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Evidence found and GRADE certainty

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

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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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Genome-wide common variants (additive dosage; present-study GWAS) vs Genome-wide significance threshold (P<5E-8)

Periodontal disease - genome-wide-significant loci (present study) · Japanese adults (present-study cohort)

The present Japanese GWAS found no genome-wide-significant loci for periodontal disease (top suggestive rs12624579/SYNDIG1); ungraded.

1 finding from 1 review
  • Genome-wide association meta-analysis identifies two novel loci associated with dental caries. 2024 All outcomes
    Lifelong (germline genotype) · Population-based genetic association study (Japanese direct-to-consumer genetic testing cohort) · Present-study GWAS (Japanese)
    In the present Japanese GWAS, no loci reached genome-wide significance for periodontal disease; several loci reached the suggestive level (P<1E-5). Top-associated variant rs12624579 (SYNDIG1 intron).
    1 study · 45525 participants
    GRADE not reported

Started toothbrushing with fluoride toothpaste at or before 12 months (earlier start) vs Started after 12 months (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste at or before 12… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 12 months (later start) (very low certainty).

2 findings from 1 review

Grade level 1-4 (first cycle) vs Grade level 5 or above

Dental caries · Primary school children in Ethiopia

Being in grade levels 1-4 was associated with higher odds of dental caries (OR 2.46, 95% CI 1.523-3.397; ungraded).

1 finding from 1 review

Second molar at Demirjian stage A-D at extraction vs Second molar at Demirjian stage G-H at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, Demirjian stage A-D vs G-H was not significantly associated with space closure (OR 2.75; not GRADE-rated).

1 finding from 1 review

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

Dental caries · children

Maternal smoking during pregnancy was associated with higher odds of dental caries in children (OR 1.78, 95% CI 1.55 to 2.05; ungraded).

14 findings from 2 reviews · compare the 2 reviews
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Started toothbrushing with fluoride toothpaste before 4 years (earlier start) vs Started after 4 years (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste before 4 years… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 4 years (later start) (very low certainty).

1 finding from 1 review

Mouth-rinse probiotic vs placebo or control

Salivary pH · Children and/or adolescents (<18 years) without background systemic disease

In a subgroup analysis, mouth-rinse probiotics reduced salivary pH (MD -0.40, 95%CI -0.54 to -0.26; p-interaction<0.01); not GRADE-rated.

1 finding from 1 review
  • Efficacy of Probiotic Consumption on Oral Outcomes in Children and/or Adolescents: A Meta-Analysis. 2024 All outcomes
    Healthy children and/or adolescents (<18 years) without systemic disease; RCTs from multiple countries (India, Thailand, Spain, Australia, New Zealand, Sweden, Poland, Colombia, Saudi Arabia); mostly school/community and clinic settings · Probiotic presentation: mouth rinse (vs other presentations; p-interaction<0.01)
    MD -0.40 [-0.54, -0.26]
    Studies not reported
    GRADE not reported

Breastfeeding promotion and support (e.g. individually tailored home-based peer counselling on the importance of breastfeeding, with advice and support for healthy breastfeeding) vs usual care

Dental caries · For interventions, pregnant and lactating women; for outcomes, children up to 6 years of age

The review found no eligible studies for this question.

2 findings from 1 review

Silver diamine fluoride (SDF) vs placebo or no treatment

Secondary prevention of caries · Children and adults (with or without carious lesions)

The review found no eligible studies for this question.

3 findings from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, nano-silver fluoride arrested more surfaces than SDF (OR 0.52 favoring the comparator; ungraded subgroup).

1 finding from 1 review

Cranberry extract / juice and proanthocyanidin (flavonoid) fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride)

pH drop / acidogenicity buffering · Streptococcus mutans (in vitro cultures and biofilms)

Cranberry extract reduces S. mutans acidogenicity / glycolytic pH drop in vitro (5 studies; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Fluoride varnish

Dental pain or sensitivity · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes dental pain or sensitivity compared with fluoride varnish (very low certainty).

1 finding from 1 review

Fluoride toothpaste less than 1000 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether fluoride toothpaste less than 1000 ppm (lower concentration) changes fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1000 ppm or more (higher concentration) (very low certainty).

2 findings from 1 review

High intake of sweets vs Lower/less intake of sweets

Dental caries · Primary school children in Ethiopia

A high intake of sweets was associated with higher odds of dental caries (OR 2.71, 95% CI 1.968-3.451; ungraded).

1 finding from 1 review

Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride)

Gtf activity · Streptococcus mutans (in vitro cultures and biofilms)

One study reported grape seed extract inhibits S. mutans Gtf activity (ungraded).

1 finding from 1 review

Fluoride-releasing primers/adhesives (Opal Seal; Clearfil Protect Bond) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel demineralization (DIAGNOdent score) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

Across three small non-randomized studies, fluoride-releasing primers (Opal Seal, Clearfil) showed no consistent clinical advantage over conventional primers in preventing white spot lesions (ungraded).

1 finding from 1 review