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Table 2 Statistically significant determinants related to children’s sex, age and weight status contributing to dental caries

From: Determinants of dental caries in children in the Middle East and North Africa region: a systematic review based on literature published from 2000 to 2019

Determinants

Association: positive ( +), negative (−)a

Author study design

Country

Type of dentition

N

Age group (gender)

Study setting

Scoring system

Type/s of statistical analysis

Dental caries/scoring results

Gender

Male (primary dentition)

 + 

Abbass et al. [20] (CS)

Egypt

Primary

Mixed

Permanent

369

3–18 y

(M, F)

Clinic

WHO

(dmft, deft, DMFT)

Kruskal–Wallis, Spearman’s

DCP = 74%

dmft = 3.23 (SD 4.07)

deft = 4.21 (SD 3.21)

DMFT = 1.04 (SD 1.56)

Male

 + 

Kabil & Eltawil, 2016 [18] (CS)

Egypt

Primary

140

2–4 y

(M, F)

Clinic

WHO

AAPD-ECC

Logistic regression

DMFT = 9.96

Male

 + 

Kabil & Eltawil [19] (CS)

Egypt

Primary

108

2–4 y

(M, F)

Clinic

WHO

Logistic regression

ECCP = 57% (2–3 y)

ECCP = 73% (3–4 y)

Male

 + 

Abu Hamila [21](CS)

Egypt

Primary

560

1–3.5 y

(M, F)

Clinic

WHO

(dmft)

Chi-Square

ECCP = 69.6%

dmft = 2.1–7.6

Male

 + 

Bayat-Movahed et al. [27] (CS)

Iran

Primary

Permanent

18,946

3,6,9,12 y

(M, F)

Community health centres

WHO

(dmft, DMFT)

T-test

Z-test

dmft = 1.9 (3 y)

dmft = 5.0 (6 y)

dmft = 3.6 (9 y)

dmft = 0.6 (12 y)

DMFT = 0.2 (6 y)

DMFT = 0.9 (9 y)

DMFT = 1.9 (12 y)

Male

 + 

Sadeghi et al. [35] (CS)

Iran

Permanent

747

12–15 y

(M, F)

School

WHO

(DMFT)

T-test, Chi-Square

Caries free = 16.1%

DMFT = 2.83 (SD 2.2)

Male

 + 

Saied-Moallemi et al. [36] (CS)

Iran

Primary

Permanent

459

9 y

(M, F)

School

WHO

(dmft, DMFT)

One-way ANOVA, Kruskal–Wallis, Mann- Whitney

dmft = 4.2 (M)

dmft = 3.4 (F)

DMFT = 0.4

Male

 + 

Goodson et al. [47] (CS)

Kuwait

Primary

Mixed

Permanent

8,319

Mean age = 11.36 y (grade 4 and 5)

(M, F)

School

Percentage of decayed or filled teethb

Multivariate rank-based Wilcoxon regression

Decayed or filled teeth (all body weights) = 11.01% (SEM 0.11)

Decayed or filled teeth (males) = 11.76% (SEM 0.19)

Decayed or filled teeth

(females) = 10.53% (SEM 0.14)

Male

 + 

Hashim et al. [85] (CS)

UAE

Primary

1036

5,6 y

(M, F)

School

WHO

(dmft, dmfs)

Chi-Square, ZINB regression

DCP = 76.1%

dmft = 4.4

dmfs = 10.2

Female

 + 

Bashirian et al. [26] (CS)

Iran

Primary

Permanent

988

7–12 y

(M, F)

School

WHO

(dmft, DMFT)

Multiple regression

DCP = 80.36%

dmft = 3.61

DMFT = 0.79

Female

 + 

Khani-Varzegani et al. [31] (CS)

Iran

Primary

756

4–7 y

(M, F)

School

WHO

(dmft)

Multivariate analysis

dmft median (25th–75th percentile):

All = 4(2–8)

Males = 4(2–9)

Females = 5(2–8)

Female

 + 

Jahani et al. [30] (CS)

