What do systematic reviews say?

Missing teeth / tooth loss vs No tooth loss

Tooth loss/edentulism 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].
  Studies not reported
  GRADE not reported

Intervention not reported

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

  Untreated fractured tooth vs no trauma
  Relative risk (reporting impact) Fourfold (4x) greater risk
  1 study
  GRADE not reported

Poor / irregular toothbrushing vs Toothbrushing alone

Irregular/poor toothbrushing 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
  The systematic review reports factors that physical disability, visual impairment, mental disorders, poor diet and irregular brushing negatively impact OHRQoL [36].
  Studies not reported
  GRADE not reported

Higher parental / maternal education vs Lower parental education (reference)

Higher parental education 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
  Adolescents from families with higher incomes and higher levels of maternal education have better OHRQoL scores [34]. Children from families with high income, parental education and family economy had better OHRQoL [42].
  Studies not reported
  GRADE not reported

Malocclusion vs Absence/lower severity of malocclusion

Malocclusion is associated with worse oral health-related quality of life 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
  The studies who avaliate occlusal disorders, concluded that this pathology have a negative impact on OHRQoL in adolescents.
  Studies not reported
  GRADE not reported

Favorable family structure (being an only child; nuclear family) vs Having siblings / non-nuclear family structure

Being an only child and growing up in a nuclear family are 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
  Being an only child, growing up in your nuclear family or family structure, household conditions, and number of people per household and maternal age are predictors of better OHRQoL [43].
  Studies not reported
  GRADE not reported

Treatment of traumatic dental injury vs Untreated dental trauma

Treating traumatic dental injuries reduces their negative impact on OHRQoL in adolescents (narrative synthesis; included review reports low certainty; no pooled estimate or GRADE rating by the umbrella review).

• 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
  Treatment of TDI reduces the negative impact on OHRQoL in adolescents, based on parental perception [33]. Treatment of traumatic dental injuries reduces the impact on the OHRQoL with low evidence [46].
  Studies not reported
  GRADE not reported

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

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

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

Prophylactic aciclovir (oral or intravenous) vs placebo

The review found no eligible studies for this question.

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  None of the prophylactic aciclovir versus placebo trials reported on patient quality of life. For prevention or treatment, no trials reported on duration of hospital stay, amount of analgesia or patient quality of life.
  0 studies
  No studies found

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in oral-health-related quality of life (OHIP-14) compared with clinical examination with 6-month recall (high certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD -0.24 [-1.55, 1.07]
  1 study · 305 participants
  High

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in oral-health-related quality of life (OHIP-14) compared with clinical examination with 24-month recall (high certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD -0.37 [-1.69, 0.95]
  1 study · 298 participants
  High

Clinical examination with risk-based recall vs Clinical examination with 6-month recall

Clinical examination with risk-based recall showed no clear difference in oral-health-related quality of life (OHIP-14) compared with clinical examination with 6-month recall (high certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD -0.35 [-1.02, 0.32]
  1 study · 1551 participants
  High

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