What do systematic reviews say?

Prophylactic valaciclovir (lower dose) vs Prophylactic valaciclovir (higher dose)

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  Orlowski 2004: 182 throat swabs performed for patients receiving 500 mg of valaciclovir (n = 40) and 198 swabs for those receiving 1000 mg (n = 41); all of the cultures proved negative (1 trial, 81; not estimable).
  1 study · 81 participants
  GRADE not reported

Prophylactic valaciclovir (lower dose) vs Prophylactic valaciclovir (higher dose)

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  One study reported adverse effects (Warkentin 2002). Twenty patients allocated to receive high dose valaciclovir reported adverse effects (42%); for the low dose group this number was 27 (52%). Adverse effects were…
  1 study · 100 participants
  GRADE not reported

Lower family socioeconomic status / income vs Higher socioeconomic position

Evidence on socioeconomic status/income and caries was inconsistent: some studies linked lower income to higher caries while others found no association (narrative synthesis; not GRADE-rated).

• Oral Health of Children and Adolescents in the United Arab Emirates: A Systematic Review of the Past Decade. 2021 All outcomes

  UAE; schools (Ajman, Dubai)
  Findings were contradictory. Hashim et al. found children from low-income families had higher odds of severe early childhood caries (OR 1.43, 95% CI 1.11-1.85), and Ahmad et al. reported significantly higher DMFT in…
  Studies not reported
  GRADE not reported

Lower parental (maternal/paternal) education vs Higher parental education

The association between parental education and caries was inconsistent; father's (but not consistently mother's) education was inversely associated with caries in some studies (narrative synthesis; not GRADE-rated).

• Oral Health of Children and Adolescents in the United Arab Emirates: A Systematic Review of the Past Decade. 2021 All outcomes

  UAE; schools/nurseries
  Maternal education was not associated with children's caries in the Hashim et al. studies, whereas father's educational level was negatively associated with DMFT in Khadri et al. (secondary-aged children: -0.35, 95% CI…
  Studies not reported
  GRADE not reported

Fluoride toothpaste 440 ppm (lower concentration) vs 1450 to 1500 ppm F toothpaste

Fluoride toothpaste 440 ppm (lower concentration) probably leads to lower fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1450 ppm (higher concentration) (moderate certainty).

• Topical fluoride as a cause of dental fluorosis in children 2024 · Cochrane All outcomes

  Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
  RR 0.72 [0.58, 0.89]
  1 study · 1009 participants
  Moderate

Fluoride toothpaste 550 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)

Fluoride toothpaste 550 ppm (lower concentration) probably leads to lower fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1000 ppm (higher concentration) (moderate certainty).

• Topical fluoride as a cause of dental fluorosis in children 2024 · Cochrane All outcomes

  Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
  RR 0.75 [0.57, 0.99]
  1 study · 959 participants
  Moderate

Intestinal trefoil factor (ITF), lower dose (336 mg) vs Intestinal trefoil factor (ITF), higher dose (2688 mg)

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
  Insufficient evidence to determine whether lower (336 mg) or higher (2688 mg) dose performs better (Analyses 11.1 to 11.3); no pooled estimate reported
  1 study · 66 participants
  GRADE not reported

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

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).

• Topical fluoride as a cause of dental fluorosis in children 2024 · Cochrane All outcomes

  Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
  OR 0.89 [0.52, 1.52]
  2 studies · 258 participants
  Very low
• Topical fluoride as a cause of dental fluorosis in children 2024 · Cochrane All outcomes

  Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
  OR 0.79 [0.62, 1.02]
  3 studies · 2037 participants
  Very low

Lower socioeconomic position measured by poverty income and education vs Higher socioeconomic position

Allostatic load partly explained socioeconomic gradients in periodontal disease.

• Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. 2016 All outcomes

  United States
  no estimate extracted
  1 study
  GRADE not reported

Lower family socioeconomic status / income vs Higher socioeconomic position

Allostatic load increased the probability of periodontitis and the association varied by race/ethnicity.

• Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. 2016 All outcomes

  United States · Race/ethnicity
  no estimate extracted
  1 study
  GRADE not reported

Populations with a lower proportion of university-educated people (<33.78% with university level) vs Populations with a higher proportion of university-educated people (>=33.78% with university level)

The proportion of university-educated people was not associated with caries experience (DMFT); pooled DMFT was similar across subgroups and the meta-regression was non-significant; ungraded observational evidence.

• Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and… 2018 All outcomes

  Population/community-based studies of adults aged 19-60 years across multiple countries (studies published 1975-2016) · High university (>=33.78%)
  MEAN 10.91 [7.95, 13.87]
  9 studies
  GRADE not reported
• Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and… 2018 All outcomes

  Population/community-based studies of adults aged 19-60 years across multiple countries (studies published 1975-2016) · Low university (<33.78%)
  MEAN 10.62 [7.30, 13.93]
  9 studies
  GRADE not reported
• Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and… 2018 All outcomes

  Population/community-based studies of adults aged 19-60 years across multiple countries (studies published 1975-2016) · Adjusted (Model 1)
  Meta-regression coefficient -4.132903
  Studies not reported
  GRADE not reported

Sociodemographic and behavioural factors (older age, lower education, lower income, poor oral hygiene/brushing, smoking, disadvantaged/slum residence, sex) vs Referent groups (younger, higher education/income, better oral hygiene, non-slum residence)

Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded.

• Systematic review of oral health in slums and non-slum urban settings of Low and Middle-Income Countries (LMICs):… 2024 All outcomes

  Cross-sectional · Urban slums and non-slum/general-urban settings, LMICs
  Fourteen studies reported determinants: older age, less education, lower income, poor oral hygiene behaviour (brushing frequency, technique), infrequent dental visits and disadvantaged/slum residential setting were…
  14 studies
  GRADE not reported