Impact of parent-related factors on dental caries in the permanent dentition of 6–12-year-old children: A systematic review

Abstract

Objective

To synthesise data from the literature on the effects of various parent-related characteristics (socio-demographic, behavioural and family environment) on dental caries in the permanent dentition of children.

Data

Available studies in which the effects of parent-related characteristics on dental caries experience in the permanent dentition of children aged 6–12 years were evaluated.

Sources

PubMed, Medline via OVID and CINAHL Plus via EBSCO, restricted to scientific articles, were searched in April 2015. English language and time filters (articles published from 2000) were used.

Study selection

A total of 4162 titles were retrieved, of which 2578 remained after duplicates were removed. After review of titles and their abstracts by two independent reviewers, 114 articles were considered relevant for full text review. Of these, 48 were considered for final inclusion. Data extraction was performed by two authors using piloted data extraction sheets.

Conclusions

Most of the literature on determinants of dental caries has been limited to socio-economic and behavioural aspects: we found few studies evaluating the effects of family environment and parental oral hygiene behaviour. Children belonging to lower socio-economic classes experienced more caries. In more than half the studies, children of highly educated, professional and high income parents were at lower risk for dental caries. There were conflicting results from studies on the effect of variables related to family environment, parents’ oral hygiene behaviour and parent’s disease status on dental caries in their children.

Introduction

Untreated dental caries in the permanent dentition is the most prevalent condition affecting more than one-third of the world population , utmost burden being observed in 6 year old children . Dental caries and other oral diseases are influenced by many factors, ranging from political and economic policies on a macro level to socio-economic, genetic , behavioural, psychosocial factors at an individual level . In addition to these individual and macro level determinants, parental socio-economic characteristics have been found to influence dental caries and even oral health related quality of life in children. These socio-economic variables account for approximately 50% of the differences in the prevalence of dental caries in children at age 12 .

Most of the literature on predictors of dental caries in children is limited to individual (socio-behavioural, lifestyle and biological factors) and community level factors. However, there is a need to study the effects of family circumstances on dental caries in children as their oral health-related behaviours and oral health are either directly or indirectly influenced by their family . Few systematic reviews have been published on the influence of parental characteristics on dental caries in children. One such study found that lower social class, lower parental education, lower family income, single-parent families, higher birth order and big family size are associated with higher prevalence and/or severity of early childhood caries . More recently another systematic review provided evidence on the influence of parents’ knowledge, attitudes and behaviour on dental caries in children and adolescents . In addition, family functioning has also been found to be associated with childhood dental caries .

There are systematic reviews on the effect of parental influences on early childhood caries and effects of parental oral hygiene behaviour on dental caries in their children . However, there is no synthesised evidence on the effects of various parent related characteristics on caries in the permanent dentitions of children aged 6–12 years which would help in better understanding of the determinants of dental caries in this important age group. This review aims to synthesise data from the literature on the effect of various parent-related characteristics (socio-demographic, behavioural and family environment) on dental caries in the permanent dentition of 6–12-year-old children.

Methods

The current systematic review conforms to the guidelines set by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and has been registered with the Prospective Register for Reporting Systematic Reviews (registration number-CRD42014010513).

Eligibility criteria

The PICO (participants, interventions, comparators and outcomes) question for this review was “What are the parent related characteristics that influence dental caries levels in permanent dentitions of 6–12 year old children”. All the cross-sectional, longitudinal and experimental studies that were published in English from 2000 to March 2015 were considered for inclusion. Reviews, personal opinions and letters were excluded. Suitability of the studies was based on the predetermined inclusion criteria of (1) the study population comprised children aged 6–12 years; and (2) caries was assessed in the permanent dentition. For study populations with mixed age groups of children and adolescents, abstracts were only considered for inclusion when the results for each age category were presented separately. Abstracts that did not state anything about socio-economic status and parental characteristics were excluded.

Search strategy

Databases searched in April 2015 were PubMed, Medline via OVID and CINAHL Plus via EBSCO. The search was restricted to scientific articles using filters of language (English) and time (from year 2000 to March 2015). The search strategy used is shown in Table 1 . A truncation for the term “child” was used. A manual search for literature was not attempted.

