Food insecurity and dental caries prevalence in children and adolescents: A systematic review and meta-analysis.

BACKGROUND: Food insecurity (FI) is associated with dietary practices, which can act as a risk factor for dental caries. AIM: This study aimed to investigate the relationship between FI and dental caries prevalence in children and adolescents. DESIGN: MEDLINE (via PubMed), EMBASE, SCOPUS, ISI web of knowledge, Cochrane, and ProQuest Dissertations & Theses Global database (up to April 19, 2022) as well as reference lists were searched. Eligible studies compared dental caries prevalence in food-secure and food-insecure individuals younger than 19 years. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using a modified Newcastle-Ottawa Scale. Meta-analysis was performed, and the pooled odds ratio (OR) was calculated at 95% confidence interval (95% CI). RESULTS: Among the 1350 retrieved records, 10 cross-sectional reports were selected for systematic review. Six studies involving 8631 participants were included in the meta-analysis. More than half of the reports were published within the period 2019-2021. All studies except one were judged as low risk of bias. Overall, the prevalence of dental caries was greater among the food-insecure children and adolescents (OR: 2.01, 95% CI: 1.52-2.65, p < .001, I2 : 73.5%). Similarly, all three categories of FI were significantly associated with caries experience (marginal FI: OR: 1.88, 95% CI: 1.56-2.27, p < .001, I2 : 0.0%; low FI: OR: 2.42, 95% CI: 1.42-4.14, p = .001, I2 : 74.4%; very low FI: OR: 2.37, 95% CI: 1.88-3.00, p < .001, I2 : 0.0%). CONCLUSION: The results showed a significant association between FI status and dental caries in both childhood and adolescence; however, there was a lack of longitudinal studies for a better understanding of this association. Health policies leading to reduction in FI may also aim to reduce dental caries.