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Evidence found and GRADE certainty

394 questions · 795 findings · 66 reviews · Dental caries

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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%

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

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

Inflammatory bowel disease (IBD) vs Healthy controls without IBD

DMFT/DMFS index (dental caries experience) · Patients with IBD (Crohn's disease and ulcerative colitis) and controls without IBD

Most included studies reported higher dental caries indices (DMF-t/DMF-s) in IBD patients (especially ulcerative colitis), but findings were inconsistent across studies and were not meta-analyzed or GRADE-rated.

1 finding from 1 review
  • Oral Health Status in Patients with Inflammatory Bowel Diseases: A Systematic Review. 2021 All outcomes
    Hospital/clinic-based case-control and cross-sectional studies in 11 countries; 15 studies total (1748 participants: 1104 Crohn's disease, 534 ulcerative colitis, 110 IBD-form unspecified)
    Not meta-analyzed (heterogeneity of caries indices). Abstract: "in most studies, patients with IBD were characterized by higher values of caries indices." Table 3 examples (IBD/subtype vs control): Zhang 2020 DMF-t…
    Studies not reported
    GRADE not reported

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

Dental caries in permanent teeth · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, the DMFT index did not differ significantly between HIV+ children on ART and HIV-negative peers (MD 0.60, 95% CI -0.53 to 1.72; very low certainty).

2 findings from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing produces a small but statistically significant reduction in tooth-surface caries (DMFS/dmfs SMD -0.22, 95% CI -0.42 to -0.01; ungraded).

1 finding from 1 review

HAART (highly active antiretroviral therapy, >=3 drugs) vs HIV-positive not receiving HAART (standard ART or HAART-naive)

Dental caries in permanent teeth · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART was associated with a significantly higher DMFT index than no HAART in case-control studies (MD 2.02, 95% CI 1.24 to 2.80; ungraded).

1 finding from 1 review

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

Dental caries (by severity) · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, HIV+ children on ART had a significantly higher DMFS index than HIV-negative peers (MD 2.00, 95% CI 1.54 to 2.46; not separately GRADE-rated).

2 findings from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported

Good brushing habits (>=2 daily tooth brushing) vs Children without dental caries

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

Good brushing habits (>=2 daily) were associated with 35% lower odds of dental caries (OR 0.65, 95% CI 0.46 to 0.92; 7 studies; not GRADE-rated).

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

Maternal education attainment vs Children without dental caries

Dental caries (association with primary maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Primary maternal education was associated with 25% higher odds of dental caries (OR 1.25, 95% CI 1.02 to 1.54; 7 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Children without dental caries

Dental caries (association with no formal maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

No formal maternal education showed a non-significant trend toward higher odds of dental caries (OR 1.34, 95% CI 0.76 to 2.36; 3 studies; not GRADE-rated).

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

Intervention not reported

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

In Brazil, pooled primary-teeth caries prevalence in 5-6 year-olds was 52% (95% CI 49-54%); certainty 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

About 56% of 5-6 year-old children in Latin America and the Caribbean had dental caries in primary teeth (95% CI 52-59%); certainty not graded.

1 finding from 1 review

Low socioeconomic status and family financial stress vs Higher socioeconomic status and lower stress

Salivary cortisol, cariogenic bacterial load and dental caries · Kindergarten-age children

In one cross-sectional study of children, low socioeconomic status, higher basal salivary cortisol and higher cariogenic bacterial counts were each independently associated with higher dental caries risk; not pooled (ungraded).

1 finding from 1 review

Intervention not reported

Dental caries prevalence in permanent teeth (cavitated lesions) · Children aged 11-13 years in Latin America and the Caribbean

In other Latin American/Caribbean countries, pooled permanent-teeth caries prevalence was 64% (95% CI 45-79%), not significantly different from Brazil (p=0.42); certainty not graded.

1 finding from 1 review

Intervention not reported

Dental caries prevalence in permanent teeth (cavitated lesions) · Children aged 11-13 years in Latin America and the Caribbean

In Brazil, pooled permanent-teeth caries prevalence in 11-13 year-olds was 56% (95% CI 53-60%), with a significant declining trend over time; certainty not graded.

1 finding from 1 review

Intervention not reported

Dental caries prevalence in permanent teeth (cavitated lesions) · Children aged 11-13 years in Latin America and the Caribbean

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.

1 finding from 1 review

Sugary drinks/sweets consumption vs Children without dental caries

Dental caries (association with sugary drinks/sweets consumption) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Sugary drinks/sweets consumption was associated with about twice the odds of dental caries in LMIC children (OR 2.04, 95% CI 1.59 to 2.60; 7 studies; not GRADE-rated).

1 finding from 1 review