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Evidence found and GRADE certainty

132 questions · 185 findings · 31 reviews

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No studies found 1 · 0.5%GRADE not reported 164 · 88.6%Very low 18 · 9.7%Low 1 · 0.5%Moderate 1 · 0.5%High 0 · 0%

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children (mixed dentition; baseline about 8 years)

In children with mixed dentition, vitamin D deficiency was associated with an 8% higher caries risk (RR 1.08; 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 · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART versus no HAART showed no significant difference in the odds of dental caries by DMFT in cross-sectional studies (OR 1.29, 95% CI 0.59 to 2.84; ungraded).

2 findings from 1 review

Prenatal vitamin D level ≤50 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a lower odds ratio at maternal prenatal vitamin D ≤50 nmol/L than at ≤35 nmol/L, without a numeric value in the available sources.

1 finding from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported an OR of 1.32 when prenatal vitamin D was measured at 6 to 38 gestational weeks.

2 findings from 1 review

Prenatal vitamin D level ≤35 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a slightly higher odds ratio at maternal prenatal vitamin D ≤35 nmol/L than at ≤50 nmol/L, without a numeric value in the available sources.

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

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 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

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

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

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries prevalence · Children aged 2 to 8 years

The review reported 44% dental caries prevalence among children of mothers with low prenatal vitamin D.

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

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Caries experience · Children and adolescents (<18 years) living with HIV (CLWH)

ART was not associated with a significant difference in dental caries experience among CLWH (very low certainty).

1 finding from 1 review

Breastfeeding vs Bottle feeding

Dental caries · Children with exclusively primary dentition (age ≤71 months)

In a meta-analysis of two cross-sectional studies, breastfed children had lower odds of dental caries than bottle-fed children (OR 0.43, 95% CI 0.23 to 0.80); certainty was not formally graded.

2 findings from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Dental caries prevalence · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

Dental caries affects about 64% of children with IDD in India (pooled prevalence 0.64, 95% CI 0.45-0.79; high heterogeneity; ungraded).

1 finding from 1 review

Any form of one-to-one oral hygiene advice (OHA) vs No OHA

Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition)

It is very uncertain whether any form of one-to-one oral hygiene advice (OHA) changes dental caries compared with no OHA (very low certainty).

1 finding from 1 review

Personalised one-to-one OHA vs Routine one-to-one OHA

Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition)
1 finding from 1 review