A scoping review on early childhood caries and inequalities using the Sustainable Development Goal 10 framework

Background: Social inequalities contribute to health disparities. This study aimed to map evidence on early childhood caries (ECC) related to the United Nations' Sustainable Development Goal 10 (SDG 10). Methods: A scoping review was conducted in May 2024 following the PRISMA-ScR guidelines. A literature search was performed in PubMed, Web of Science, and CINAHL for studies published in English and addressing population level social inequalities. Studies measuring individual level of social inequalities were excluded as they were covered by other SDGs. However, studies incorporating individual measures as additional measures of population level social inequality were included. Retrieved papers were summarized, inductively analysed and a conceptual framework linking SDG 10 was developed. Results: Of 452 studies retrieved, 42 met the inclusion criteria. Studies measured inequality among groups (deprivation, family income, indigenous communities, ethnicity, minority status) [14 studies], institutions (type of school, nursery or school facility, school poverty index, public primary health care units) [five studies], and inequality in communities (neighbourhood socio-economic status, Human Development Index, employment rate, income inequality, sanitary sewer and water supply, residents/household ratio, urban vs rural vs remote rural, accessibility index, location index, the slope index of inequality) [24 studies]. These levels of social inequalities were linked to higher prevalence of ECC; social and economic policies contributed to widening inequalities in ECC severity; and although effective interventions targeted at at-risk populations could reduce dental health disparities, study interventions differed by deprivation status. Six studies (14.3%) addressed SDG 10.1, 33 (78.6%) addressed SDG 10.2, 11 (26.2%) addressed SDG 10.3, and three (7.1%) addressed SDG 10.4. Fourteen studies (33.3%) addressed a combination of SDGs. The conceptual framework highlights the role of structural inequalities stemming from the cumulative impact of institutional decisions and systemic inequalities. Conclusion: This scoping review underscores the profound influence of social inequality on ECC through interactions between multi-level factors. Further research is needed to explore the links between ECC and other SDG 10 targets, especially in low- and lower-middle-income countries.