Abstract for: Systematic Mapping of Multilevel Factors Contributing to Dental Caries in Adolescents

Dental caries is the most prevalent chronic disease among adolescents in the United States. Caries activity increases significantly during adolescence, and it is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades. Several conceptual and data-driven models have proposed unidirectional mechanisms that contribute to the extant disparities in adolescent dental caries experience. Our objective, using a focused literature review, is to provide an overview of risk factors contributing to adolescent dental caries and map the relationships among the multilevel factors that influence dental caries among adolescents. The methods that we use are two-fold: 1) a focused literature review using PubMed and Cochrane databases to find contributing factors; and 2) the system dynamics approach for mapping feedback mechanisms underlying adolescent dental caries through causal loop diagramming. The results of this study, based on the review of 138 articles, identified individual, family and community-level factors and their interactions contributing to dental caries experience in adolescents. Our results lead to a deeper understanding of these multilevel factors and provide hypotheses about the mechanisms underlying persistence of dental caries among adolescents.