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Evidence found and GRADE certainty

76 questions · 167 findings · 22 reviews

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No studies found 0 · 0%GRADE not reported 159 · 95.2%Very low 7 · 4.2%Low 1 · 0.6%Moderate 0 · 0%High 0 · 0%

Western/Northern Europe (UN M49 region) vs Eastern/Southern Europe (UN M49 geographical categorization)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT is lowest in West Europe (0.88) and North Europe (1.34) and highest in East Europe (2.76) and South Europe (2.61) (Figure 3); not GRADE-rated.

4 findings from 1 review
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Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT in 12-year-olds rises as national income falls: 0.90 (very high income), 2.38 (high income), 3.30 (middle income) (Figure 2); not GRADE-rated.

3 findings from 1 review

Very high Human Development Index (HDI >=0.800) vs High Human Development Index (HDI 0.700-0.799)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT was higher in high-HDI (3.41) than very-high-HDI (1.73) countries (ANOVA p<.01); descriptive country-level means only, not meta-analyzed or GRADE-rated.

2 findings from 1 review

All European countries pooled (overall) vs None (overall pooled prevalence)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Across European countries the overall pooled mean DMFT in 12-year-olds was 2.10 (95% CI 1.63 to 2.57), with very high between-country heterogeneity (I2=100%); not GRADE-rated.

1 finding from 1 review

Isolated cleft palate (CP) or other specific cleft type vs Cleft lip and palate (CLP) or other cleft type

Caries experience by cleft type · Children in the primary dentition with cleft lip and/or palate (CL/P)

Whether cleft type is associated with caries experience could not be determined; the planned CP-versus-CL/P subgroup analysis was not possible owing to sparse isolated-CP data (5 studies described narratively; ungraded).

1 finding from 1 review
  • Caries in children with and without orofacial clefting: A systematic review and meta-analysis. 2022 All outcomes
    Children with CL/P and comparable non-CL/P children across 12 countries (India, Brazil, China, Sweden, UK, USA, Germany, Greece, Ireland, Netherlands, Jordan, Thailand); studies published 1989-2021
    Five studies investigated caries experience by cleft type (Howe 2017; Kirchberg 2014; Mutarai 2008; Sunderji 2017; Zhu 2010). A subgroup analysis comparing CP and CL/P as different entities was not possible due to the…
    5 studies
    GRADE not reported

Older adults (population mean age >33.4 years) vs Younger adults (population mean age <=33.4 years)

Caries experience (mean DMFT) · Adults aged 19-60 years

Studies of older adults (mean age >33.4 years) had higher pooled DMFT than younger adults, but the age to DMFT meta-regression was not statistically significant; ungraded observational evidence.

5 findings from 1 review
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Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with low socioeconomic status (>=22.4% of the population with low SES) vs Populations with higher socioeconomic status (<22.4% of the population with low SES)

Caries experience (mean DMFT) · Adults aged 19-60 years

Populations with a higher proportion of people with low socioeconomic status had higher caries experience (pooled DMFT 15.99 vs 5.50), and meta-regression associated low SES with higher DMFT (about 10.35 more DMFT per unit; p=0.050); ungraded observational evidence.

5 findings from 1 review
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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)

Caries experience (mean DMFT) · Adults aged 19-60 years

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.

5 findings from 1 review
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Populations with a low level of schooling (>=33.60% of the population with low schooling) vs Populations with a higher level of schooling (<33.60% of the population with low schooling)

Caries experience (mean DMFT) · Adults aged 19-60 years

Population level of schooling was not significantly associated with caries experience (DMFT) in subgroup meta-analysis or meta-regression; ungraded observational evidence with very high heterogeneity.

5 findings from 1 review
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High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Dental caries prevalence · Nigerian individuals, including children and adults, with primary or permanent dentition

High-frequency sugar consumption was associated with 18% higher but non-significant odds of dental caries in Nigeria (OR 1.18, 95% CI 0.87 to 1.59; I2=36%; ungraded).

1 finding from 1 review

Illicit drug use vs People who do not use drugs

DMFT/DMFS index (dental caries experience) · People who use drugs (PWUD): methamphetamine, heroin, opiate, cannabis and cocaine users

Illicit drug use was associated with substantially higher odds of dental caries experience (DMFT) (pooled OR 4.11, 95% CI 2.07-8.15; 7 studies; high heterogeneity I2=90.5%; ungraded).

1 finding from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from heavily contaminated areas, individual studies gave inconsistent DMFT/dmft differences; the review did not pool them and drew no firm conclusion (ungraded).

4 findings from 1 review
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Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from weakly contaminated areas, individual cross-sectional studies reported mostly higher but inconsistent DMFT/dmft in exposed vs non-exposed children; the review did not pool the data and drew no firm conclusion (ungraded).

4 findings from 1 review
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Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children of mixed ages (mean approximately 12 years; no age separation)

In children of mixed ages from heavily contaminated areas, individual studies reported modestly higher DMFT/dmft in exposed children; the review did not pool them and drew no firm conclusion (ungraded).

5 findings from 1 review
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Residence in low-contamination area (approx. 5-15 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from a low-contamination area, individual studies reported higher DMFT/dmft in exposed than non-exposed children; not pooled (ungraded).

2 findings from 1 review

Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from weakly contaminated areas, individual studies mostly reported higher DMFT/dmft in exposed children but with wide variation; the review did not pool the data (ungraded).

9 findings from 1 review
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Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in the United Kingdom

In UK studies, OHPPs were associated with lower DMFT/S (OR 0.04, 95% CI 0.00 to 0.58; ungraded).

1 finding from 1 review

Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children of mixed ages (mean approximately 12 years; no age separation)

In children of mixed ages from a weakly contaminated area, one study reported higher DMFT/dmft in exposed than non-exposed children; not pooled (ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review