Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

52 questions · 108 findings · 12 reviews

No studies found 0 · 0%GRADE not reported 104 · 96.3%Very low 2 · 1.9%Low 2 · 1.9%Moderate 0 · 0%High 0 · 0%

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children aged <6 years

No significant association between cesarean vs vaginal delivery and ECC among America/Canada/Brazil studies (OR 1.11, 95% CI 0.70-1.76).

17 findings from 1 review
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Presence of oral Candida albicans vs Absence of oral Candida albicans

Early childhood caries (ECC) · Children aged ≤6 years (early childhood)

RETRACTED. Among studies before 2017, oral C. albicans presence was associated with higher odds of ECC (OR 4.89, 95% CI 2.79-8.58); ungraded subgroup from a retracted review.

16 findings from 1 review
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Breastfeeding <24 months vs Breastfeeding for ≥24 months

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding Peres et al. (2017), breastfeeding for less than 24 months was associated with fewer caries (RR 0.49, 95% CI 0.39 to 0.62; I²=6%).

1 finding from 1 review

Breastfeeding vs No breastfeeding

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding five studies, breastfeeding was associated with lower ECC risk in cohort studies (RR 0.82, 95% CI 0.71 to 0.95; I²=0%).

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children with average age >3 years

No significant association between cesarean vs vaginal delivery and ECC among children with average age >3 years (OR 1.24, 95% CI 0.89-1.71).

1 finding from 1 review

Breastfeeding <18 months vs Breastfeeding for ≥18 months

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding two studies, breastfeeding for less than 18 months was associated with fewer dental caries (RR 0.26, 95% CI 0.16 to 0.42; I²=0%).

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children with average age ≤3 years

No significant association between cesarean vs vaginal delivery and ECC among children with average age ≤3 years (OR 0.86, 95% CI 0.67-1.10).

1 finding from 1 review

Breastfeeding <12 months vs Breastfeeding for ≥12 months

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding three studies, breastfeeding for less than 12 months was associated with lower dental caries risk (RR 0.70, 95% CI 0.62 to 0.80; I²=0%).

1 finding from 1 review

Low birth weight (<2500 g) vs Normal birth weight (2500 g or more)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

Adjusted analyses also showed no association between low birth weight and early childhood caries (adjusted OR 1.05, 95% CI 0.71 to 1.57); certainty not graded.

3 findings from 1 review

Preterm birth (<37 weeks gestation) vs Full-term birth (37 weeks or more gestation)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

In children aged 3 years or younger, preterm birth was not associated with early childhood caries (OR 0.90, 95% CI 0.59 to 1.37); certainty not graded.

2 findings from 1 review

Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded.

2 findings from 1 review

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

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

Pooled ECC prevalence in Tunisia was 38% (95% CI 24-51), significantly lower than Egypt and Sudan.

10 findings from 1 review
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Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Early childhood caries (ECC) - incidence/risk · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Children exposed to secondary smoking from infancy have a higher incidence of early childhood caries by age 3 (RR 1.45; low certainty).

1 finding from 1 review

Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Caries prevalence (early childhood caries) · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Preschool children exposed to secondary smoking have higher odds of caries prevalence (OR 1.77), but the cross-sectional evidence is very uncertain (very low certainty).

2 findings from 1 review

Cesarean section delivery vs Vaginal delivery

Caries prevalence (early childhood caries) · Toddlers and preschool children, 2 to 6 years of age (primary dentition)

Caesarean section delivery may be associated with a modestly higher prevalence of early childhood caries than vaginal delivery (pooled OR 1.48), but the evidence is inconsistent and of very low certainty.

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of CDH17 (chr8q22.1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of CDH17 was significantly associated with ECC in the TWAS (p = 3.32e-8); genetic association, ungraded.

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs1044956 (7:24854765; nearest gene(s) OSBPL3, NPVF) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs1044956 near OSBPL3, NPVF showed suggestive (not genome-wide significant) association with ECC (Z = 4.551, p = 5.35e-6); genetic association, ungraded.

2 findings from 1 review