Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,323 questions · 5,762 findings · 263 reviews · Dental caries

No studies found 321 · 5.6%GRADE not reported 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%

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Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Number of natural teeth (missing/present teeth, edentulousness, MT component of DMFT) · General population (children and adults) assessed for dental hard-tissue health

Evidence on the number of natural teeth was conflicting and could not be pooled (ungraded).

1 finding from 1 review
  • Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes
    Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
    Seven studies reported on the number of teeth with conflicting findings; meta-analysis was not possible due to inconsistent outcome definitions. One study found vegetarians had significantly more teeth; two found no…
    7 studies
    GRADE not reported

Tooth bleaching (carbamide or hydrogen peroxide; home and/or in-office) vs No bleaching (untreated or pH-cycling control)

Caries susceptibility, enamel demineralisation, erosion, or microhardness · Permanent teeth / enamel specimens (in vitro)

Low-quality in vitro evidence suggests that bleaching of permanent teeth does not increase susceptibility to caries, demineralisation or erosion (ungraded); the clinical question could not be answered because only in vitro studies were available.

1 finding from 1 review

Intervention not reported

Dental caries in primary teeth · Children (primary dentition) worldwide

In Australia, the pooled prevalence of primary-teeth caries in children was 28.5% (95% CI 20.3 to 38.5); certainty not graded.

1 finding from 1 review

AG + GG genotype (G-allele carriers) of ENAM rs1264848 vs AA genotype of ENAM rs1264848

Dental caries susceptibility · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

No significant association between AG + GG genotype (G-allele carriers) vs AA genotype of ENAM rs1264848 and dental caries susceptibility (AG + GG vs AA model: OR 1.69, 95% CI 0.78-3.68) in the Ethnicity: Mixed subgroup; certainty not graded.

6 findings from 1 review
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Intervention not reported

Dental caries in permanent teeth · Children (permanent dentition) worldwide

In Africa, the pooled prevalence of permanent-teeth caries in children was 58.9% (95% CI 29.4 to 83.1); certainty not graded.

1 finding from 1 review

Spectra caries detection device (Air Techniques; blue fluorescence) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    The Spectra caries detection device fits into the blue fluorescence category but no studies provided data for inclusion in the meta-analysis (Markowitz 2015).
    1 study
    GRADE not reported

rs1126478, co-dominant model (GA genotype) vs GG or AA genotype

Dental caries · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

rs1126478 showed no significant association with dental caries under a co-dominant model (OR 0.97, 95% CI 0.72 to 1.32; ungraded).

1 finding from 1 review

Intervention not reported

Prevalence of GERD/reflux (esophagitis or positive pH testing) · Adults with dental erosion

Among patients with dental erosion, 64% to 75% had GERD or reflux findings across four studies; evidence is ungraded and not pooled.

1 finding from 1 review

Bleaching vs No bleaching (untreated control)

Caries susceptibility, enamel demineralisation, erosion, or microhardness · Permanent teeth or extracted human teeth with artificial lesions

The laboratory studies did not find increased susceptibility to caries or enamel demineralisation, but no firm conclusions can be drawn because of high risk of bias.

1 finding from 1 review

TT genotype of AMELX rs946252 vs CC + CT genotype of AMELX rs946252

Dental caries susceptibility · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

No significant association between TT genotype vs CC + CT genotype of AMELX rs946252 and dental caries susceptibility (TT vs CC + CT model: OR 0.73, 95% CI 0.19-2.87) in the Control group: Caries-free subgroup; certainty not graded.

6 findings from 1 review
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No additional acid etching (etch-and-rinse adhesive alone) after Er,Cr:YSGG preparation vs Prior acid etching before etch-and-rinse adhesive after Er,Cr:YSGG preparation

Incidence of microleakage · Er,Cr:YSGG laser-prepared cavities restored with etch-and-rinse adhesive systems (in vitro)

Prior acid etching with etch-and-rinse adhesives did not significantly change microleakage after Er,Cr:YSGG preparation (RR 1.18, 95% CI 0.63-2.22; ungraded).

1 finding from 1 review

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

Number of visits to the dentist for repair of sealant or fluoride varnish application · Children and adolescents (general population, aged under 20 years)

The review found no eligible studies for this question.

1 finding from 1 review

T allele of AMELX rs6639060 vs C allele of AMELX rs6639060

Dental caries susceptibility · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

No significant association between T allele vs C allele of AMELX rs6639060 and dental caries susceptibility (T vs C model: OR 1.08, 95% CI 0.63-1.85) in the Ethnicity: Caucasian subgroup; certainty not graded.

3 findings from 1 review

Gastroesophageal or laryngopharyngeal reflux (GERD/LPR) vs Healthy controls

Salivary function impairment (buffering capacity, flow rate, oral pH) · Adults with gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR)

Reflux is associated with impaired salivary function (notably reduced buffering capacity) as a proposed pathophysiological mechanism, based on several ungraded studies.

1 finding from 1 review
  • Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review. 2020 All outcomes
    Adult patients in gastroenterology, ENT and dental clinical settings
    Mixed/controversial salivary findings: reduced salivary buffering capacity supported in three studies (Correa, Holbrook, Filipi) with low oral pH and reduced flow as additional factors in GERD patients, but Meurman and Schroeder found no significant salivary abnormalities; no pooled estimate.
    6 studies
    GRADE not reported