Table 1
Search strategy used in the present study.
#1 Dental caries
#2 Child* OR children
#3 Socioeconomic factors OR parent–child relations OR health knowledge, attitudes, practice OR education OR occupations OR income OR social environment OR family OR family relations OR housing OR educational status OR parents OR mothers OR fathers
#4 #1 and #2 and #3

Study selection

Two authors (SK and JT) screened the titles and abstracts independently. When the information in the abstract was inconclusive, to decide on its suitability for inclusion (for instance, age of the study sample has not been provided), it was considered for full text review. There was no disagreement between the reviewers on determining the suitability of articles for inclusion.

Data collection

Data extraction was done using piloted data extraction sheets by two authors (SK and JT). Data collected was rechecked for accuracy by the senior authors (JK and NWJ). Data on study design and setting, sample size, age, parental characteristics, statistical tests, findings on association of dental caries with parental characteristics, caries diagnosis criteria and caries outcome measure were extracted from each study. Studies included exhibited clinical heterogeneity as they differed widely in design, method of caries diagnosis, participants, parental characteristics assessed and the measure of dental caries used as outcome. Therefore, no single effect size estimates could be calculated. Quantitative systematic review with single effect size estimates (Meta-analysis) of all the studies was not possible as the parent characteristics were diverse, ranging from education to home environment. Moreover, subgroup analysis with respect to each parent characteristic (e.g. education) was also not possible due to non-uniform definition of the characteristic and its categorisation. Further, the definition of the outcome measure (e.g. prevalence of decayed teeth, total decayed teeth, and total caries count) was different between the studies.

Quality assessment criteria

Quality assessment criteria for the articles included were adopted from a previous systematic review . Scoring was done for each article on three different criteria:

(1) Caries diagnosis: based on the method of caries diagnosis used in the study, caries at the pre-cavity level was given a score of 1 and those at cavity level and subject/parent reported caries were scored 2 and 3 respectively.

(2) Representativeness of the study sample: samples collected from random clusters or strata of countries or provinces were scored 1 while those on towns and cities were scored 2. Studies on convenience samples that were randomly chosen were scored 3 and those on convenience samples with no randomisation were scored 4.

(3) Statistical adjustment: studies that statistically adjusted for the effect of confounders when evaluating the influence of independent variables on dental caries were scored 1 while those lacking statistical adjustment were scored 2.

A fourth criteria on study design was added to these where a score of 1 was allocated to longitudinal studies or studies that used a life course approach, while a score of 2 was allocated to cross-sectional studies.

Methods

The current systematic review conforms to the guidelines set by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and has been registered with the Prospective Register for Reporting Systematic Reviews (registration number-CRD42014010513).

Eligibility criteria

The PICO (participants, interventions, comparators and outcomes) question for this review was “What are the parent related characteristics that influence dental caries levels in permanent dentitions of 6–12 year old children”. All the cross-sectional, longitudinal and experimental studies that were published in English from 2000 to March 2015 were considered for inclusion. Reviews, personal opinions and letters were excluded. Suitability of the studies was based on the predetermined inclusion criteria of (1) the study population comprised children aged 6–12 years; and (2) caries was assessed in the permanent dentition. For study populations with mixed age groups of children and adolescents, abstracts were only considered for inclusion when the results for each age category were presented separately. Abstracts that did not state anything about socio-economic status and parental characteristics were excluded.

Search strategy

Databases searched in April 2015 were PubMed, Medline via OVID and CINAHL Plus via EBSCO. The search was restricted to scientific articles using filters of language (English) and time (from year 2000 to March 2015). The search strategy used is shown in Table 1 . A truncation for the term “child” was used. A manual search for literature was not attempted.

Table 1
Search strategy used in the present study.
#1 Dental caries
#2 Child* OR children
#3 Socioeconomic factors OR parent–child relations OR health knowledge, attitudes, practice OR education OR occupations OR income OR social environment OR family OR family relations OR housing OR educational status OR parents OR mothers OR fathers
#4 #1 and #2 and #3

Study selection

Two authors (SK and JT) screened the titles and abstracts independently. When the information in the abstract was inconclusive, to decide on its suitability for inclusion (for instance, age of the study sample has not been provided), it was considered for full text review. There was no disagreement between the reviewers on determining the suitability of articles for inclusion.

