[Social inequalities in oral health and early childhood caries: How can they be effectively prevented? A scoping review of disease predictors]

Abstract

Background: Early childhood caries represent a major public health problem. In addition to their individual impact, the massive social inequalities in oral health that are at the roots and result from the disease have largely underestimated consequences for the child, his family and the community. In response to the question of "how and where to act?", this scoping review identifies the individual characteristics associated with the disease on which it would be possible to act, using appropriate prevention strategies.

Methods: This scoping review is aimed at describing and analyzing available data in the literature on the different factors associated with early childhood caries.

Results: The predictors of early childhood caries are represented by mediating (knowledge, attitudes and parents' oral health practices) and moderating (psychosocial parameters, parental health literacy and alcohol consumption) factors. Twenty-eight articles fulfilled the selection criteria, twenty of which studied mediators related to early childhood caries, and fourteen of which dealt with moderators. The lower the parents' level of knowledge and literacy in oral health, the higher a child's dmft index. Additional studies are needed to assess the role of psychosocial parameters.

Conclusion: Parents' knowledge and oral health literacy are the key predictors to be preferentially targeted in view of reducing social inequalities in health through actions undertaken on a local scale. The prevention of early childhood caries necessitates a combination of generic and targeted interventions.

Keywords: Carie dentaire; Child; Dental caries; Enfant; Healthcare disparities; Inégalités devant les soins; Oral health; Review; Revue de littérature; Santé orale.