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Evidence found and GRADE certainty

87 questions · 196 findings · 18 reviews · Oral Health

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No studies found 0 · 0%GRADE not reported 187 · 95.4%Very low 2 · 1%Low 7 · 3.6%Moderate 0 · 0%High 0 · 0%

Breastfeeding for more than 24 months vs Not breastfed at the same age or breastfed for a shorter duration

Early childhood caries (ECC) - incidence/risk · Children with exclusively primary dentition (age ≤71 months)

Breastfeeding beyond 24 months is associated with an increased risk (incidence) of early childhood caries versus not breastfeeding at the same age (RR 2.44, 95% CI 1.97 to 3.02; low certainty).

1 finding from 1 review

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

Early childhood caries experience (mean dmft) · Children younger than 71 months (under 6 years)

Mean dmft was lowest (1.62 teeth) in low-inequality countries by Gini index.

16 findings from 1 review
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Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Early childhood caries (ECC) · Children younger than 71 months (under 6 years)

Pooled ECC prevalence in Europe was 36% (95% CI 25-47).

16 findings from 1 review
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Growth stunting (linear growth retardation, low height-for-age) vs Children without growth stunting (normal height-for-age)

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

One Nigerian cross-sectional study reported a significant adjusted association between nutritional (stunting) status and ECC (APR 0.14, 95% CI 0.03-0.69); ungraded.

4 findings from 1 review
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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

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

Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years)

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

In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded.

2 findings from 1 review

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

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

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 IGSF5 (chr21q22.2) · 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 IGSF5 expression reached the TWAS threshold for ECC (p = 7.22e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

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 LACC1 (chr13q14.11) · 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 LACC1 expression reached the TWAS threshold for ECC (p = 3.98e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; 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 rs74470773 (3:33958083; nearest gene(s) PDCD6IP) · 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 rs74470773 near PDCD6IP showed suggestive (not genome-wide significant) association with ECC (Z = -4.589, p = 4.46e-6); genetic association, ungraded.

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 TAS2R43 (chr12p13.2) · 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 TAS2R43 was significantly associated with ECC in the TWAS (p = 8.78e-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 rs76823412 (8:134690570; nearest gene(s) ST3GAL1) · 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 rs8091366 near CHST9, KCTD1 showed suggestive (not genome-wide significant) association with ECC (Z = 4.476, p = 7.60e-6); genetic association, ungraded.

2 findings from 1 review