Data collection

Data extraction was done using piloted data extraction sheets by two authors (SK and JT). Data collected was rechecked for accuracy by the senior authors (JK and NWJ). Data on study design and setting, sample size, age, parental characteristics, statistical tests, findings on association of dental caries with parental characteristics, caries diagnosis criteria and caries outcome measure were extracted from each study. Studies included exhibited clinical heterogeneity as they differed widely in design, method of caries diagnosis, participants, parental characteristics assessed and the measure of dental caries used as outcome. Therefore, no single effect size estimates could be calculated. Quantitative systematic review with single effect size estimates (Meta-analysis) of all the studies was not possible as the parent characteristics were diverse, ranging from education to home environment. Moreover, subgroup analysis with respect to each parent characteristic (e.g. education) was also not possible due to non-uniform definition of the characteristic and its categorisation. Further, the definition of the outcome measure (e.g. prevalence of decayed teeth, total decayed teeth, and total caries count) was different between the studies.

Quality assessment criteria

Quality assessment criteria for the articles included were adopted from a previous systematic review . Scoring was done for each article on three different criteria:

(1) Caries diagnosis: based on the method of caries diagnosis used in the study, caries at the pre-cavity level was given a score of 1 and those at cavity level and subject/parent reported caries were scored 2 and 3 respectively.

(2) Representativeness of the study sample: samples collected from random clusters or strata of countries or provinces were scored 1 while those on towns and cities were scored 2. Studies on convenience samples that were randomly chosen were scored 3 and those on convenience samples with no randomisation were scored 4.

(3) Statistical adjustment: studies that statistically adjusted for the effect of confounders when evaluating the influence of independent variables on dental caries were scored 1 while those lacking statistical adjustment were scored 2.

A fourth criteria on study design was added to these where a score of 1 was allocated to longitudinal studies or studies that used a life course approach, while a score of 2 was allocated to cross-sectional studies.

Results

A total of 4162 titles were retrieved from electronic searches in PubMed (2492), Medline via OVID (926) and CINAHL Plus via EBSCO (744). After duplicates were removed 2578 titles remained. Fig. 1 describes the titles retrieved, screened, full text articles included and excluded with reasons. All the titles along with their abstracts were reviewed. One hundred and fourteen articles were relevant and considered for full text review, from which 48 were selected. Sixty six articles were excluded (see supplementary file) for reasons such as: population level socio-economic variables were used; no separate data were presented for ages 6–12; combined caries data were reported for the deciduous and permanent dentitions; effect of parental characteristics on dental caries was not analysed; no parental variables were studied; studies were initiated before 2000; age of the study population was not provided; impact of parental characteristics was only evaluated on the deciduous dentition; and permanent dentition was not examined. Seven articles were excluded for more than one of the above reasons.

Fig. 1
PRISMA flow chart depicting the article selection procedure.

Background characteristics

Ten studies were conducted in Brazil , three each from Australia , India and a collaboration across Germany and Ireland . There were two articles each from Iran , Japan , Thailand , Greece , Russia and Norway . There were nineteen single country papers. The majority of the studies were cross-sectional in design and one article presented data from previous studies . Two studies were longitudinal and there was one each of experimental , cohort and retrospective design .

Quality of the articles

Quality of each study in constituent criteria is presented in Table 3 . Most of the studies diagnosed caries at cavity level. Only seven studies were conducted on randomly selected clusters of the country or provinces. Nineteen studies statistically controlled the effect of confounders when evaluating the influence of independent variables on dental caries. There were only five studies that were longitudinal or used a life course approach.

Socio-economic status (SES)

SES-related parental characteristics studied were a composite scale of SES, household income, parents’ education, parents’ occupation, house ownership, family health insurance coverage, owning a car, money regularly spent on sweets and daily pocket money for snacks. A composite SES scale based on parents’ education and employment level was used in five studies , all of which observed an inverse relation between SES and caries (i.e. people belonging to poor SES exhibited greater caries). Table 2 presents the significant parental characteristics and their direction of relation with dental caries in all the included studies.

