What do systematic reviews say?

Toothache vs No dental pain

Toothache/dental pain is associated with worse OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

• Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes

  Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
  Toothache, DMT and tooth loss have a high impact on OHRQoL in adolescentes [26]. There is low evidence that dental pain has a negative impact on OHRQoL [37].
  Studies not reported
  GRADE not reported

Access to dental care / health services vs No / limited access to dental care

Access to dental care is associated with better OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

• Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes

  Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
  having parents who can provide dental care and safe housing are positive predictors for OHRQoL. access to dental care and the performance of health promotion programs are directly proportional to OHRQoL in adolescents.
  Studies not reported
  GRADE not reported

Dental (tooth) agenesis vs No dental agenesis

Evidence is insufficient to establish a relationship between dental agenesis and OHRQoL in adolescents (evidence gap; narrative synthesis; no pooled estimate or GRADE rating).

• Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes

  Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
  tooth agenesis does not have enough scientific evidence to support a relationship between OHRQoL [41]. No articles were found that had evaluated children and adolescent. Only one was found to have a greater impact in…
  Studies not reported
  GRADE not reported

Skin color / ethnicity vs Reference skin color / ethnicity

There is no concrete evidence on the impact of skin color/ethnicity on OHRQoL in adolescents (evidence gap; narrative synthesis; no pooled estimate or GRADE rating).

• Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes

  Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
  Biological data such as skin color and age have no concrete evidence about this impact in the OHRQoL. Important aspects like gender and skin color did not have their level of impact clarified.
  Studies not reported
  GRADE not reported

Atraumatic restorative treatment vs placebo

ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).

• Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. 2022 All outcomes

  Post-treatment · Pediatric dental care; trials conducted in China, the USA, and Brazil · Indirect network estimate (no direct trials)
  MD -0.01 [-0.40, 0.38]
  0 studies
  GRADE not reported

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Evidence on OHRQoL was limited: one study found no significant difference between groups while another found orofacial symptoms affected daily life more in JIA; no pooled estimate (ungraded).

• Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. 2019 All outcomes

  Brazil (Santos 2015) and Sweden (Leksell 2012)
  Santos et al. [29] found oral health status had little or no effect on well-being with no significant difference between JIA and healthy groups (SF:13-B-PCPQ); Leksell et al. [38] found orofacial symptoms influenced…
  2 studies · 111 participants
  GRADE not reported

Low income vs High family income

Children from low-income families had higher odds of poor OHRQoL (OR 1.16, 95% CI 1.11-1.21; 4 studies; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income country (Brazil); studies 2010-2014
  OR 1.16 [1.11, 1.21]
  4 studies
  GRADE not reported

Younger children's age (3-5 years) vs Older children (>5 years)

Children aged 3 years had higher odds of poor OHRQoL than older children (OR 2.00, 95% CI 1.42-2.57; 2 studies; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries (Brazil); studies 2011-2012 · Age 3 years
  OR 2.00 [1.42, 2.57]
  2 studies
  GRADE not reported
• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries (Brazil); studies 2011-2012 · Age 4 years
  OR 2.13 [1.50, 2.76]
  2 studies
  GRADE not reported

All exposure-OHRQoL estimates pooled for publication-bias correction (meta-trim sensitivity); specific exposure set not defined in source vs Not specified

A trim-and-fill sensitivity analysis pooling every exposure estimate gave an overall OR of 0.17 (95% CI 0.13-0.21) after correcting for significant publication bias (Fig. 13); this combined estimate spans heterogeneous exposures and is a publication-bias sensitivity result (ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Children across multiple countries (Brazil, Hong Kong, Sri Lanka, New Zealand) · Trim-and-fill adjusted (publication-bias corrected), random-effects
  OR 0.17 [0.13, 0.21]
  Studies not reported
  GRADE not reported

Periodontal disease (present) vs Individuals without periodontal disease (by LOA)

Periodontal disease was associated with higher odds of poor OHRQoL (OR 1.15, 95% CI 1.12-1.18; 3 studies; no heterogeneity; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries (Brazil); studies 2010-2014
  OR 1.15 [1.12, 1.18]
  3 studies
  GRADE not reported

