers. Risk of bias was assessed adopting the Cochrane Risk of Bias tool. Data on caries incidence, sealant retention, fluoride uptake, adverse events, treatment duration, patients' discomfort and cost-effectiveness ratio was extracted.Data analysisExtracted data were presented narratively due to the heterogeneity of included studies.ResultsSeven RCTs and two CCTs, all with an evident risk of bias, met inclusion criteria, pooling together 269 individuals and 1628 teeth. CO2, neodymium-doped yttrium aluminium garnet, erbium-doped yttrium aluminum garnet (Er:YAG), erbium, chromium: yttrium scandium gallium garnet (Er,Cr:YSGG) and Argon lasers were used. In the permanent dentition, lasers only when used in combination with TPIs were effective in reducing caries when compared with untreated teeth (risk ratio (RR)=0.44 (0.20-0.97); Er:YAG laser) or with TPIs used alone (RR=0.39 (0.22-0.71); CO2 laser). Moreover, Argon laser significantly improved the fluoride uptake into the enamel surfaces (ANalysis Of VAriance (ANOVA) tests: 95%, p<0.0001). Likewise, sealant retention improved when acid etching was performed on previously irradiated enamel fissures by CO2 laser (RR=0.63 (0.38-1.04)) or Er:YAG laser (RR=0.54 (95% CI: 0.34 to 0.87)). In addition, laser resulted safe and well tolerated by patients.ConclusionDespite some positive indications, an inadequate level of evidence was found in the included studies concerning the lasers' effectiveness in preventing caries. Further studies with a higher methodological quality level are required.

Project description:BackgroundAs part of the Global Strategy on Oral health, the World Health Organization (WHO) is exploring cost-effective interventions for oral health, including taxation on sugar-sweetened beverages (SSBs). To inform this process, this umbrella review aimed to identify the best available estimates pertaining to the impact of SSB taxation on the reduction of sugars intake, and the sugars-caries dose-response, such that estimates of the impact of SSB taxation on averting dental caries in both high (HIC) and low and middle (LMIC) countries be available.MethodsThe questions addressed were: (1) what are the effects of SSB taxation on consumption of SSBs and (2) sugars? (3) What is the effect on caries of decreasing sugars? and (4) what is the likely impact of a 20% volumetric SSB tax on the number of active caries prevented over 10 years? Data sources included PubMed, Embase, Web of Science, Scopus, CINAHL, Dentistry and Oral Sciences Source, Cochrane Library, Joanna Briggs Institute (JBI) Systematic Review Register, and PROSPERO. The review was conducted with reference to JBI guidelines. The quality of included systematic reviews was assessed using AMSTAR to identify best evidence.ResultsFrom 419 systematic reviews identified for questions 1 & 2, and 103 for question 3, 48 (Questions 1 & 2) and 21 (Question 3) underwent full text screening, yielding 14 and five included reviews respectively. Best available data indicated a 10% tax would reduce SSB intake by 10.0% (95% CI: -5.0, 14.7%) in HIC and by 9% (range -6.0 to 12.0%) in LMIC, and that a 20% tax would reduce free sugars intake on average by 4.0 g/d in LMIC and 4.4 g/d in HIC. Based on best available dose response data, this could reduce the number of teeth with caries per adults (HIC and LMIC) by 0.03 and caries occurrence in children by 2.7% (LMIC) and 2.9% (HIC), over a 10-year period.ConclusionBest available data suggest a 20% volumetric SSB tax would have a modest impact on prevalence and severity of dental caries in both HIC and LMIC.

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Dataset Information

A Global Perspective of Racial-Ethnic Inequities in Dental Caries: Protocol of Systematic Review.

Publications

A Global Perspective of Racial-Ethnic Inequities in Dental Caries: Protocol of Systematic Review.

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