Prevalence of toothache and associated factors in children and adolescents: a systematic review and meta-analysis

Abstract

Objectives: This systematic review aimed to determine the pooled prevalence of toothache in children and adolescents and to verify its association with sociodemographic characteristics and dental caries experience.

Material and methods: Six main and three grey literature databases were searched in February 2021. Observational studies that assessed the prevalence of toothache and associated factors were included. The methodological quality of the studies was evaluated following the guidelines by Fowkes and Fulton. Proportion and association meta-analyses were performed in MedCalc and Revman software, respectively. The certainty of the evidence was determined with the GRADE approach.

Results: Seventy-one studies met the inclusion criteria. Thirty-two presented high methodological quality and a low risk of bias. The overall pooled prevalence of toothache in children and adolescents was 36.2% (95%CI: 33.0-39.42; I²: 99.72%; P < 0.001). Females (OR: 1.17; 95%CI: 1.08-1.26; I²: 91%; P < 0.001) and children and adolescents whose caregivers had ≤ 8 years of schooling (OR: 1.42; 95%CI: 1.30-1.56; I²: 77%; P < 0.001) presented the higher chance of reporting toothache. Dental caries experience increased the chance of reporting toothache in 3.49 times (95%CI: 2.70-4.51; I²: 92%; P < 0.001). The certainty of the evidence was very low.

Conclusions: The overall pooled prevalence of toothache was considered high. Sociodemographic characteristics (sex and caregivers' educational level) and previous dental caries experience were significantly associated with toothache reports.

Clinical relevance: Toothache is still a recurrent issue in many countries. Thus, it is essential to understand its possible associated factors to reduce the occurrence of new episodes.

Keywords: Adolescent; Child; Meta-analysis; Risk factors; Systematic review; Toothache.