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What do systematic reviews say?

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Evidence found and GRADE certainty

394 questions · 795 findings · 66 reviews · Dental caries

No studies found 5 · 0.6%GRADE not reported 753 · 94.7%Very low 31 · 3.9%Low 4 · 0.5%Moderate 2 · 0.3%High 0 · 0%

Genome-wide common variants (aggregate additive; LD score regression) vs Not applicable (variance-component estimate)

Dental caries - SNP-based heritability · Japanese adults (present-study cohort)

SNP-based heritability of dental caries was low (h2=0.0258, SE 0.0155); ungraded.

1 finding from 1 review

Mixed breast- and bottle-feeding vs Bottle feeding

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between mixed breast-and-bottle-fed and bottle-fed-only children (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Higher parental education (tertiary) vs Parental high school (secondary) education

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

Parental tertiary education (vs high-school education) was associated with about 1.8 times higher odds of early childhood caries in South Africa (OR 1.77, 95% CI 1.22-2.57; 2 studies; not GRADE-rated).

1 finding from 1 review

Bottle-feeding only vs Breastfeeding only

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between bottle-fed-only and breast-fed-only children (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Low parental socioeconomic status (SES) vs High parental socioeconomic status (SES)

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between children of low- versus high-SES parents (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Untreated dental caries and caries risk · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

Across individual cross-sectional studies, e-cigarette users tended to have more untreated caries and higher caries risk than non-smokers (per-study OR ~2.0-4.2), but results were not pooled (ungraded, narrative).

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Sensitivity for dental caries diagnosis · Children and adults with primary or permanent dentition

Sensitivity ranged from 48% to 98.3% across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Specificity for dental caries diagnosis · Children and adults with primary or permanent dentition

Specificity ranged from 83% to 100% across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Adolescents (12-18 years) without background systemic disease

In a subgroup analysis, probiotics reduced the number of caries in adolescents (MD -0.60, 95%CI -0.92 to -0.28; p-interaction=0.02); not GRADE-rated.

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the number of dental caries versus control (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; low certainty).

1 finding from 1 review

Socioeconomic status category vs Children without dental caries

Dental caries · Children (deciduous and/or permanent dentition) in low- and middle-income countries

High SES showed no significant association with dental caries (OR 1.03, 95% CI 0.81 to 1.31; 5 studies; not GRADE-rated).

2 findings from 1 review

Electronic cigarette use vs Non-smokers

DMFT/DMFS index (dental caries experience) · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

A meta-analysis of 3 studies compared DMFT/DMFS in e-cigarette users vs non-smokers, but the pooled effect appears only in Figure 3A (unavailable) and heterogeneity was very high (I2=98%); the effect of vaping on dental caries remains unclear (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