Meta-Analysis of Global Distribution of Root-Caries Prevalence in Middle-Aged and Elderly

Introduction: Root caries (RC) remains a global health problem leading to negative impacts on an elderly person s well-being causing oral health-related quality of life issues, such as inadequate nutrition and detrimental oral functionality. The present systematic review with meta-analysis is designed to synthesize existing research findings on the prevalence and experience of root caries globally over the past 30 years. It aims to describe its distribution by country and explore its links with various socioeconomic indicators. Methods: Selection criteria: Three electronic databases (PubMed, Embase, and Scopus) were screened for observational epidemiological studies (cross-sectional and cohort studies) reporting the prevalence of RC and/or mean RC experience between 1990 and 2023. No languages were applied. Study selection, data extraction, and quality assessment were done in duplicate. Risk of bias was graded with customized quality assessment tools (Study Quality Assessment Tools NHLBI, NIH). Data collection and analysis: studies reporting on (1) root-caries experience (mean and SD) and (2) root-caries prevalence (%) were used to synthesize the results. It was assessed as decayed, missing, and filled teeth (RDMFT). Results: A total of 91 publications were included in the descriptive analysis; the estimated overall pooled mean RC was 2.87 teeth and the global estimated random-effects pooled RC prevalence was 41%. Low gross national income (GNI) countries reported a low mean number of RC (1.35 GNI