Global Caries Experience in Adults and Elderly: Relationship with Country Level Income and Current Tobacco Smoking

Background: Dental caries remains a major global public health concern. This study aimed to evaluate the worldwide distribution of caries experience among adults and older adults, and to examine the impact of current tobacco smoking and country-level income on caries experience. Methodology: This ecological study utilized data on caries experience and current smoking prevalence from the World Health Organization (WHO), and income classifications from the World Bank. Caries experience was measured using the Decayed, Missing, and Filled Teeth (DMFT) index. DMFT scores and smoking prevalence were compared across low, lower-middle, upper-middle, and high-income countries. Bivariate and multivariate analyses were conducted to assess the relationships among variables. Results: Globally, adults had a lower mean DMFT score (9.62 ± 5.01) compared to the elderly (19.46 ± 6.72). The global prevalence of current smoking in adults was 19.80%. Low-income countries had significantly lower caries experience in both adults (P<0.001) and the elderly (P=0.009), and also lower adult smoking prevalence (P<0.001) compared to high-income countries. Adult caries experience was positively correlated with country-level income (r=0.58, P<0.001), smoking prevalence (r=0.26, P=0.006), and elderly caries experience (r=0.82, P<0.001). Multivariate analysis confirmed significant associations between adult caries experience and country-level income (B=2.64, P<0.001), and between elderly and adult caries experience (B=0.94, P<0.001). Conclusion: Global disparities in dental caries exist across income levels and age groups. Caries experience in adults is significantly influenced by both national income and caries levels in the elderly population.