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Int J Paediatr Dent. 2018 Oct 26. doi: 10.1111/ipd.12441. [Epub ahead of print]

Does oral health influence school performance and school attendance? A systematic review and meta-analysis.

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School of Dentistry, Federal University of Amazonas, Manaus, Amazonas, Brazil.
Unit Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.



To examine the evidence on the influence of oral health status on school performance and school attendance in children and adolescents.


A systematic review was performed in accordance with PRISMA included epidemiological studies that assessed concomitantly oral health measures, participants' school performance and/or school attendance. Electronic search was conducted on MEDLINE, SCOPUS, Web of Science, ScienceDirect, and LILACS. Studies published up to May 2018 in any language were eligible. The risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was used to obtain pooled estimates between oral health measures and school performance and school attendance.


Eighteen studies were included. Of them, fifteen studies were used for the meta-analyses. Most studies were assessed as moderate quality. Children with one or more decayed teeth had higher probability of poor school performance (OR = 1.44 95%CI: 1.24-1.64) and poor school attendance (OR = 1.57 95%CI: 1.08-2.05) than caries-free children. Poor parent's perception of child's oral health increased the odds of worse school performance (OR = 1.51 95%CI: 1.10-1.92) and poor school attendance (OR = 1.35 95%CI: 1.14-1.57).


Children and adolescents with dental caries and those reporting worse oral health experience poor school performance and poor school attendance.


adolescents; children; dental problems; oral health; school attendance; school performance


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