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Evidence found and GRADE certainty

10 questions · 13 findings · 2 reviews

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No studies found 1 · 7.7%GRADE not reported 12 · 92.3%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

High-intensity sweeteners other than stevia (aspartame, sucralose, saccharin) in food products vs Any comparator (dietary sugar, no treatment, or other sweetener)

Effects of non-stevia high-intensity sweeteners (aspartame, sucralose, saccharin) on cariogenic bacteria in dental plaque or saliva · healthy people

No eligible studies evaluated high-intensity sweeteners such as aspartame, sucralose, or saccharin for their effect on cariogenic bacteria.

1 finding from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs Sorbitol (low-intensity sweetener)

Change in Mutans streptococci (MS) count in saliva · healthy people

Xylitol and sorbitol did not differ significantly for Mutans streptococci in saliva (SMD -0.16, 95% CI -0.44 to 0.12; 2 trials, P=.25); not GRADE-rated.

1 finding from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs Sorbitol (low-intensity sweetener)

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol reduced Mutans streptococci in dental plaque more than sorbitol (SMD -0.45, 95% CI -0.69 to -0.21; 4 trials, I2=7%); not GRADE-rated.

1 finding from 1 review

Stevia (high-intensity/non-nutritive sweetener) in a daily snack vs Baseline (within-group change); white sugar snack is a parallel arm with no between-group effect size reported

Change in Mutans streptococci (MS) and Lactobacilli in saliva · Schoolchildren (6-9 years), high caries risk

The single stevia trial (Cocco 2019) reported a significant reduction in salivary Mutans streptococci and lactobacilli, but gave no effect size and was not GRADE-rated.

1 finding from 1 review
  • Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. 2024 All outcomes
    42 days · Schoolchildren in Italy, high caries risk; sweetener delivered as a daily snack · Single study (Cocco 2019); not pooled
    Cocco 2019 (the only high-intensity sweetener trial): the stevia snack showed a significant decrease in MS (P < .01) and in lactobacilli (P = .03) versus baseline, whereas the white-sugar snack showed no significant…
    1 study · 271 participants
    GRADE not reported

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs no intervention

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol significantly reduced Mutans streptococci in dental plaque compared with no treatment (SMD -0.73, 95% CI -1.09 to -0.37; 5 trials, I2=53%; not GRADE-rated).

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected Significant Caries (SiC) index · Alaska Native children (below age 18)

A simulation projected a 50% drop in the Significant Caries index for children (12.3 to 6.1) under the PDHA model (certainty not graded).

2 findings from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected proportion of caries-free children (5-18 years) · Alaska Native children (below age 18)

A simulation projected 0% of children aged 5-18 would be caries-free under the baseline scenario (certainty not graded).

3 findings from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected receipt of school-based prevention services · Alaska Native children (below age 18)

A simulation projected that over 90% of children would receive school-based prevention services under the PDHA model, up from 53% (certainty not graded).

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected dental care utilisation · Alaska Native children (below age 18)

A simulation projected that the PDHA program would raise dental care utilisation from 75% to 90% (certainty not graded).

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected mean DMFT (children below 5 years) · Alaska Native children (below age 18)

A simulation projected mean DMFT in children under 5 would fall from 7.4 to 4.9 under the PDHA model (certainty not graded).

1 finding from 1 review