Table 2
Background characteristics, significant parental characteristics and the direction of relation of the parental characteristics with the outcome variable (dental caries) in the studies reviewed.
Study design Study sample Study location Age Sample size Parental characteristics studied Significant parental characteristics in uni or bivariate analysis Significant parental characteristics in multivariable analysis Direction of relation Outcome variable Reference
CSS School children West Baghdad, Iraq 12 391 Mother’s education
Father’s education
Mother’s education Mother’s education Caries experience greater in children of highly educated mothers DMFT Ahmed et al.
CSS School children Jeddah, Saudi Arabia 9 880 Father’s education
Mother’s education
Family income
Type of home
Home ownership
Receipt of government monetary support
Medical insurance coverage
Dental insurance coverage
Father’s education
Mother’s education
Home ownership
None Children of parents with less than high school education and those owning a home had higher caries prevalence. ‘D’ of DMFT Al Agili et al.
CSS School children Porto Alegre, Brazil 12 1528 Brazilian socio-economic classification (based on education level of head of family and purchase power of family) SES SES Greater caries prevalence and experience in lower SES children DMFT Alves et al.
CSS School children Lithgow, New south wales, Australia 10–12 257 Living in a single parent household
Education level of female parent/guardian
Education level of male parent/guardian
Occupation of female parent/guardian
Occupation of male parent/guardian
Family income
Occupation of male parent/guardian Occupation of male parent/guardian Children whose male parent/guardian was a pensioner, a laborer, or unemployed had greater extent of caries than those children whose male parent/guardian was manager or had a professional occupation DMFT Arora and Evans
CSS School children Piracicaba city, Brazil 12 724 Monthly family income
Number of people living in the household
Mother’s educational level
Fathers’ educational level
Home ownership
Monthly family income
Father’s education
Mother’s education
Monthly family income Children of parents earning less income were at greater risk than those earning more
Caries was less prevalent in children of parents with higher education than their counterparts
DMFT Benazzi et al.
CSS School children Sassari, Sardinia (Italy) 12 403 Socio-economic category and status of the family
Age of the mother
Socio-economic category and status of the family None Children belonging to higher socio-economic level had lower caries levels DMFT DMFS Campus et al.
CSS School children Vienna, Austria 12 736 Migration background of parents
Parent’s education (parent with highest level of education was considered)
Migration background of parents
Parent’s education
Migration background of parents Children with a migration background are at high risk of dental caries and children of parents with low educational level experienced greater caries levels. DMFT Cvikl et al.
CS School children Yazd and Hadi-Shahr cities, Iran 12 1223 Parents’ job
Parents’ Educational level (no information about which parent it was)
None None DMFT Daneshkazemi and Davari
CSS School children Thiruvananthapuram, Kerala 12 838 Mother’s education None None DMFT David et al.
Data from two previous CSS Children who attended school dented service South Australia and Queensland 6–12 7875 Equivalized household income (based on Household size and income) Equivalized household income Equivalized household income Children of lowest income category more risk at caries DMFS Do et al.
CSS School children Clermont-Ferrand, France 10 427 Family status
Number of children in the family
Birth order of the child
Mother’s employment
Father’s employment
Country of origin of the parents
Basic dental insurance
Number of children in the family
Mother’s employment
Father’s employment
Country of origin of the parents
Basic dental insurance
Number of children in the family
Father’s employment
Country of origin of the parents
Greater caries in families with more children
Children of jobless parents had greater caries
Children of one or both immigrant parents had greater caries
Children with state aid insurance had more caries than those with private insurance
DMFT Enjary et al.
CSS School children Montserrat(Bristish overseas territory) 12 32 Fathers occupation No inferential statistics done No inferential statistics reported DMFT Fergus
CSS School children Nairobi west and Mathira west districts, Kenya 12 639 Mother’s education Not conducted Mother’s education in Nairobi west district Children of illiterate mothers more prone for dental caries than those whose mothers were educated DMFT Gathecha et al.
CSS School children Benghazi, Libya 12 2662 Father’s education
Mother’s education
Father’s education Father’s education Children of less educated fathers had greater caries DMFT
DMFS
Huew et al.
CSS data from a LS School children National representative sample of Australia 6–7 4464 Socio-economic position (SEP) (derived from combined annual household income, parents’ years of education and occupation) Not conducted SEP Lower SEP was associated with higher odds of parent-reported caries Parent reported caries levels Kilpatrick et al.
CSS School children Arkhangelsk, North West Russia; Tromso, Northern Norway 12 590-Russian;