Iran

Primary

Permanent

845

9 y

(M, F)

School

WHO

(dmft, DMFT)

Ordinal logistic regression

Moderate to high DCPc = 50% of the children

Female

 + 

Farsi & Elkhodary [65] (CS)

KSA

Permanent

801

Mean age = 16.5 y (Grade 11)

(M, F)

School

ASTDD

(DT)

Mann- Whitney

DT boys = 3.9 (SD 3.5)

DT girls = 4.9 (SD 3.7)

Female

 + 

Huew et al. [50] (CS)

Libya

Permanent

791

12 y

(M, F)

School

WHO

(DMFT, DMFS)

Multivariate analysis

DCP = 57.8%

DMFT = 1.78

DMFS = 2.39

Female

 + 

Bener et al. [55] (CS)

Qatar

Permanent

1284

6–15 y

(M, F)

Clinic

WHO

(DMFT)

Multivariate analysis

DCP = 73%

DMFT = 4.5

Gender

Unclear

Khadri et al. [90] (CS)

UAE

Permanent

803

11–17 y

(M, F)

School

WHO

(DMFT)

Multivariate regression

DCP = 75%

DMFT = 3.19 (SD 2.9)

Age

Age

 + 

Abbass et al. [20] (CS)

Egypt

Primary

Mixed

Permanent

369

3–18 y

(M, F)

Clinic

WHO

(dmft, deft, DMFT)

Kruskal–Wallis, Spearman’s

DCP = 74%

dmft = 3.23 (SD 4.07)

deft = 4.21 (SD 3.21)

DMFT = 1.04 (SD 1.56)

Age

 + 

Abu Hamila [21] (CS)

Egypt

Primary

560

1–3.5 y

(M, F)

Clinic

WHO

(dmft)

Chi-Square

ECCP = 69.6%

dmft = 2.1–7.6

Age

 + 

Bashirian et al. 2018 [26] (CS)

Iran

Primary

Permanent

988

7–12 y

(M, F)

School

WHO

(dmft, DMFT)

Multiple regression

DCP = 80.36%

dmft = 3.61

DMFT = 0.79

Age

 + 

Shaghaghian et al. [37] (CS)

Iran

Primary

396

3–6 y

(M, F)

School

WHO

(dmft)

Multivariate analysis

DCP = 69.9%

dmft = 3.88

Age

 + 

Khani-Varzegani et al. [31] (CS)

Iran

Primary

756

4–7 y

(M, F)

School

WHO

(dmft)

Multivariate analysis

Median (25th–75th percentile) dmft:

All = 4 (2–8)

Boys = 4 (2–9)

Girls = 5 (2–8)

Age

 + 

Eslamipour et al. [28] (CS)

Iran

Permanent

748

11–20 y

(M, F)

School

WHO

(DMFT)

Chi-Square, Binary logistic regression

DCP = 88.8%

DMFT (11–14 y) = 4.94 (SD 3.59)

DMFT (11–14 y) = 3.02 (SD 2.51)

DMFT = 5.00 (SD 3.37) (14–17 y)

DMFT (17–20 y) = 6.66 (SD 3.82)

Age

 + 

Mohebbi et al. [33] (CS)

Iran

Primary

504

12–36 m

(M, F)

Clinic

WHO

(dmft)

Logistic regression

ECCP:

12–15 m = 3%

16–19 m = 9%

20–25 m = 14%

26–36 m = 33%

dmft =  < 0.1 (12–15 m)

dmft = 0.2 (16–19 m)

dmft = 0.4(20–25 m)

dmft = 1.2(26–36 m)

Age

 + 

Askarizadeh & Siyonat [23] (CS)

Iran

Primary

620

2–6 y

(M, F)

School

WHO

(dmft)

Chi-Square

DCP = 17.2%

dmft = 8.5 (M)

dmft = 7.8 (F)

Age

 + 

Sayegh et al. 2002d [43] (CS)

Sayegh et al. d [45] (CS)

