Findings

What do systematic reviews say?

417 questions · 819 findings · 72 reviews

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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%

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Caries in primary teeth: dmft (3 years) · Children and adolescents with juvenile idiopathic arthritis (JIA)

There was no significant difference in dental caries of the primary teeth (dmft) between children with JIA and healthy peers (pooled MD -1.16, 95% CI -3.02 to 0.71; 3 cross-sectional studies; very high heterogeneity I2=87.9%; ungraded).

1 finding from 1 review

Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. 2019 All outcomes
United Kingdom and Brazil (Ahmed 2004, Santos 2015, Welbury 2003); paediatric dental/rheumatology settings
MD -1.16 [-3.02, 0.71]
3 studies · 141 participants
GRADE not reported

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Dental caries in permanent teeth · Children and adolescents with juvenile idiopathic arthritis (JIA)

There was no significant difference in dental caries of the permanent teeth (DMFT) between children/adolescents with JIA and healthy peers (pooled MD -0.08, 95% CI -0.42 to 0.26; 6 cross-sectional studies; no heterogeneity I2=0%; ungraded).

1 finding from 1 review

Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. 2019 All outcomes
United Kingdom, Brazil and Poland (Ahmed 2004, Feres de Melo 2014, Santos 2015, Welbury 2003, Kobus 2017); paediatric dental/rheumatology settings
MD -0.08 [-0.42, 0.26]
6 studies · 320 participants
GRADE not reported

Referral letter based on the common-sense model (CSM) of self-regulation plus dental information guide (DIG) vs Standard referral letter

Proportion of children with treated/untreated caries (receipt of dental care) · School children, primary schools in the USA

It is very uncertain whether referral letter based on the common-sense model (CSM) of… changes proportion of children with treated/untreated caries (receipt of… compared with standard referral letter (very low certainty).

1 finding from 1 review

School dental screening programmes for oral health 2022 · Cochrane All outcomes
mean 8 months
OR 1.26 [0.82, 1.93]
1 study · 395 participants
Very low

Slum residence vs Non-slum urban setting

Dental caries · Adult residents of slums and non-slum urban settings of LMICs

Slum residents had non-significantly higher odds of caries than non-slum residents (OR 1.21, 95% CI 0.94-1.56; single study); ungraded.

1 finding from 1 review

Systematic review of oral health in slums and non-slum urban settings of Low and Middle-Income Countries (LMICs):… 2024 All outcomes
Cross-sectional · Urban slums and non-slum/general-urban settings, LMICs · Slum vs non-slum urban (Osuh 2022, Nigeria)
OR 1.21 [0.94, 1.56]
1 study · 1357 participants
GRADE not reported

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

Dental caries prevalence · Children or adolescents

In permanent dentition, CLWH on ART had higher caries prevalence than healthy controls (OR 2.49, 95% CI 1.86 to 3.32; single study).

3 findings from 1 review

Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · Permanent dentition (DMFT > 0)
OR 2.49 [1.86, 3.32]
1 study · 724 participants
GRADE not reported
Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal)
OR 2.70 [2.01, 3.62]
2 studies · 1028 participants
GRADE not reported
Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · Primary dentition (dmft > 0)
OR 1.93 [1.34, 2.79]
1 study · 564 participants
GRADE not reported

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

Dental caries (by severity) · Children or adolescents

One study reported higher median caries severity among CLWH under 12 years; no meta-analytic estimate was pooled.

1 finding from 1 review

Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal)
Rajonson 2017 reported significantly higher median DMFT/dmft/DMFS/dmfs among CLWH than uninfected children below 12 years; no pooled effect estimate reported.
1 study
GRADE not reported

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

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: oral health education
SMD -1.05 [-2.03, -0.08]
3 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · WHO health-promoting-schools framework
SMD -0.57 [-1.56, 0.42]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Non-WHO-framework interventions
SMD -1.88 [-3.15, -0.60]
Studies not reported
GRADE not reported

Show 2 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: other (daily tooth brushing)
SMD -1.23 [-1.46, -1.00]
1 study
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -1.09 [-1.91, -0.27]
4 studies · 3755 participants
Very low

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

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 5-8 years
SMD -0.36 [-0.76, 0.04]
5 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.34 [-0.69, 0.02]
5 studies · 5492 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 9-12 years
SMD -0.20 [-0.44, 0.04]
1 study
GRADE not reported

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

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

Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. 2016 All outcomes
Kindergarten children, California, USA (Peers and Wellness Study)
no estimate extracted
1 study · 94 participants
GRADE not reported

Electronic cigarette use vs Non-smokers (non-users)

Dental caries and cariogenic bacteria (Streptococcus mutans, Lactobacilli) · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with more cariogenic bacteria and increased dental caries risk compared with non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

An Umbrella Review of E-Cigarettes' Impact on Oral Microbiota and Biofilm Buildup. 2025 All outcomes
Oral health / dental care (community and clinical samples)
Narrative synthesis: e-cigarette use linked to increased cariogenic bacteria (S. mutans, Lactobacilli) and worsening dental caries, with flavored e-liquids noted as a caries risk factor (Zieba, Camoni, Yang…
3 studies
GRADE not reported

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

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
RR 0.70 [0.53, 0.94]
4 studies · 2968 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
RR 0.95 [0.75, 1.21]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
RR 0.58 [0.40, 0.84]
2 studies
GRADE not reported

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Prevalence and severity of oral and TMJ diseases/conditions (periodontal status and dental caries) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

1 finding from 1 review

Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. 2019 All outcomes
Multiple countries (Brazil, Sweden, Germany); paediatric rheumatology/dental settings
Higher JIA disease activity/severity was associated with worse oral outcomes in several studies: JADAS and global activity scores correlated positively with DMFT and gingival indices [27]; a polyarticular RF-negative…
Studies not reported
GRADE not reported

Pre-radiotherapy extraction of diseased molar teeth vs Conservative treatment (restoration of the teeth and leaving them in place during radiotherapy, with oral health education and disease prevention: oral hygiene, fluoride, diet advice)

Development of post-radiotherapy dental complications (caries, fractured teeth, periapical infection, periodontal disease, osteoradionecrosis) · Patients diagnosed with head and neck cancer planned to undergo any type of radiotherapy (external beam, intensity modulated,…

The review found no eligible studies for this question.

1 finding from 1 review

Dental extractions prior to radiotherapy to the jaws for reducing post‐radiotherapy dental complications 2013 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Pre-radiotherapy extraction of healthy molar teeth vs Conservative treatment (leaving the teeth in place during radiotherapy, with oral health education and disease prevention: oral hygiene, fluoride, diet advice)

The review found no eligible studies for this question.

1 finding from 1 review

Dental extractions prior to radiotherapy to the jaws for reducing post‐radiotherapy dental complications 2013 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).

1 finding from 1 review

Fluoride mouthrinses for prevention of initial caries in orthodontic patients - a systematic review and meta-analysis. 2025 All outcomes
At debonding (~23-24 months) · Clinical orthodontic (fixed multi-bracket appliance) treatment
In one study assessments of proximal caries incidence were made as well [18]. However, just the data on the incidence of white spot lesions was included in our meta-analysis as different endpoints for the assessments…
1 study
GRADE not reported

Referral letter based on the common-sense model (CSM) of self-regulation vs Standard referral letter

Proportion of children with treated/untreated caries (receipt of dental care) · School children, primary schools in the USA

1 finding from 1 review

School dental screening programmes for oral health 2022 · Cochrane All outcomes
mean 8 months
OR 0.97 [0.62, 1.51]
1 study · 388 participants
Very low