Prevalence of dental caries among adolescents in Sub-Saharan Africa: a systematic review and meta-analysis

Dental caries remains a persistent oral health challenge in Sub-Saharan Africa (SSA). Adolescence (10–19 years) is a high-risk period due to increased dietary autonomy and shifting oral hygiene habits amidst rapid regional urbanization. This systematic review and meta-analysis aimed to determine the pooled prevalence and severity (DMFT) of dental caries among adolescents in SSA and identify factors contributing to epidemiological heterogeneity. Following PRISMA and MOOSE guidelines, databases (PubMed, EMBASE, AJOL, Scopus, WOS) were searched through the year 2025. Data from 82 studies ( n = 50,059) were synthesized using a DerSimonian-Laird random-effects model. Risk of bias was assessed using the JBI assessment tool for cross-sectional studies, and heterogeneity was explored through subgroup analysis, meta-regression, and sensitivity analysis. Analyses included pooled prevalence of dental caries, mean DMFT index, and moderator analyses. Publication bias was assessed via Egger’s test and corrected using the Duval and Tweedie trim-and-fill method. The pooled prevalence of dental caries was 28% (95% CI: 24%–33%), with a mean DMFT of 0.69. Southern and East Africa reported the highest prevalence (38%), significantly higher than West Africa (20%). Hospital-based studies (51%) and mixed rural-urban study settings showed higher disease burdens. Study quality significantly influenced results ( p = 0.001), with low-risk studies reporting 27% prevalence. While meta-regression showed no significant temporal trends or gender associations, trim-and-fill analysis suggested an adjusted prevalence of 37% after accounting for publication bias. Adjusted bias-corrected prevalence shows approximately one in three adolescents in SSA is affected by dental caries. While disease severity remains relatively low, marked regional and contextual disparities underscore the need for early, prevention-oriented oral health strategies tailored to local epidemiological realities. PROSPERO (CRD42024525279).