Contextual Social Inequities and Occurrence of Dental Caries in Adolescents: A Systematic Review.

Purpose: This systematic review sought to determine whether there is consistent evidence of the association between contextual social inequities and the occurrence of dental caries in adolescents. Materials and Methods: An electronic survey in ISI Web of Science, SCOPUS, MEDLINE, LILACS, Cochrane Library, and SciELO databases was performed, establishing a specific search strategy in each of them. Only analytical articles in which social indicators were measured at the contextual level published up to December 2015 were included. The risk of bias of studies selected was assessed from parameters suggested by MOOSE (Meta-analysis of Observational Studies in Epidemiology), classifying them in each item as adequate, partially adequate, inadequate and unclear. After evaluation, studies were classified as good (level 1), regular (level 2) or bad (level 3) quality. Results: Of the 181 articles identified, four met the inclusion and exclusion criteria, and of these, only one showed high risk of bias. Four articles showed significant association between contextual socioeconomic factors and caries. Despite the measurement of different social inequities such as social class and neighbourhood empowerment level, the articles showed significant association between contextual socioeconomic factors and caries. Conclusions: The scientific evidence that adolescents from areas of higher social inequity are at higher risk for caries is weak, especially considering the small number of existing studies, methodological vulnerabilities and the risk of study bias.