Risk Factors for Caries in Children and Adolescents: A Systematic Review

Introduction Tooth decay is a bacterial infection influenced by a multifactorial interplay of risk factors. This review aimed to examine both established and emerging determinants of dental caries in children and adolescents, with an emphasis on dietary and behavioral influences. Methods Following PRISMA guidelines and PICOS criteria, a systematic search was performed across PubMed, Scopus, Web of Science, Embase, ClinicalTrials.gov, and Google Scholar for studies published between January 2015 and December 2024. Eligible studies included cross-sectional, cohort, and case-control designs reporting on caries risk factors. Results A total of 18 studies met the inclusion criteria. Established risk factors included poor socioeconomic status, high sugar intake, infrequent toothbrushing, younger maternal age, and higher maternal DMFT scores. Emerging risk factors were nighttime feeding, prolonged breastfeeding beyond 18 months, lack of parental supervision during toothbrushing, maternal unemployment, and single motherhood. Additional associations included low birth weight, poor dietary diversity, and inadequate fluoride exposure. Discussion The findings highlight the multifactorial and context-specific nature of caries development in young populations. While traditional risk factors remain highly relevant, newer determinants such as feeding practices and parental factors require further validation through longitudinal and interventional research. Variability in diagnostic tools and methodological heterogeneity across studies limits direct comparability. Conclusion This review underscores both established and emerging risk factors for childhood caries. Identifying these determinants may guide preventive strategies, particularly for vulnerable populations, and may inform policy and clinical interventions.