Twetman · Dentistry journal 2026 · narrative review · n=?

Who Gets Dental Caries? A Comprehensive Review.

Level 5 - mechanism / opinion, no new human data

Narrative review without systematic search or meta-analytic methodology

PubMed 42505707 · doi:10.3390/dj14070400 · record verified 2026-08-26

What was done

Narrative review synthesizing findings from global prospective birth cohorts, genetic studies, and clinical risk assessment tools to identify risk factors for dental caries development in children.

What was found

Genetic factors (enamel quality, saliva composition, biofilm function, taste preferences) are reported to account for 35% to 55% of the variation in caries scores in the young permanent dentition. Prospective birth cohort data identify poverty, socioeconomic level, early introduction and excessive sugar intake, prolonged breastfeeding, childhood obesity, and maternal oral health as key factors. Clinically, past caries history and selected social/behavioral factors are the strongest predictors, with current risk assessment tools demonstrating acceptable reliability.

Why it matters

It highlights that effective caries prevention requires family-level interventions targeting maternal oral health and sugar intake alongside clinical risk assessment.

Limits

As a narrative review, it lacks a systematic search methodology, formal quality assessment of included studies, and meta-analytic pooling. Specific effect sizes, participant counts, and quantitative diagnostic accuracy metrics (e.g., sensitivity, specificity) for the risk assessment tools are not reported in the abstract.