What do systematic reviews say?

Intervention not reported

About 58% of 11-13 year-old children in Latin America and the Caribbean had dental caries in permanent teeth (95% CI 54-61%); certainty not graded.

• Does the Decline in Caries Prevalence of Latin American and Caribbean Children Continue in the New Century? Evidence… 2016 All outcomes

  Studies with data collected after 2000 (21st century) · Latin America and the Caribbean; population/community-based epidemiological surveys
  Prevalence 0.58 [0.54, 0.61]
  63 studies · 95188 participants
  GRADE not reported

Intervention not reported

• Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. 2019 All outcomes

  -
  Proportion with untreated caries NR (significantly higher in JIA)
  2 studies
  GRADE not reported

Disability (developmental, intellectual, or sensory) vs Persons without disabilities

Dental caries prevalence and severity are high among persons with disabilities in Saudi Arabia (60% to over 80%), and the one comparative autism study reported significantly higher caries than controls; synthesized narratively (ungraded).

• Disabilities and Disparities in Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis in Saudi… 2024 All outcomes

  Cross-sectional · Autism centres and dental/hospital settings in Saudi Arabia (Riyadh, Jeddah)
  Narrative synthesis (no pooled estimate). High dental caries burden among PWDs: caries prevalence 60% to over 80% (abstract). Alkahtani 2019 (hearing-impaired adults, single-arm): caries prevalence 82.2%, treatment…
  Studies not reported
  GRADE not reported

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

No significant difference in dental caries/severity between ART regimens (very low certainty).

• Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and Meta-Analysis. 2022 All outcomes

  Hospitals and AIDS outpatient centres in India, Brazil, and several Asian countries
  No significant difference in dental caries/severity between CLWH on cART and those on monotherapy or dual therapy (no numeric estimate reported in the text); 2 study(ies).
  2 studies
  Very low

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

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).

• 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) · Permanent dentition (DMFT > 0)
  OR 2.49 [1.86, 3.32]
  1 study · 724 participants
  GRADE not reported
• 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)
  OR 2.70 [2.01, 3.62]
  2 studies · 1028 participants
  GRADE not reported
• 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) · Primary dentition (dmft > 0)
  OR 1.93 [1.34, 2.79]
  1 study · 564 participants
  GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
  RR 0.70 [0.53, 0.94]
  4 studies · 2968 participants
  Very low
• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  <2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
  RR 0.95 [0.75, 1.21]
  2 studies
  GRADE not reported
• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  >=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
  RR 0.58 [0.40, 0.84]
  2 studies
  GRADE not reported

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

• Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. 2019 All outcomes

  Multiple countries (Brazil, Sweden, Germany); paediatric rheumatology/dental settings
  Higher JIA disease activity/severity was associated with worse oral outcomes in several studies: JADAS and global activity scores correlated positively with DMFT and gingival indices [27]; a polyarticular RF-negative…
  Studies not reported
  GRADE not reported