Female gender (girls) vs Male gender (boys)

Girls had modestly higher odds of poor OHRQoL than boys (OR 1.13, 95% CI 1.09-1.17; 3 studies; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries (Brazil); studies 2010-2013
  OR 1.13 [1.09, 1.17]
  3 studies
  GRADE not reported

Higher dental caries experience vs Caries-free controls

Higher dental caries experience was associated with substantially higher odds of poor OHRQoL (OR 1.66, 95% CI 1.43-1.88; 6 studies; high heterogeneity I2=83.5%; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries (5 studies) and one high-income country; studies 2011-2017
  OR 1.66 [1.43, 1.88]
  6 studies
  GRADE not reported

Low maternal education (<=6 years of schooling) vs Higher maternal education (>6 years)

Lower maternal education was associated with poor OHRQoL (OR 1.12, 95% CI 1.00-1.23; 4 studies; high heterogeneity; CI lower bound at the null; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries; studies 2010-2014
  OR 1.12 [1.00, 1.23]
  4 studies
  GRADE not reported

Orthodontic treatment need vs No orthodontic treatment need

Orthodontic treatment need was associated with modestly higher odds of poor OHRQoL (OR 1.13, 95% CI 1.07-1.18; 3 studies; ungraded).

• The Association of Oral Health Status, demographic characteristics and socioeconomic determinants with Oral… 2020 All outcomes

  Upper-middle-income countries (Brazil); studies 2012-2019
  OR 1.13 [1.07, 1.18]
  3 studies
  GRADE not reported

Silver diamine fluoride (SDF) vs placebo

SDF did not significantly differ from placebo for oral health-related quality of life in children (MD 0.03, 95% CI -0.16 to 0.22; ungraded).

• Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. 2022 All outcomes

  Post-treatment · Pediatric dental care; trials conducted in China, the USA, and Brazil
  MD 0.03 [-0.16, 0.22]
  2 studies · 440 participants
  GRADE not reported

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

SDF did not significantly differ from atraumatic restorative treatment for oral health-related quality of life (MD 0.02, 95% CI -0.32 to 0.36; ungraded).

• Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. 2022 All outcomes

  Post-treatment · Pediatric dental care; trials conducted in China, the USA, and Brazil
  MD 0.02 [-0.32, 0.36]
  2 studies · 134 participants
  GRADE not reported

Silver diamine fluoride (SDF) plus fluoride varnish vs Atraumatic restorative treatment + fluoride varnish (ART+FV)

SDF plus fluoride varnish did not significantly differ from ART plus fluoride varnish for oral health-related quality of life (MD 0.16, 95% CI -0.1 to 0.42; ungraded).

• Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. 2022 All outcomes

  Post-treatment · Pediatric dental care; trials conducted in China, the USA, and Brazil
  MD 0.16 [-0.1, 0.42]
  1 study · 246 participants
  GRADE not reported

Silver diamine fluoride (SDF, including SDF + fluoride varnish) vs Other standard-of-care caries treatments pooled (placebo, ART, or ART + fluoride varnish)

SDF had no significant effect on oral health-related quality of life versus pooled standard-of-care caries treatments (SMD -0.06, 95% CI -0.20 to 0.08; ungraded).

• Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. 2022 All outcomes

  Post-treatment (follow-up varied by trial) · Pediatric dental care; trials conducted in China, the USA, and Brazil
  SMD -0.06 [-0.20, 0.08]
  5 studies · 820 participants
  GRADE not reported

Intervention not reported

• Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes

  Overall (pooled across all studies)
  MEAN 77.0
  45 studies
  GRADE not reported

Country-level periodontal disease prevalence (Global Burden of Disease) vs Low vs high periodontal disease prevalence

OHRQoL did not differ significantly by country-level periodontal disease prevalence; no pooled estimate was reported in the text (ungraded).

• Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes

  Community-dwelling older adults across 25 countries · Across periodontal disease prevalence categories
  No statistically significant difference in OHRQoL based on periodontal disease prevalence (Fig. 4b).
  Studies not reported
  GRADE not reported