Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,971 questions · 9,849 findings · 853 reviews

No studies found 1,150 · 11.7%GRADE not reported 3,387 · 34.4%Very low 1,963 · 19.9%Low 1,809 · 18.4%Moderate 1,207 · 12.3%High 333 · 3.4%

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Probiotics vs placebo or control

Streptococcus mutans count · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably reduce Streptococcus mutans count versus control (MD -0.40 CFU/mL, 95%CI -0.57 to -0.24; moderate certainty).

1 finding from 1 review

Second molar at Demirjian stage E at extraction vs Second molar at Demirjian stage F-H at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, extraction at Demirjian stage E (vs later F-H) increases odds of space closure (OR 3.81; low certainty).

1 finding from 1 review

Dental crowding present vs Dental spacing present

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

One study found space closure more likely with crowding than spacing (OR 5.9; single study; not GRADE-rated).

1 finding from 1 review

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Dental caries prevalence · Institutionalized orphan children (roughly 3 to 18 years)

Institutionalized orphan children may be at higher risk of dental caries than parented children (pooled RR 1.19), but the estimate is imprecise and not statistically significant (very low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Gingival bleeding (various bleeding indices) · Children and/or adolescents (<18 years) without background systemic disease

Only one trial (Borrell 2021) reported the bleeding index, showing slightly more bleeding with probiotics (MD 0.10, 95%CI 0.02 to 0.18); not pooled or GRADE-rated.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

TNF-α level · Children and young adults (3-25 years)

Salivary TNF-α levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 14.81 pg/mL, 95% CI 4.76 to 24.86; 7 studies); ungraded.

1 finding from 1 review

Obesity (Unclassified) vs Normal Weight or Non‐Obese

Caries experience (mean DMFT) · Brazilian children/adolescents in permanent dentition (BMI classified by CDC 2000 growth charts)

Normal-weight adolescents may have higher caries experience (DMFT) than obese peers in the permanent dentition, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

Periodontal therapy (scaling and root planing), post-treatment vs Pre-treatment (baseline, same group)

High salivary S. mutans (over 10^4 CFU/ml) · Periodontitis patients

High-level S. mutans did not change significantly after periodontal therapy (OR 1.54).

1 finding from 1 review

Overweight/obesity (combined) vs Normal Weight or Non‐Obese

Dental caries prevalence · Brazilian children/adolescents (BMI classified by WHO 2007 percentile)

The evidence is very uncertain about the effect of overweight/obesity on caries odds (WHO 2007 percentile; very low certainty).

1 finding from 1 review

Disability (developmental, intellectual, or sensory) vs Not applicable (single-group prevalence)

Moderate gingival inflammation / gingival health · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or multiple disabilities)…

Gingival inflammation is common among persons with disabilities in Saudi Arabia (moderate-to-severe up to about 60%), reported narratively without a pooled comparative estimate (ungraded).

1 finding from 1 review

Probiotics vs placebo or control

Plaque index (PI) / oral hygiene · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to the bacterial plaque index versus control (MD 0.21, 95%CI -0.55 to 0.96; very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF and nano-silver fluoride showed no significant difference in tooth-level caries arrestment (OR 1.47; ungraded subgroup).

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Sensitivity for dental caries diagnosis · Children and adults with primary or permanent dentition

Sensitivity ranged from 48% to 98.3% across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review