Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

417 questions · 819 findings · 72 reviews

No studies found 9 · 1.1%GRADE not reported 759 · 92.7%Very low 39 · 4.8%Low 5 · 0.6%Moderate 6 · 0.7%High 1 · 0.1%

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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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

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 5-7 years (early school-age)

In early school-age children (5-7 y) from heavily contaminated areas, individual studies gave conflicting DMFT/dmft differences (some favouring exposed, some non-exposed); the review did not pool them (ungraded).

4 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 5-7 years (early school-age)

In early school-age children (5-7 y) from a low-contamination area, one study reported higher DMFT/dmft in exposed than non-exposed children; the estimate was not pooled (ungraded).

1 finding from 1 review

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Dental caries prevalence · Institutionalized orphan children (roughly 3 to 18 years)

Institutionalized orphan children may be at higher risk of dental caries than parented children (pooled RR 1.19), but the estimate is imprecise and not statistically significant (very low certainty).

1 finding from 1 review

GERD vs Healthy individuals without reflux (controls)

Dental caries · Adults with gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR)

Reflux appears associated with a higher prevalence of dental caries than in healthy individuals based on three studies, though to a lesser extent than erosion; evidence is ungraded and not pooled.

1 finding from 1 review

Postnatal passive tobacco exposure (secondhand/household smoke in infancy) vs No passive tobacco exposure (non-exposed children)

Caries presence in primary teeth · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

Postnatal (infancy) tobacco exposure is associated with higher odds of caries in primary dentition (pooled OR 1.72, 95% CI 1.45 to 2.05; 13 studies; high heterogeneity I2=83%); certainty not graded.

1 finding from 1 review

Prenatal passive tobacco exposure (maternal smoking during pregnancy / in the womb) vs No passive tobacco exposure (non-exposed children)

Caries presence in primary teeth · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

Prenatal (in-womb) tobacco exposure is associated with higher odds of caries in primary dentition (pooled OR 1.46, 95% CI 1.41 to 1.52; 4 studies; no heterogeneity); certainty not graded.

1 finding from 1 review

Postnatal passive tobacco exposure (secondhand/household smoke in infancy) vs No passive tobacco exposure (non-exposed children)

Dental caries in permanent teeth · Children and adolescents with permanent dentition

Postnatal (infancy) tobacco exposure is associated with higher odds of caries in permanent dentition (pooled OR 1.30, 95% CI 1.25 to 1.34; 9 studies; no heterogeneity); certainty not graded.

1 finding from 1 review

Prenatal passive tobacco exposure (maternal smoking during pregnancy / in the womb) vs No passive tobacco exposure (non-exposed children)

Dental caries in permanent teeth · Children and adolescents with permanent dentition

No eligible studies examined prenatal tobacco exposure and caries in permanent dentition.

1 finding from 1 review

Non-syndromic cleft lip and palate (CLP) status and its oral microbiota (exposure/grouping) vs Children and adolescents aged 0-18 years without CLP (controls)

Dental caries · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

Pooling 3 studies, children/adolescents with CLP were about 2.03 times more likely to have dental caries than non-CLP controls (p<0.005; low heterogeneity), though most included studies were at high risk of bias; the evidence is ungraded.

1 finding from 1 review

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

Positive predictive value for dental caries diagnosis · Children and adults with primary or permanent dentition

Positive predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; 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

Negative predictive value for dental caries diagnosis · Children and adults with primary or permanent dentition

Negative predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Passive tobacco exposure (prenatal maternal smoking or postnatal secondhand/household smoke) vs No passive tobacco exposure (non-exposed children)

Dental caries · Children and adolescents (general population, aged under 20 years)

In children and adolescents, passive tobacco exposure (prenatal or postnatal) is associated with higher odds of dental caries (pooled OR 1.53, 95% CI 1.39 to 1.68; 21 studies), though heterogeneity was high (I2=86.5%); certainty of evidence not graded.

1 finding from 1 review

Intervention not reported

Dental caries prevalence in primary teeth (cavitated lesions) · Children aged 5-6 years in Latin America and the Caribbean

In other Latin American/Caribbean countries, pooled primary-teeth caries prevalence was 70% (95% CI 59-79%), significantly higher than Brazil (p=0.002); certainty not graded.

1 finding from 1 review