264-Norwegian
Family economy
Family status
Money spent on sweets per week
Parental education
Parents self-evaluated oral health
Oral health problems in the past 2 years
Last dental attendance
Adequate help obtained during last visit to dentist
Number of teeth
Self-evaluated oral health
Oral health problems in the past 2 years,
Adequate help obtained during last visit to dentist
Oral health problems in the past 2 years Children were more at caries risk if their parents evaluated their oral health as moderate/bad, and had oral problems in the last 2 years and have not received adequate help in last dental visit DMFT Koposova et al.
CSS School children Arkhangelsk, North West Russia; Tromso, Northern Norway 12 48-North west Russia;
36-Tromso, Norway
Family status
Money spent on sweets per week
Parental education
Self-evaluated oral health condition
Oral health problems in the past 2 years
Number of teeth
Time since last visit to dentist
Parental education
Self-evaluated oral health
Oral problems during the past 2 years
Time since last visit to dentist
Parental education
Time since last visit to dentist
Children more at risk of caries if parents had <12 years of education, bad self-evaluated oral health and oral health problems during the last 2 years
No information given on the direction of relation of caries with parents’ time since last dental visit
DMFT Koposova et al.
CSS Children selected from citizen registry Subsample of Thailand National oral health survey 12 1063 Daily pocket money for snacks Daily pocket money for snacks Daily pocket money for snacks Children receiving pocket money of >10 bahts had greater caries than those receiving 0-10 baht DMFT Krisdapong et al.
RS Children attending Ylivieska
Public Health Center
Ylivieska district, Finland 10 93 (xylitol), 55 (F or CHX) and 359 (none) Mothers’ receiving preventive intervention (three groups; xylitol chewing gum, fluoride or CHX varnish treatments , no intervention None None DMFT Laitala et al.
CSS School children Berisso city, Buenos Aires province, Argentina 6 804 Socio-economic position (from father’s or mother’s occupation) Socio-economic position Not conducted Children of manual workers had greater caries experience than those whose parents were managers, professionals and employees DMFT
DMFS
Llompart et al.
CSS School children City of Sao Paulo, Brazil 12 4249 House crowding
Mother’s education
Father’s education
Family income
Owning a car
House crowding
Mother’s education
Father’s education
Family income
Owning a car
House crowding
Family income
Greater caries in children living in over-crowded houses
Children of less educated parents had more caries
Greater caries in children with less family income
More caries in children of families with no car
Untreated caries (D of DMFT) Lopes et al.
CSS School children Na Klang district, Nongbua Lampoo province, Thailand 12 111 Father’s education
Mother’s education
Family income
Family income Family income Children belonging to families with more income were at greater risk for caries DMFT Lueangpiansamut et al.
CSS School children Parkala and Udupi towns, India 12 200 Social class based on per capita income None Not performed DMFT
SIC
Mahalakshmi et al.
CSS School children Belo Horizonte, Minas Gerais, Brazil 8–10 1204 Household income
Number of residents in the home
Caregivers’ schooling
Household income
Caregivers’ schooling
None Children of caregiver with lesser education and less household income had greater caries experience and severity DMFT Martins et al.
CSS School children (Autistic and non-autistic) From three districts of Istanbul, Turkey 6–12 363 (62-autistic, 301-non-autistic) Mother’s education
Father’s education
Family income
Family income Family income Children from low income families had more caries DMFT Namal et al.
CSS Mothers and children attending Hiroshima University Dental Hospital Hiroshima city, Japan 8–11 117 Mother’s gingival health and oral hygiene level (measured by Oral rating index)
Mothers oral health behaviour
Mother’s gingival health and oral hygiene level Mother’s gingival health and oral hygiene level Mothers with better gingival health and oral hygiene had children with lower caries DFT Okada
CSS School children Hiroshima, Japan 7–12 296 Parent’s oral health behaviour Parent’s oral health behaviour on decayed teeth (DT) only Parent’s oral health behaviour on DT Children of parents with better oral health behavior had less caries DT
FT
Okada
CSS School children Greece 12 1224 Father’s education
Mother’s education
Father’s education
Mother’s education
Father’s education
Mother’s education
Children of mother or father with higher education had lower caries experience DMFT
DMFS
Oulis et al.
CSS School children Piracicaba city, Sao Paulo, Brazil 12 1001 Family monthly income
Number of residents living in the house
Mother’s education
Father’s education
Home ownership
DMFS and DMFS + WL
Family income
Residents in house
Mother’s education
Father’s education
WL:
Family income
Residents in house
Fathers education
DMFS and DMFS + WL
Family income
Residents in house
Father’s education
WL:
Family income
Children from high income families had less caries
Children in houses with more residents had greater caries
Children of father or mother with greater education had less caries
DMFS
DMFS + WL