Jordan

Primary

1140

4–5 y

(M, F)

School

WHO

(dmft)

Multivariate analysis

DCP = 67%

dmft > 4 in 31%

Age

 + 

Al-Malik et al. [57] (CS)

KSA

Primary

987

2–5 y

(M, F)

School

BASCD

Stepwise multiple logistic regression

DCP = 73%

ECCP = 43%

dmft = 4.8

dmfs = 12.7

Age

 + 

Wyne et al. [69] (CS)

KSA

Primary

1016

2–6 y

(M, F)

School

WHO

(dmft)

Logistic regression

DCP = 27.3%

dmft = 8.6

Age

 + 

Al-Mutawa el al. [46] (CS)

Kuwait

Primary

Permanent

4588

5,6,12,14 y

(M, F)

School

WHO (dft, DMFT, DFS)

Multivariate analysis

dft = 4.6 (5–6 y)

DMFT = 0.4(6 y)

DMFT = 2.6 (12 y)

DMFT = 3.9 (14 y)

DFS = 0.4 (6 y)

DFS = 3.4 (12 y)

DFS = 5.2 (14 y)

Age

 + 

Qadri et al. [73] (CS)

Syria

Primary

400

3–5 y

(M, F)

School

ECC

WHO

(dmft, dmfs)

Logistic regression

ECCP = 48%

DCP = 70%

dmft = 4.25 (SD 4.24)

Age

 + 

Ä°nan-EroÄŸlu et al. [78] (CS)

Turkey

Primary

395

36–71 m

(M, F)

School

WHO

(dmft, dmfs)

Mann–Whitney, Kruskal–Wallis

dmft = 4.7

dmfs = 8.0

Age

 + 

Dogan et al. [77] (CS)

Turkey

Primary

3171

8–60 m

(M, F)

Clinic

WHO (dft)

Chi-Square

ECCP = 17.3%

dft = 0.63 (1.79)

Age

 + 

Namal et al. [80] (CS)

Turkey

Primary

598

3–6 y

(M, F)

School

WHO (dft)

Multiple logistic regression

dft = 74.1%

Age

 + 

Olmez et al. [82] (CS)

Turkey

Primary

95

9–57 m

(M, F)

Clinic

WHO (dft)

Chi-Square, Kruskal–Wallis

DCP = 75.5%

dft = 6.2

Age

 + 

Bener et al. [55] (CS)

Qatar

Permanent

1284

6–15 y

(M, F)

Clinic

WHO

(DMFT)

Multivariate analysis

DCP = 73%

DMFT = 4.5

Age

Unclear

Khadri et al. [90] (CS)

UAE

Permanent

803

11–17 y

(M, F)

School

WHO

(DMFT)

Multivariate regression

DCP = 75%

DMFT = 3.19 (SD 2.9)

Age

 + 

Hashim et al. [85] (CS)

UAE

Primary

1036

5,6 y

(M, F)

School

WHO

(dmft, dmfs)

Chi-Square,ZINB regression

DCP = 76.1%

dmft = 4.4

dmfs = 10.2

Weight status

Over weight

 + 

Jahani et al. [30] (CS)

Iran

Primary

Permanent

845

9 y

(M, F)

School

WHO

(dmft/DMFT)

Ordinal logistic regression

Moderate to high DCP1 = 50% of the children

BMI

 + 

Bagherian & Sadeghi [25] (CS)

Iran

Primary

400

30–70 m

(M, F)

Not specified

WHO (defs)

Multiple logistic regression

ECCP = 55.2%

S-ECCP = 51.2%

defs = 8.37 (SD 11.2)

BMI

 + 

Abu El Qomsan et al. [56] (CS)

KSA

Permanent

386

6–12 y

(M, F)

School and Clinic

WHO

(DMFT, DT, FT)

One-way ANOVA, Spearman’s

DT:

Underweight = 3.06 (SD 1.48)

Normal weight = 2.90 (SD 2.34)

Over weight = 3.69 (SD 2.39)

