Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,317 questions · 75,239 findings · 5,342 reviews

No studies found 15,213 · 20.2%GRADE not reported 10,323 · 13.7%Very low 17,528 · 23.3%Low 17,951 · 23.9%Moderate 11,190 · 14.9%High 3,034 · 4%

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Missing teeth / tooth loss vs No tooth loss

Oral health-related quality of life · Adolescents (10-19 years)

Tooth loss/edentulism is associated with worse OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).

1 finding from 1 review

Fluoride-containing amalgam (FAAG) vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 2 or more years in permanent teeth, secondary caries did not differ significantly between fluoride-containing amalgam and GIC (RR 0.95, 95% CI 0.45-2.00; low certainty).

1 finding from 1 review

Bruxism vs No bruxism

Oral health-related quality of life · Adolescents (10-19 years)

Bruxism was not shown to impact OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    While dental erosion and bruxism have not been shown to impact the quality of life of adolescents [26]. Bruxism does not impact quality of life in children and adolescentes [33].
    Studies not reported
    GRADE not reported

Dental erosion vs No dental erosion

Oral health-related quality of life · Adolescents (10-19 years)

The umbrella review reported that dental erosion has not been shown to affect oral health-related quality of life.

2 findings from 1 review

Caries-associated bacterial biofilm vs Sound/control tissue (sound dentin, sound root, or enamel caries)

Bacterial collagenolytic protease gene expression · Human ex vivo carious lesions / caries-associated biofilm

Genes encoding bacterial collagenolytic proteases were detected/overexpressed in coronal and root caries (ungraded; GRADE not feasible).

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs Caries-free status

CA VI activity · Children (age about 2-9 years) across the 7 meta-analyzed activity samples; excludes Kivela 1999 adults (18-24 years), qualitative only…

Salivary/biofilm CA VI activity is significantly higher in individuals with dental caries than in caries-free individuals (SMD 0.894, 95% CI 0.386 to 1.392; not GRADE-rated).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Adverse events (participants with >=1 adverse event) · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin showed a borderline, non-significant increase in adverse events versus placebo (RD 0.10, 95% CI 0.00 to 0.21; ungraded subgroup).

1 finding from 1 review

38% silver diamine fluoride vs Atraumatic restorative treatment (ART)

restoration and caries status · children with caries in permanent molars

The review reported SDF was beneficial for arresting caries; no effect estimate or GRADE rating was reported.

1 finding from 1 review

Dental fluorosis (assessed by TFI or WHO criteria) vs Individuals without dental fluorosis

Oral health-related quality of life · Indian children and young adults

Two studies found dental fluorosis significantly associated with poorer OHRQoL; narrative, ungraded.

1 finding from 1 review

Composite resin vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

Over 2 or more years in deciduous teeth, secondary caries did not differ significantly between resin composite and RMGIC (RR 1.60, 95% CI 0.85-3.00; low certainty).

1 finding from 1 review

CPP-ACP enamel pre-treatment for remineralization of white spot lesions before bonding metallic orthodontic brackets vs No enamel pre-treatment before bonding, or treatment with another material

Shear bond strength (SBS) of metallic orthodontic brackets · Demineralized enamel of extracted permanent human teeth

When used to remineralize white spot lesions on demineralized enamel, CPP-ACP pre-treatment did not significantly affect shear bond strength (MD 1.501, 95% CI -0.630 to 3.632; ungraded).

1 finding from 1 review

Favorable socioeconomic and family environment vs Less favorable socioeconomic and family environment

Oral health-related quality of life · Adolescents (10-19 years)

The umbrella review reported better oral health-related quality of life with favorable housing, parental education, income, family environment, and access to dental care.

1 finding from 1 review

Compomer (Dyract) vs Resin composite restoration

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

In deciduous teeth at 1 year, secondary caries did not differ significantly between compomer and resin composite, with high heterogeneity (RR 0.41, 95% CI 0.02-8.34; I2=83%; ungraded).

1 finding from 1 review

P11-4 + fluoride varnish vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Combined self-assembling peptide P11-4 plus fluoride varnish significantly improved white spot lesion remineralization versus control (SMD -0.96, 95% CI -1.44 to -0.48) and ranked highest of seven therapies by SUCRA (89.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Light-emitting diode (LED) photobiomodulation vs Conventional orthodontic appliance treatment

Orthodontic tooth movement (OTM) during alignment stage · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment

The review found no eligible studies for this question.

1 finding from 1 review

Chlorhexidine mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce the Gingival Index versus blank control in the short term (WMD -0.54, 95% CI -0.96 to -0.13), but with very high heterogeneity the evidence is very uncertain (very low certainty).

1 finding from 1 review