Association between socioeconomic status and dental caries in adolescents - a systematic review of cohort studies.

Abstract

Early adolescence is a critical period for caries initiation, underlining the need for updated knowledge on effective caries indicators. This systematic review of cohort studies aimed to assess the association between socioeconomic status (SES), involving a wide range of indicators, and dental caries in adolescents aged 12-19. Four databases (MEDLINE, Embase, Cochrane Library, and Web of Science) were systematically searched for relevant publications from January 1, 2000, through December 5, 2025. SES and SES proxy indicators were parental education, income, and occupation, and adolescents' school type, their social capital, and immigrant background. Composite SES indicators combined the aforementioned variables. The risk of bias was evaluated using a modified Newcastle-Ottawa Scale. Studies (n = 21) from 11 countries across five continents were included, covering approximately 66,000 adolescents. An inverse relationship was documented between caries and mothers' education (six of seven studies), fathers' education (three of four studies), and parental income (three of six studies). School type (three studies), social capital (two studies), immigrant background (four studies), and composite SES indicators (five of six studies) were also linked to caries. However, the effect measures and definitions of exposures and outcomes were not consistent. An inverse association was observed between maternal education and caries, while corresponding associations with fathers' education and parental income were weaker and less consistent. This type of association was also observed for adolescents' school types, their social capital, and composite SES indicators. Immigrant background served as a caries predictor. However, the substantial heterogeneity in the included studies did not allow for meta-analyses and limited definite conclusions. The findings underscore the need to develop and validate robust composite SES measures applicable across diverse global contexts.