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Evidence found and GRADE certainty

417 questions · 819 findings · 72 reviews · Oral Health

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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%

TaqI (rs731236 T>C) polymorphism in the VDR gene (C allele / variant genotype) vs CC genotype vs CT/TT genotype (recessive model)

Dental caries susceptibility · Children and adults (no age limit) assessed for dental caries susceptibility

No significant association between the TaqI (rs731236 T>C) polymorphism and dental caries for mixed dentition caries under the recessive (CC vs CT/TT) model (OR 1.23, 95% CI 0.66 to 2.29); ungraded.

6 findings from 1 review
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TaqI (rs731236 T>C) polymorphism in the VDR gene (C allele / variant genotype) vs C allele vs T allele (allele contrast model)

Dental caries susceptibility · Children and adults (no age limit) assessed for dental caries susceptibility

No significant association between the TaqI (rs731236 T>C) polymorphism and dental caries in Caucasians under the allele contrast (C vs T) model (OR 1.16, 95% CI 0.90 to 1.50); ungraded.

6 findings from 1 review
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TaqI (rs731236 T>C) polymorphism in the VDR gene (C allele / variant genotype) vs CT genotype vs TT genotype (heterozygous model)

Dental caries susceptibility · Children and adults (no age limit) assessed for dental caries susceptibility

No significant association between the TaqI (rs731236 T>C) polymorphism and dental caries in Caucasians under the heterozygous (CT vs TT) model (OR 0.93, 95% CI 0.56 to 1.56); ungraded.

6 findings from 1 review
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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

Down syndrome vs Individuals without Down syndrome (healthy controls: siblings, schoolchildren or others)

Mean DMFT (decayed, missing, filled permanent teeth) · Individuals of all ages

Individuals with Down syndrome had a lower mean DMFT in permanent teeth than controls (pooled SMD -0.18, 95% CI -0.35 to -0.02; 6 studies; I2=20%); certainty of evidence not graded.

1 finding from 1 review

Individually designed, patient-centred preventive programme: dietary counselling (snacking timing, regular meals, fermentable carbohydrates) plus toothbrushing counselling, delivered by trained dental hygienists (a multi-intervention) vs Basic prevention offered as standard in public dental clinics

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children aged 11 to 12 years with at least one active initial caries lesion, screened in a town in Finland
2 findings from 1 review

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

Caries in primary teeth: dmft (3 years) · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, the dmft (primary dentition) index did not differ significantly between HIV+ children on ART and HIV-negative peers (MD 0.92, 95% CI -0.09 to 1.93; very low certainty).

2 findings from 1 review

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

Dental caries severity (dmfs index, primary dentition) · Children and adolescents (<18 years) living with HIV (CLWH)

In case-control studies, HIV+ children on ART had a significantly higher dmfs index than HIV-negative peers (MD 5.15, 95% CI 2.20 to 8.11; not separately GRADE-rated).

2 findings from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Dental caries increment, DMFT/dmft (whole-tooth level) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing has no statistically significant effect on whole-tooth caries (DMFT/dmft SMD 0.05, 95% CI -0.27 to 0.37; ungraded).

1 finding from 1 review

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

Caries in primary teeth: dmft (3 years) · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART versus no HAART showed no significant difference in the dmft index in case-control studies (MD 0.66, 95% CI -0.26 to 1.58; ungraded).

1 finding from 1 review

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

Annual increment in DMFS (D3) · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Oral-health-education interventions significantly reduced net increment in DMFS (SMD -1.05); no significant subgroup difference vs other interventions (P=0.74).

5 findings from 1 review
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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