Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

369 questions · 463 findings · 41 reviews · All outcomes

No studies found 44 · 9.5%GRADE not reported 336 · 72.6%Very low 31 · 6.7%Low 26 · 5.6%Moderate 15 · 3.2%High 11 · 2.4%

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Osteoporosis · European-ancestry adults

In multivariable MR (adjusted for periodontitis), higher genetically predicted dental caries (DMFS) causally increased osteoporosis risk (OR 1.165, moderate evidence).

2 findings from 1 review

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Bone mineral density in forearm · European-ancestry adults

Genetically predicted dental caries (DMFS) had no causal effect on forearm BMD.

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Forearm fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Country-level income (World Bank income classification) vs Higher- vs lower-income country categories

Oral health-related quality of life · people aged 60 years and older living in the community

Community-dwelling older adults in higher-income countries had better OHRQoL than those in lower-income countries (77.9, 95% CI 70.2 to 85.6 vs 66.9, 95% CI 56.7 to 77.0); the difference by income was statistically significant (ungraded).

2 findings from 1 review

Country-level income inequality (Gini index) vs Lower vs higher income inequality categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in countries with relative income equality (low Gini index) had markedly higher OHRQoL (91.3, 95% CI 90.0 to 92.6) than those in less equal countries; the difference by Gini index was statistically significant (ungraded).

4 findings from 1 review
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Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Osteoporosis with pathological fracture · European GWAS participants

The SVMR MR-Egger interval included the null.

3 findings from 1 review

Higher per-capita expenditure on dental health care vs Lower per-capita expenditure on dental health care (USD bands: $0-50 / $51-100 / >$100)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Countries with higher per-capita dental expenditure had lower mean DMFT (>$100: 0.96; $51-100: 2.14; $0-50: 3.06) (Figure 4); not GRADE-rated.

3 findings from 1 review

Higher parental education (tertiary) vs Lower parental education (reference)

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

Paternal tertiary education was associated with lower odds of ECC (OR 0.381).

3 findings from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

Odds of higher caries (DMFT) category · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Higher national income was strongly associated with lower odds of poor oral health (OR 0.10, 95% CI 0.03 to 0.37; about 90% lower odds); not GRADE-rated.

1 finding from 1 review

Sugar consumption (higher sugar intake) vs No sugar consumption (lower/no intake)

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

Higher sugar consumption is associated with early childhood caries in children under 6 years: pooled OR 1.59 (95% CI 1.50 to 1.68) from 9 cohort studies with no heterogeneity (I2=0%); the body of evidence was not GRADE-rated (ungraded).

1 finding from 1 review

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Lumbar spine and pelvis fracture · European-ancestry adults

Genetically predicted dental caries (DMFS) had no significant causal effect on fracture of lumbar spine and pelvis (multivariable MR, OR 0.968).

2 findings from 1 review

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Forearm fracture · European-ancestry adults

Genetically predicted dental caries (DMFS) had no significant causal effect on fracture of forearm (multivariable MR, OR 0.973).

2 findings from 1 review

Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Femur fracture · European GWAS participants

The SVMR MR-Egger interval included the null.

3 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Osteoporosis with pathological fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on osteoporosis with pathological fracture (single-variable MR, OR 1.003).

2 findings from 1 review

Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Lumbar spine and pelvis fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Postmenopausal osteoporosis with pathological fracture · Postmenopausal women (European ancestry)

In multivariable MR (adjusted for periodontitis), genetically predicted dental caries (DMFS) causally increased postmenopausal osteoporosis with pathological fracture (OR 1.422, moderate evidence).

2 findings from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT in 12-year-olds rises as national income falls: 0.90 (very high income), 2.38 (high income), 3.30 (middle income) (Figure 2); not GRADE-rated.

3 findings from 1 review

Genetically predicted periodontitis vs Without periodontitis (lower genetic liability)

Lacunar stroke · European-ancestry adults

Genetically predicted periodontitis was associated with modestly higher odds of lacunar stroke (OR 1.24); ungraded MR, though the FDR-adjusted P was 0.064 for the primary IVW-FE method (ML-adjusted P 0.037).

1 finding from 1 review

Human Development Index (HDI) vs Higher vs lower HDI categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in higher-HDI countries had better OHRQoL (high 79.9, 95% CI 74.4 to 85.5; very high 78.4, 95% CI 71.1 to 85.8) than those in medium-HDI countries (63.5, 95% CI 54.3 to 72.7); the difference by HDI was statistically significant (ungraded).

3 findings from 1 review