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Evidence found and GRADE certainty

417 questions · 819 findings · 72 reviews · Oral Health

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%

Obesity or overweight (higher BMI, mostly WHO BMI ≥25/≥30; 2 studies used waist circumference) vs Normal Weight or Non‐Obese

Dental caries · Adults (≥18 years)

After adjustment for confounders, obesity/overweight was not associated with dental caries (OR 1.00, 95% CI 0.89 to 1.12; ungraded).

9 findings from 1 review
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High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Early childhood caries experience (mean dmft) · Nigerian children with primary dentition (approximately 6 months to 5 years)

In primary dentition, high-frequency sugar consumption was associated with slightly higher, non-significant odds of caries (OR 1.13, 95% CI 0.23 to 5.44), with high heterogeneity (I2=83%; ungraded).

1 finding from 1 review

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

Dental caries · Individuals of all ages

Individuals with Down syndrome had a lower prevalence of dental caries than those without (pooled OR 0.36, 95% CI 0.22 to 0.57; 2 studies; I2=0%); certainty of evidence not graded.

1 finding from 1 review

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

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

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

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

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

Referral letter based on the common-sense model (CSM) plus dental information guide (DIG) vs Referral letter based on the common-sense model (CSM) alone

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) plus dental… changes proportion of children with treated/untreated caries (receipt of… compared with referral letter based on the common-sense model (CSM) alone (very low certainty).

1 finding from 1 review

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

HDI (quantitative) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

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

rs10974056 effect allele A (intron variant in GLIS3, chr9:3,889,264) vs Non-effect allele C

Dental caries · Adults from Japanese and European cohorts (present-study Japanese direct-to-consumer cohort + GLIDE consortium and UK Biobank European…

Meta-analysis identified a novel genome-wide-significant locus for dental caries at rs10974056 in GLIS3 (P=3.93E-08); ungraded.

1 finding from 1 review

rs4801882 effect allele G (intron variant in SIGLEC5, chr19:52,127,053) vs Non-effect allele A

Dental caries · Adults from Japanese and European cohorts (present-study Japanese direct-to-consumer cohort + GLIDE consortium and UK Biobank European…

Meta-analysis identified a novel genome-wide-significant locus for dental caries at rs4801882 in SIGLEC5 (P=1.71E-08); ungraded.

1 finding from 1 review

Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Dental caries measures other than pooled DMFT (DMFS, decayed/filled surfaces and teeth, root caries, nonvisible lesions, white spots) · General population (children and adults) assessed for dental hard-tissue health

Evidence on other dental-caries measures was inconsistent: some indices (decayed surfaces/teeth, root caries, white spots) were higher in vegetarians while some studies found lower caries in vegetarian children (ungraded).

1 finding from 1 review
  • Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes
    Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
    Eleven studies reported dental caries using 11 definitions; four (DMFT) were meta-analysed (see O2). Narrative findings were inconsistent: DMFS results were mixed; decayed surfaces and decayed teeth and percentages of…
    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

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)

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