Abstract
Objective To evaluate the influence of gross domestic product (GDP), government expenditures on education and health (% of GDP), per capita sugar consumption, and years of schooling on caries experience (DMFT) in 12-year-old children globally. Methods The study analyzed global data of GDP, sugar consumption, years of schooling, expenditure on education and health, and DMFT from 69 countries. Information about DMFT and sugar consumption was retrieved from the World Health Organization while data of other study variables were available from the United Nations Development Program. Data were compared among low, middle, and high-income countries. Results Sugar consumption (p = 0.005) and years of schooling increased progressively from low-income to high-income countries (p < 0.001). The greater percentage of GDP was spent on health (6.55 +/- 2.94) than on education (3.48 +/- 2.60). Upper-middle-income countries had the highest mean DMFT score (2.23 +/- 1.23) and per capita sugar consumption (33.28 +/- 14.06). High-income countries spent 4.33% of their GDP on education followed by low-income countries (3.92%) (p = 0.037). Similar trends were observed with regards to the percentage of GDP spent on health (p = 0.003). Univariate analysis showed a significant negative correlation between the percentage of GDP spent on education (r = -0.252, p = 0.037) and DMFT. Significant correlation remained in multivariate analysis; the percentage of GDP spent on education and DMFT in children (B = -0.128, p = 0.028). Conclusion Low, middle, and high-income countries demonstrated significant inequalities regarding caries experience, sugar consumption, and share of GDP spent on health and education. Increasing the share of GDP on education may reduce caries burden in children globally.