What do systematic reviews say?

CT + TT genotype (T-allele carriers) of AMELX rs946252 vs CC genotype

The pooled odds ratio was 0.98 (95% CI 0.46 to 2.07).

• Association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility: a meta-analysis. 2020 All outcomes

  Ethnicity: Mixed (n=1)
  OR 0.98 [0.46, 2.07]
  1 study
  GRADE not reported

CT + TT genotype (T-allele carriers) of AMELX rs2106416 vs CC genotype

The pooled odds ratio was 0.59 (95% CI 0.15 to 2.31).

• Association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility: a meta-analysis. 2020 All outcomes

  Overall (n=3)
  OR 0.59 [0.15, 2.31]
  3 studies · 285 participants
  GRADE not reported

AG genotype of LTF rs1126478 vs AA genotype

The pooled odds ratio was 1.00 (95% CI 0.80 to 1.25).

• Association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility: a meta-analysis. 2020 All outcomes

  Overall (n=4)
  OR 1.00 [0.80, 1.25]
  4 studies · 2662 participants
  GRADE not reported

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

No eligible studies examined the influence of complementary feeding practices on later dental caries; this is an evidence gap.

• Complementary Feeding Caregivers' Practices and Growth, Risk of Overweight/Obesity, and Other Non-Communicable… 2022 All outcomes

  Later in life · Outpatient care in Western industrialized (European/Anglo-Saxon) countries
  No studies on the influence of caregivers' feeding practices during complementary feeding on dental caries later in life were identified.
  0 studies
  No studies found

Intervention not reported

• Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2021 All outcomes

  Onabotulinumtoxin A open-label, no control (Møller 2015)
  Event count (narrative; no estimate) No cases of tooth decay (0 caries events)
  1 study
  GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

• Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes

  Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care · BoNT-B 2500 U vs placebo (Isaacson RCT)
  RR 2.4 [0.48, 11.80]
  1 study
  GRADE not reported
• Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes

  Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care · BoNT-B 3500 U vs placebo (Isaacson RCT)
  RR 1.4 [0.24, 8.12]
  1 study
  GRADE not reported

Intervention not reported

In Australia, the pooled prevalence of primary-teeth caries in children was 28.5% (95% CI 20.3 to 38.5); certainty not graded.

• Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and… 2020 All outcomes

  Community- and school-based child populations worldwide (multiple continents) · Australia
  Prevalence 0.285 [0.203, 0.385]
  3 studies · 6472 participants
  GRADE not reported

Intervention not reported

In Africa, the pooled prevalence of primary-teeth caries in children was 53.1% (95% CI 44.3 to 61.7); certainty not graded.

• Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and… 2020 All outcomes

  Community- and school-based child populations worldwide (multiple continents) · Africa
  Prevalence 0.531 [0.443, 0.617]
  5 studies · 3004 participants
  GRADE not reported

Intervention not reported

In Asia, the pooled prevalence of primary-teeth caries in children was 52.6% (95% CI 46.7 to 58.5); certainty not graded.

• Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and… 2020 All outcomes

  Community- and school-based child populations worldwide (multiple continents) · Asia
  Prevalence 0.526 [0.467, 0.585]
  50 studies · 54680 participants
  GRADE not reported

Intervention not reported

In Europe, the pooled prevalence of primary-teeth caries in children was 21.4% (95% CI 15.3 to 29.1); certainty not graded.

• Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and… 2020 All outcomes

  Community- and school-based child populations worldwide (multiple continents) · Europe
  Prevalence 0.214 [0.153, 0.291]
  10 studies · 9977 participants
  GRADE not reported

Intervention not reported

In the Americas, the pooled prevalence of primary-teeth caries in children was 45.8% (95% CI 34.2 to 58.0); certainty not graded.

• Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and… 2020 All outcomes

  Community- and school-based child populations worldwide (multiple continents) · America
  Prevalence 0.458 [0.342, 0.58]
  14 studies · 6825 participants
  GRADE not reported

Intervention not reported

The pooled worldwide prevalence of dental caries in primary teeth in children was 46.2% (95% CI 41.6 to 50.8), with very high heterogeneity (I2=99.2%); certainty not graded.

• Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and… 2020 All outcomes

  Community- and school-based child populations worldwide (multiple continents)
  Prevalence 0.462 [0.416, 0.508]
  81 studies · 80405 participants
  GRADE not reported

High maternal allostatic load (chronic stress) and low socioeconomic status vs Lower maternal allostatic load

In one cross-sectional study, higher maternal allostatic load was associated with child dental caries experience and with health-related maternal care-taking behaviours; not pooled (ungraded).

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

  General population mother-child pairs, USA (NHANES III)
  no estimate extracted
  1 study · 1184 participants
  GRADE not reported

Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Among adults, the lower DMFT score in vegetarians was smaller and not statistically significant (mean difference -0.09, 95% CI -0.32 to 0.13; ungraded).

• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings · Adults only
  MD -0.09 [-0.32, 0.13]
  3 studies
  GRADE not reported
• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
  MD -0.15 [-0.29, -0.02]
  4 studies
  GRADE not reported

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

• 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) · Overall
  MEAN 9.38 [7.58, 11.18]
  14 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) · Unadjusted model
  Meta-regression coefficient 4.324884
  Studies not reported
  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) · Younger (mean age <=33.4 years)
  MEAN 7.31 [5.89, 8.73]
  7 studies
  GRADE not reported

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)

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.

• 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) · Very high HDI (>=0.800)
  MEAN 11.91 [10.20, 13.63]
  19 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) · Overall (very high + high HDI)
  MEAN 11.49 [9.96, 13.03]
  25 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) · High HDI (<0.800)
  MEAN 10.01 [5.34, 14.69]
  6 studies
  GRADE not reported

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)

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.

• 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 SES (>=22.4% with low SES)
  MEAN 15.99 [14.35, 17.63]
  4 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) · Unadjusted model
  Meta-regression coefficient 10.49365
  Studies not reported
  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) · Overall
  MEAN 11.49 [7.50, 15.48]
  7 studies
  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

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)

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.

• 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) · Unadjusted model
  Meta-regression coefficient -2.301079
  Studies not reported
  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 schooling (>=33.60% with low schooling)
  MEAN 9.63 [4.38, 14.89]
  5 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) · Overall
  MEAN 10.87 [7.53, 14.20]
  11 studies
  GRADE not reported

HIV-infected children on antiretroviral therapy (HI) vs HIV-exposed but uninfected children (HEU)

HIV-infected children on ART had higher odds of dental caries than HEU children in a cohort study (OR 2.88, 95% CI 1.71 to 4.84; ungraded).

• Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review… 2025 All outcomes

  Prospective follow-up · Dental examination of children/adolescents with HIV in clinic and community settings; low- and middle-income countries (Brazil, India, Nigeria, Cambodia, Uganda, West Africa) · Cohort studies
  OR 2.88 [1.71, 4.84]
  Studies not reported
  GRADE not reported
• Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review… 2025 All outcomes

  Not specified (cross-sectional) · Dental examination of children/adolescents with HIV in clinic and community settings; low- and middle-income countries (Brazil, India, Nigeria, Cambodia, Uganda, West Africa) · Cross-sectional studies
  OR 3.73 [1.88, 7.40]
  Studies not reported
  GRADE not reported