Oral Health Care among European Native and Immigrant’s Children and Adolescents : A systematic review and meta-analysis

Abstract: Background: Globally, oral health remains a public health concern, particularly in relation towell-being of children and adolescents. Dental caries, one of the most common oral health problem in this group, is considered as a transmissible, infectious disease with significant health consequences. Migration in Europe has increased over the recent years due to geopolitical causes, employment, family reunion, and so forth. Earlier studies show that immigrant populations in Europe have a higher rate of oral problems, and are at higher risk to oral diseases. This review aims to evaluate oral health status among children and adolescents with immigrant and native backgrounds and to evaluate if there are disparities in oral health between these twogroups. Methods: This study involved a systematic review of research articles comparing oral health between native European and immigrant children and adolescents. MeSH terms and key words comprised oral health, Europe, dental care, disparities, immigrant, environment, social and cultural, mouth care, children and adolescent. An open-access, validated tool was used toperform meta-analysis. Results: 15 studies were eligible for inclusion in the systematic review; 6 of which reported differences in mean Decayed Missing Filled teeth index (DMFT) scores, 7 reported odds ratios (OR) and two studies reported prevalence. The combined effect size for the DMFT scores was 0.54 (95% CI: 0.35 – 0.73), indicating a statistically significant difference of 46% in the mean DMFT scores between natives and immigrants, with the former having lower DMFT scores. The combined effect size for studies yielding ORs was 4.12 (95% CI: 2.51-6.78); implying 4-fold higher odds of dental caries among immigrants. Significant heterogeneity among the studies were observed. The likelihood of publication bias was also high. Conclusion: This review captured higher risk of dental caries, plaque formation and staining on teeth among immigrant than native children and adolescents in Europe. However, the studies included did not have the scope to examine potential causes for such a gap; which is an important knowledge gap to be addressed in future.