The association between postpartum depression and early childhood caries

Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review

BACKGROUND

The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC.

METHODS

The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework.

RESULTS

In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4-12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services.

CONCLUSION

The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.

A scoping review on the association of early childhood caries and maternal gender inequality

AIM

The objective of this scoping review is to present current evidence regarding the association between early childhood caries (ECC) and maternal-related gender inequality.

METHODS

Two independent reviewers performed a comprehensive literature search using three databases: EMBASE, PubMed, and Web of Science. Literature published in English from 2012 to 2022 was included in the search and was restricted to only primary research by using the following key terms: "dental caries", "tooth decay", "gender", "sex", "preschool", "toddler," and "infant". The included studies were limited to those reporting an association between ECC and maternal aspects related to gender inequality. Titles and abstracts were screened, and irrelevant publications were excluded. The full text of the remaining papers was retrieved and used to perform the review. The critical appraisal of selected studies was guided by the Joanna Briggs Institute (JBI) Critical Appraisal Tools.

RESULTS

Among 1,103 studies from the three databases, 425 articles were identified based on publication years between 2012 and 2022. After full-text screening, five articles were included in the qualitative analysis for this review. No published study was found regarding a direct association between ECC and maternal gender inequality at the level of individuals. Five included studies reported on the association between ECC and potential maternal-gender-related inequality factors, including the mother's education level (n = 4), employment status (n = 1), and age (n = 1). Regarding the quality of the included studies, out of five, two studies met all JBI criteria, while three partially met the criteria.

CONCLUSIONS

Based on the findings of this scoping review, evidence demonstrating an association between gender inequality and ECC is currently limited.

Scoping Review of Oral Health-Related Birth Cohort Studies: Toward a Global Consortium

The multidisciplinary nature and long duration of birth cohort studies allow investigation of the relationship between general and oral health and indicate the most appropriate stages in life to intervene. To date, the worldwide distribution of oral health-related birth cohort studies (OHRBCSs) has not been mapped, and a synthesis of information on methodological characteristics and outcomes is not available. We mapped published literature on OHRBCSs, describing their oral health-related data and methodological aspects. A 3-step search strategy was adopted to identify published studies using PubMed, Embase, Web of Science, and OVID databases. Studies with baseline data collection during pregnancy or within the first year of life or linked future oral health data to exposures during either of these 2 life stages were included. Studies examining only mothers' oral health and specific populations were excluded. In total, 1,721 articles were suitable for initial screening of titles and abstracts, and 528 articles were included in the review, identifying 120 unique OHRBCSs from 34 countries in all continents. The review comprised literature from the mid-1940s to the 21st century. Fifty-four percent of the OHRBCSs started from 2000 onward, and 75% of the cohorts were from high-income and only 2 from low-income countries. The participation rate between the baseline and the last oral health follow-up varied between 7% and 93%. Ten cohorts that included interventions were mostly from 2000 and with fewer than 1,000 participants. Seven data-linkage cohorts focused mostly on upstream characteristics and biological aspects. The most frequent clinical assessment was dental caries, widely presented as decayed, missing, and filled teeth (DMFT/dmft). Periodontal conditions were primarily applied as isolated outcomes or as part of a classification system. Socioeconomic classification, ethnicity, and country- or language-specific assessment tools varied across countries. Harmonizing definitions will allow combining data from different studies, adding considerable strength to data analyses; this will be facilitated by forming a global consortium.

Psychosocial, education, economic factors, decision-making ability, and caries status of mothers of children younger than 6 years in suburban Nigeria

Background

Little information is available on the relationship between mothers’ psychosocial profile and caries status, and less information is available on the oral health status and psychosocial status of mothers of young children in Africa. This study examined the association between the psychosocial profile of mothers in Nigeria and their prevalence of caries.

Methods

The prevalence of caries and severe caries (DMFT > 3) in mothers with children 71 months old and younger recruited through a household survey in Ile-Ife, Nigeria, was estimated through clinical examination. The explanatory variables were maternal education, income, decision-making status, and psychosocial status (dental anxiety, general anxiety, depressive symptoms, parenting stress, executive dysfunction, sense of coherence, fatalism and social support). The risk indicators for maternal caries were analyzed with logistic regression.

Results

The prevalence of caries was 3.3%. Twenty (39.2%) of the 51 women with caries had DMFT > 3. Most study participants were 25–34 years old (59.3%), had secondary level education (63.1%), earned N18,000 ($49)-N30000 ($84) per month (42.9%), and can make autonomous decisions about their health care, household purchases, or visits to family/relatives (68.8%). Most women had normal general anxiety (79.9%), low dental anxiety (90.4%), and normal stress (76.4%) levels. Most also had high fatalism (56.6%), perceived moderate social support (81.6%), had normal depressive symptoms (75.9%), low executive dysfunction (55.9%), and high sense of coherence (53.8%). Mothers who had clinically significant levels of stress were twice more likely to have caries than were those whose level of stress was normal (AOR: 2.26; 95%CI: 1.04–4.89; P = 0.039). Also, mothers who had high fatalism were less likely to have caries than were those with low fatalism (AOR: 0.40; 95%CI: 0.21–0.75; P = 0.004).

Conclusion

High levels of parenting stress was a risk indicator for caries while high fatalism was protective from caries in mothers of children younger than 6-years. Maternal education, income and decision-making ability were not associated with maternal caries. Though the caries prevalence for women with young children was low, the prevalence of severe caries was high and this because of the possible negative effect on their health and wellbeing.