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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Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

Oral health-related quality of life · Children with dental caries

SDF did not significantly differ from atraumatic restorative treatment for oral health-related quality of life (MD 0.02, 95% CI -0.32 to 0.36; ungraded).

1 finding from 1 review

Primary dentition DMFT score 1-3 vs No caries in primary teeth (DMFT = 0)

Caries prevalence in permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

A primary-dentition DMFT of 1-3 is associated with 1.5 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

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

Treatment failure (annual failure rate) · Children with deep dentine caries in primary molars restored with composite resin (indirect pulp treatment; pulpotomy only if pulp exposed…

Complete caries removal with composite resin had an annual failure rate of 6.8% in primary molars (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

Caregiver help with child tooth brushing vs Not applicable (single-group prevalence)

Caregiver help with tooth brushing prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 54% of children with caries in LMICs received caregiver help with tooth brushing (pooled prevalence 0.541, 95% CI 0.266 to 0.803; 3 studies; not GRADE-rated).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between ART regimens (very low certainty).

1 finding from 1 review

Preformed metal crown (PMC) vs Resin-modified glass-ionomer cement + composite resin (modified open-sandwich restoration)

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

In one RCT, preformed metal crowns had an annual failure rate of 2.5% after 2 years.

1 finding from 1 review

Female sex vs Not applicable (single-group prevalence)

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

Among children with caries in LMICs, about half were female (pooled prevalence 0.497, 95% CI 0.475 to 0.519; 6 studies; I2=0%; not GRADE-rated).

1 finding from 1 review

Fluoride-releasing resin-based sealant vs Resin-based sealant

Retention of sealant (complete or partial retention) · Children with caries-free second primary molars, aged 4-8 years (dental clinic, Turkey and Spain)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-24 months
    Effect estimate not calculable; 69 (2 studies). Retention equivocal: Unal 2015 100% (fluoride resin) vs 96.0% (resin) at 12 months; Baca 2007 84.1% (fluoride resin) vs 97.7% (resin) at 12 months; at 24 months 87.8% vs…
    2 studies · 69 participants
    Very low

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Dental caries prevalence · Children or adolescents

In permanent dentition, CLWH on ART had higher caries prevalence than healthy controls (OR 2.49, 95% CI 1.86 to 3.32; single study).

3 findings from 1 review

Resin infiltration vs Baseline before resin infiltration

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

Eckstein (2015) reported a statistically significant color-change effect.

4 findings from 1 review
Show 1 more finding

CD4+ T-cell count below 250 cells/mm3 vs CD4+ T-cell count >=250 cells/mm3

HIV-related oral lesions · Children and adolescents living with HIV on ART/HAART

Lower CD4+ counts (<250 cells/mm3) were associated with roughly twice the odds of HIV-related oral lesions in two studies (not pooled).

1 finding from 1 review
  • Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
    Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · CD4+ T-cell count <250 cells/mm3 vs higher
    CLWH with CD4+ <250 cells/mm3 were about twice as likely to have HIV-related oral lesions: Baghirath 2013 OR 1.916 (95% CI 0.613 to 2.513), p=0.001; Divakar 2015 OR 1.999 (95% CI 0.129 to 3.688), p=0.001. Not pooled.
    2 studies
    GRADE not reported

Responsive complementary feeding (RCF) / other caregivers' feeding practices vs Other models of complementary feeding (traditional/non-responsive CF)

Type 2 diabetes (later in life) · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western industrialized countries

No eligible studies examined the influence of complementary feeding practices on later type 2 diabetes; this is an evidence gap.

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction

Dental caries detection accuracy · Dental images of human beings

The review reported 70% accuracy for dental caries detection in Mayank et al. (Ungraded).

3 findings from 1 review

Sugary drinks/sweets consumption vs Not applicable (single-group prevalence)

Sugary drinks/sweets consumption prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 70% of children with caries in LMICs consumed sugary drinks/sweets (pooled prevalence 0.697, 95% CI 0.478 to 0.877; 7 studies; very high heterogeneity; not GRADE-rated).

1 finding from 1 review

Dental caries vs Caries-free status

Alpha diversity (Observed, Chao1, Shannon, and Simpson) · Participants in oral 16S rRNA caries microbiome studies

Across the combined sample set, alpha-diversity metrics were significantly higher in caries than in health, but no pooled effect estimate was reported.

1 finding from 1 review