Does the Decline in Caries Prevalence of Latin American and Caribbean Children Continue in the New Century? Evidence from Systematic Review with Meta-Analysis

Objective
To carry out a systematic review with meta-analysis of prevalence of caries in Latin America and Caribbean children considering studies performed in this new century.
Methods
Two reviewers searched PubMed, Embase, LILACS and governmental databases through May 2016 to identify papers published in English, Portuguese or Spanish. Studies in those countries performed with 5–6 or 11–13 year-old children and that presented separate prevalence figures from primary and permanent teeth were selected. We performed a descriptive analysis of studies and meta-analysis to calculate the overall prevalence and 95% confidence intervals (95% CI) in both primary and permanent teeth. We also analyzed the trends of prevalence of caries through the years and influence of other variables on caries prevalence using multilevel analysis.
Results
Seventy-five studies were included from the 1,306 articles initially retrieved. The meta-analysis of caries prevalence grouped for Latin American and the Caribbean countries were highly different from Brazil and other investigated countries for primary teeth (5–6 years-old—Brazil: 0.52, other countries:0.70) and permanent teeth (11–12 years-old—Brazil: 0.56, other countries: 0.63). For studies conducted only in Brazil the prevalence was significant lower for primary but not for permanent teeth. In Brazil, a downward trend of caries prevalence was observed in 11-13-year-old children.
Conclusion
Despite the decline of caries prevalence in permanent teeth, mainly in Brazil, the disease still affects more than half of the children population in Latin American and Caribbean countries in the 21st Century.

研究目的
本研究旨在针对本世纪以来拉丁美洲与加勒比地区儿童龋病患病率开展系统综述与荟萃分析。

方法
两名研究者检索了PubMed、Embase、LILACS及各国政府数据库，检索时限截至2016年5月，以筛选以英语、葡萄牙语或西班牙语发表的相关文献。纳入针对上述地区5~6岁或11~13岁儿童开展、且分别报告乳牙与恒牙龋病患病率的研究。本研究对纳入文献进行描述性分析，并开展荟萃分析以计算乳牙与恒牙的总体患病率及95%置信区间（95% CI）；同时采用多水平分析法分析龋病患病率的年度变化趋势，以及其他变量对龋病患病率的影响。

结果
初始检索共获取1306篇文献，最终纳入75项研究。针对拉丁美洲与加勒比地区整体的龋病患病率荟萃分析结果，与仅针对巴西及其他受调研国家的结果差异显著：乳牙组（5~6岁儿童：巴西为0.52，其他国家为0.70）；恒牙组（11~12岁儿童：巴西为0.56，其他国家为0.63）。仅针对巴西开展的研究显示，乳牙龋病患病率显著更低，但恒牙组无此差异。在巴西，11~13岁儿童的龋病患病率呈下降趋势。

结论
尽管恒牙龋病患病率有所下降（尤以巴西为甚），但在21世纪，拉丁美洲与加勒比地区仍有超过半数儿童受龋病困扰。