Dental caries experience in Indigenous children and adolescents: a systematic review and meta-analysis assessing worldwide disparities and time trends (1968-2024).

OBJECTIVE

To summarize the evidence on the global experience of dental caries among Indigenous children and adolescents worldwide using decayed, missing, and filled teeth indices for deciduous (dmft) and permanent (DMFT) dentitions.

MATERIALS AND

METHODS

A systematic review of the PubMed, SciELO, Embase, and Scopus databases was conducted. The search included studies with primary data on dmft and DMFT in Indigenous populations worldwide published until February 9, 2026. The pooled means (95% CI) of dmft and DMFT were calculated using a random-effects meta-analysis. Subgroup analyses and meta-regression explored heterogeneity through sociodemographic, geographic and time variables.

RESULTS

A total of 95 studies from 19 countries were included in the systematic review, 59 of which provided data for meta-analysis. The pooled mean for dmft was 3.75 (3.58-3.92) and for DMFT was 2.36 (2.18-2.55). Considerable heterogeneity was detected in pooled analyses for dmft and DMFT. Both indices were higher in studies from North America (dmft = 5.23 [4.61-5.86]; DMFT = 4.74 [2.28-7.20]) than in those from Oceania and Asia (dmft = 3.30 [3.11-3.50]; DMFT = 1.74 [1.57-1.91]). Multivariate meta-regression revealed that dmft increased as the percentage of female participants rose (β = 0.10, p-value = 0.030). Additionally, DMFT increased with increasing age (β = 0.40, p-value < 0.001) and decreased with increasing HDI (β=-3.13, p-value = 0.034). No statistically significant differences in caries experience were found across the study periods.

CONCLUSIONS

For nearly six decades, Indigenous children and adolescents worldwide have consistently experienced dental caries affecting approximately two to four teeth. Disparities in dental caries were observed across age, sex, and national human development levels.

CLINICAL RELEVANCE: The persistence of dental caries underscores the urgency of implementing effective preventive strategies that are culturally adapted to Indigenous contexts.