What do systematic reviews say?

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

In the USA study, maternal smoking during pregnancy was associated with increased odds of childhood dental caries (OR 1.85, 95% CI 1.38 to 2.49).

• Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis. 2024 All outcomes

  Exposure during pregnancy; caries assessed in early childhood · Multiple countries (Japan, England, Australia, Poland, USA, Sweden, Italy, Singapore); population/community-based · Study region: USA
  OR 1.85 [1.38, 2.49]
  1 study
  GRADE not reported
• Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis. 2024 All outcomes

  Exposure during pregnancy; caries assessed in early childhood · Multiple countries (Japan, England, Australia, Poland, USA, Sweden, Italy, Singapore); population/community-based · Dental examination: Clinical and radiographic examinations
  OR 2.21 [2.09, 2.34]
  1 study
  GRADE not reported
• Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis. 2024 All outcomes

  Exposure during pregnancy; caries assessed in early childhood · Multiple countries (Japan, England, Australia, Poland, USA, Sweden, Italy, Singapore); population/community-based · Study region: Europe
  OR 1.67 [1.40, 1.99]
  4 studies
  GRADE not reported

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

For prenatal vitamin D measured across gestational weeks 6-38, the OR of dental caries was 1.32 (no CI reported); ungraded.

• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Maternal 25(OH)D measured at gestational weeks 6 to 38 · Observational pregnancy/birth-cohort studies (one cross-sectional), mostly in developed countries (USA, Canada, Japan, Australia, Spain, Netherlands, Poland, New Zealand, Turkey) · Gestational-age subgroup: weeks 6 to 38
  OR 1.32 [1.04, 1.59]
  4 studies
  GRADE not reported
• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Prenatal exposure; dental caries assessed in children aged 2 to 8 years · Observational pregnancy/birth-cohort studies (one cross-sectional), mostly in developed countries (USA, Canada, Japan, Australia, Spain, Netherlands, Poland, New Zealand, Turkey) · Overall (all studies pooled)
  OR 1.35 [1.22, 1.47]
  12 studies · 11021 participants
  GRADE not reported
• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Prenatal exposure; dental caries in children aged 2 to 8 years · Observational pregnancy/birth-cohort studies (one cross-sectional), mostly in developed countries (USA, Canada, Japan, Australia, Spain, Netherlands, Poland, New Zealand, Turkey) · Publication-bias adjustment: Trim & Fill corrected pooled estimate
  OR 1.28 [1.14, 1.48]
  Studies not reported
  GRADE not reported

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

In the single study of children aged 6-8 years, the association was not statistically significant (OR 1.07, 95% CI 0.84-1.30); ungraded.

• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Prenatal exposure; dental caries at 6 to 8 years · Observational pregnancy/birth-cohort studies (one cross-sectional), mostly in developed countries (USA, Canada, Japan, Australia, Spain, Netherlands, Poland, New Zealand, Turkey) · Children's age subgroup: 6 to 8 years
  OR 1.07 [0.84, 1.30]
  1 study
  GRADE not reported

Prenatal vitamin D deficiency (maternal 25(OH)D measured at gestational weeks 24 to 38) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

For prenatal vitamin D measured across gestational weeks 24-38, the OR of dental caries was 1.30 (no CI reported); ungraded.

• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Maternal 25(OH)D measured at gestational weeks 24 to 38 · Observational pregnancy/birth-cohort studies (one cross-sectional), mostly in developed countries (USA, Canada, Japan, Australia, Spain, Netherlands, Poland, New Zealand, Turkey) · Gestational-age subgroup: weeks 24 to 38
  OR 1.30 [1.15, 1.45]
  4 studies
  GRADE not reported

Higher BMI (continuous / per-unit increment) vs Lower BMI (continuous reference / per 1 kg/m2 decrement)

Pooling studies that used BMI as a continuous variable showed no significant association between per-unit BMI and childhood dental caries (OR 1.01, 95% CI 0.99 to 1.03; I2=3.5%); ungraded.

• Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… 2024 All outcomes

  Dental examinations of children; 15 countries across Europe, Asia, the Americas and Oceania · Continuous BMI, direct pooling (studies reporting BMI as a continuous variable)
  OR 1.01 [0.99, 1.03]
  4 studies
  GRADE not reported
• Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… 2024 All outcomes

  Dental examinations of children; 15 countries across Europe, Asia, the Americas and Oceania · Non-linear dose-response (restricted cubic splines)
  Fig. 5: significant non-linear (restricted cubic spline) dose-response between BMI and childhood dental caries; relative risk rises at higher BMI (curve reaches ~2.4-2.9 at BMI 30-35) and is also elevated among…
  Studies not reported
  GRADE not reported
• Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… 2024 All outcomes

  Dental examinations of children; 15 countries across Europe, Asia, the Americas and Oceania · Linear dose-response (GLST, per 1 kg/m2 BMI increment)
  OR 1.01 [1.00, 1.03]
  16 studies
  GRADE not reported

Intervention not reported

The intervention led to higher dental caries in children; GRADE not reported.

• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Children's age subgroup: 2 to 4 years
  OR 1.20 [1.04, 1.36]
  4 studies
  GRADE not reported

Higher waist circumference vs Lower waist circumference

Waist circumference was not significantly associated with childhood dental caries (pooled OR 1.08, 95% CI 0.90 to 1.30; I2=47.7%); ungraded.

• Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… 2024 All outcomes

  Dental examinations of children; 15 countries across Europe, Asia, the Americas and Oceania
  OR 1.08 [0.90, 1.30]
  2 studies
  GRADE not reported

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

Among children aged 4-6 years, prenatal vitamin D deficiency is associated with significantly higher odds of dental caries (OR 1.44, 95% CI 1.32-1.56); ungraded.

• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Prenatal exposure; dental caries at 4 to 6 years · Observational pregnancy/birth-cohort studies (one cross-sectional), mostly in developed countries (USA, Canada, Japan, Australia, Spain, Netherlands, Poland, New Zealand, Turkey) · Children's age subgroup: 4 to 6 years
  OR 1.44 [1.32, 1.56]
  8 studies
  GRADE not reported

Intervention not reported

• Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and… 2024 All outcomes

  Meta-regression adjusted estimate
  Proportion 0.21 [0.16, 0.26]
  Studies not reported
  GRADE not reported

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

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).

• 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

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

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).

• School dental screening programmes for oral health 2022 · Cochrane All outcomes

  mean 8 months
  OR 1.30 [0.85, 1.99]
  1 study · 411 participants
  Very low

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

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).

• 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