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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CPP-ACFP 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…

CPP-ACFP versus control gave SMD -0.42 (95% CI -0.84 to 0.00); the review classed CPP-ACFP as statistically significant versus control although the reported CI upper limit is at the null (0.00); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Surgery plus radiotherapy vs Radiotherapy alone

Adverse events associated with treatment · Adults with oral cavity or oropharyngeal cancer
1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported

Self-assembling peptide P11-4 vs CPP-ACFP

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…

Self-assembling peptide P11-4 did not differ significantly from CPP-ACFP (SMD -0.13, 95% CI -0.68 to 0.42); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Herbal mouthwash vs Blank control

Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced some gingival inflammation-related indices, but certainty is very low.

1 finding from 1 review

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Adverse events associated with treatment · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)
1 finding from 1 review

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Disease-free survival · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)
1 finding from 1 review

Herbal mouthwash vs Blank control

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash showed mixed effects on Mutans streptococci, with very low-certainty evidence.

1 finding from 1 review

Mutans streptococci detected in plaque or saliva at baseline vs No mutans streptococci detected in plaque or saliva at baseline

Development of any (cavitated or non-cavitated) carious lesion · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Across the sample-based sensitivity analysis, mutans streptococci at baseline were associated with higher odds of developing caries.

1 finding from 1 review

Elective radical (comprehensive) neck dissection vs Elective selective neck dissection

Disease-free survival · Adults with oral cavity cancer

It is very uncertain whether elective radical (comprehensive) neck dissection changes disease-free survival (new disease, progression, and mortality) compared with elective selective neck dissection (very low certainty).

1 finding from 1 review

Skin color / ethnicity vs Reference skin color / ethnicity

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

There is no concrete evidence on the impact of skin color/ethnicity on OHRQoL in adolescents (evidence gap; 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
    Biological data such as skin color and age have no concrete evidence about this impact in the OHRQoL. Important aspects like gender and skin color did not have their level of impact clarified.
    Studies not reported
    GRADE not reported

Fluoride toothpaste vs Not applicable (single-group prevalence)

Fluoride toothpaste use prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 39% of children with caries in LMICs used fluoride toothpaste (pooled prevalence 0.391, 95% CI 0.166 to 0.644; 2 studies; not GRADE-rated).

1 finding from 1 review

Resin infiltration vs Baseline before resin infiltration

Lightness change · Patients with post-orthodontic white spot lesions and permanent dentition

Knosel (2019) reported a statistically significant lightness-change effect.

3 findings from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Salivary immunoglobulin A (SIgA) concentration · Children and adolescents (<18 years) living with HIV (CLWH)

Evidence on salivary IgA in CLWH on versus off ART was divergent and inconclusive (very low certainty).

1 finding from 1 review

Selective caries removal (SCR) + composite resin vs Complete caries removal (CCR) + composite resin

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, selective caries removal had a 3.44 higher probability of failure than complete caries removal.

1 finding from 1 review