WL (non cavitated active caries lesion)
Pardi et al.
CSS School children Piracicaba city, Sao Paulo, Brazil 12 929 Monthly family income
Number of people living in the household
Father’s education
Mother’s education
Car ownership
Home ownership
Monthly income ,
Father’s education
Mother’s education
Car ownership
Monthly income
Father’s education
Children in families with more income had less caries
Children of father or mother with better education had less caries
Children in families with more number of cars had less caries
DMFT Pereira et al.
Cohort Children of Pelotas, brazil Pelotas, brazil 12 339 Social class at birth (employment status)
Family income at birth
Father’s schooling at birth
Mother’s schooling at birth
Family economic level at age 12
Mother’s schooling at birth None Children of less educated mothers had greater caries DMFT Peres et al.
CSS School children City of Santa Maria, Brazil 12 792 Household income
Mother’s schooling
Father’s schooling
Mother’s occupation
Father’s occupation
DMFT prevalence:
Household income
Mother’s schooling
Father’s schooling
Mother’s occupation
DMFT mean:
Household income
Father’s schooling
SiC:
Household income
Father’s schooling
DMFT prevalence:
Household income
DMFT mean :
Household income
SiC:
Household income
Children of mother or father with less education had more caries
Children of unemployed mothers had more caries
DMFT prevalence
DMFT mean
SiC
Piovesan et al.
CSS School children Jordan 12 2560 Parents’ level of education Not conducted Parents’ level of education Children of parents with low education had greater caries experience and were at greater risk DMFT Rajab et al.
LS School children Belo Horizonte, Brazil 9–11 224 Family income
Mother´s education
None None Incidence of carious lesion on the occlusal surface of 1 st permanent molars Rossete Melo et al.
CSS School children Frielburg, Germany 12 322 Parents education Parents education Not done Children with parents with greater education had less caries DMFT Sagheri et al.
CSS School children Freiburg, Germany and Dublin, Ireland 12 699 Social class (based on parents’ educational level and parents’ employment) Social class in both cities Not performed Children belonging to lower social class had more caries but in Freilburg, caries was poorest in middle social class followed by low and high DMFT Sagheri et al.
CSS School children North-west Dublin, Ireland 12 332 Family’s medical card status (available to low income individuals and families) None Not performed DMFT Sagheri et al.
CSS School children Dublin, Ireland and Freiburg, Germany 12 567 Social class (based on parents’ educational level and parents’ employment) Social class Social class Children belonging to lower social class had more caries but in Dublin, caries was poorest in middle social class followed by low and high DMFT Sagheri et al.
CSS School chidren Tehran, Iran 9 409 Parent’s education (highest of either of the parents) Parent’s education (only on Decayed component) Not performed Children of low education parents had greater decayed teeth D
DMFT
Saied-Moallemi et al.
CSS School children Davangere city, India 6 765 SES (based on percapita family income) SES Not performed Children belonging to lower SES had more caries DMFT Sakeenabi et al.
CSS School children Galiza, Spain 12 1217 Mother’s education Mother’s education Mother’s education Children of mothers with higher education had less caries DMFT Smyth and Caamano
CSS School children South Belfast area, Ireland 11–12 230 Parental employment status (no information about which parent it was) Parental employment status Parental employment status No information on direction Untreated caries “D” of DMFT Sweeney and Kinirons
CSS School children Southland provinvce, New Zealand 9 443 New Zealand Socio-economic Index (based on the occupation of the parent with higher occupation) None SES (only in unadjusted analysis) Children belonging to families with higher SES had less caries DMFS Thomson and Mackay
ES Children Varberg city, Sweden 10 405 Mothers MS levels at 18 months of child’s age
Mothers’ chewing gums (four groups: xylitol, CHX + Xyl + sorbitol, F + Xyl + Sorb & non chewing group) when child was of 6-18 months age
Mothers MS levels Not conducted Mothers MS levels positively correlated with caries experience in children DS (cavitated and non-cavitated lesion) Thorlid et al.
CSS School children Municipality of Curitibanos, Brazil 12 253 Father’s education
Mother’s education
Father’s education
Mother’s education
Father’s education
Mother’s education
Children of father or mother with greater education had less caries DMFT Traebert et al.
CSS School children Bangladesh 12 631 Social class (based on father’s education) None None DMFT Ullah et al.
CSS Children Greece 12 1224 Mother’s education
Father’s education
Not conducted Mother’s education
Father’s education
Children of father or mother with greater education had less caries DMFS Vadiakas et al.
CSS School children Guangdong province, China 12 1576 Parents’ education Not conducted None DMFT Wong et al.
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Jun 19, 2018 | Posted by in General Dentistry | Comments Off on Impact of parent-related factors on dental caries in the permanent dentition of 6–12-year-old children: A systematic review
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