Obese = 4.00 (SD 2.57)

FT:

Underweight = 0.25 (SD 0.68)

Normal weight = 0.34 (SD 0.95)

Over weight = 0.39 (SD 0.70)

Obese = 0.68 (SD 1.18)

BMI

−

Alghamdi & Almahdy [59] (CS)

KSA

Permanent

610

14–16 y

(M)

School

Not specified

DMFT

Logistic regression

DCP = 54.1%

Low BMI

 + 

Quadri et al. [68] (CS)

KSA

Primary

Permanent

360

6–15 y

(M, F)

School

WHO

(dft/DMFT)

Logistic regression

dft/DMFT = 

2.52 (F),

1.88 (M)

BMI

−

Goodson et al. [47] (CS)

Kuwait

Primary

Mixed

Permanent

8,319

Mean age = 11.36 y (grade 4 & 5)

(M, F)

School

Percentage of decayed or filled teeth1

Multivariate rank-based Wilcoxon regression

Decayed or filled teeth (all body weights) = 11.01% (SEM 0.11)

Decayed or filled teeth (males) = 11.76% (SEM 0.19)

Decayed or filled teeth (females) = 10.53% (SEM 0.14)

Under weight

 + 

Köksal et al. [79] (CS)

Turkey

Primary

Permanent

245

5–6 y

(M. F)

Unclear

WHO

(dmft, DMFT, dmfs)

Chi-Square, Mann- Whitney, Spearman’s

DCP = 85.9%

dmft = 5.3 (SD 3.78)

DMFT = 0.27(SD 0.74)

dmfs = 10.5(SD 9.67)

DMFS = 0.33(SD 0.95)

Weight status

Variede

Bhayat et al. [64] (CS)

KSA

Permanent

402

12 y

(M)

School

WHO

(DMFT)

Linear regression

DCP = 49%

DMFT = 1.46 (SD 2.04)

BMI

 + 

Bener et al. [55] (CS)

Qatar

Permanent

1284

6–15 y

(M, F)

Clinic

WHO

(DMFT)

Multivariate analysis

DCP = 73%

DMFT = 4.5

  1. AAPD American Association Paediatric Dentistry, BASCD British Association for the Study of Community Dentistry, CS Cross-sectional, CC Case control, DCP Dental caries prevalence, deft decayed, extracted due to caries and filled primary teeth, dfs decayed, filled surfaces in primary teeth, dft decayed, filled primary teeth, dmfs decayed, missing and filled surfaces in primary teeth; DMFS decayed, missing and filled surfaces in permanent teeth, dmft decayed, missing, filled primary teeth, DMFT decayed, missing, filled permanent teeth, ECC Early childhood caries, ECCP Early childhood caries prevalence, F Female, ICADS The international caries Detection and Assessment System, L Longitudinal, KSA Kingdom of Saudi Arabia, m months, M Male, WHO World Health Organisation, SiC Significant caries index, SD standard deviation, y years
  2. aAssociation: Positive ( +), negative (−) refers to this factor being either a statistically significant risk factor for caries (positive, +) or to this factor being statistically significant protective against caries (negative, −). In some studies it could not be determined whether a factor was positively or negatively associated with caries and in these cases the relation is described as unclear
  3. bThe author calculated this as follows the decayed or filled teeth (%) = 100 × [(number of primary teeth with fillings) + (number of permanent teeth with fillings) + (number of decayed primary teeth) + (number decayed permanent teeth)]/[(number of primary teeth) + (number of permanent teeth)]
  4. cThe children were categorized into three groups on the basis of WHO caries severity classification. Low caries level was defined as dmft/DMFT ≤ 2.6, moderate caries as dmft/DMFT of 2.7–4.4 and high caries as dmft/DMFT > 4.4
  5. dSayegh et al. 2002 and Sayegh et al. 2005 seem to be based on the same study population and the results mentioned in this table, have been reported in both articles
  6. eNormal weight status-positive association to caries, whereas the caries prevalence was lower in under and overweight children