Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

821 questions · 993 findings · 80 reviews · Dental caries

No studies found 60 · 6%GRADE not reported 749 · 75.4%Very low 109 · 11%Low 41 · 4.1%Moderate 34 · 3.4%High 0 · 0%

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between ART regimens (very low certainty).

1 finding from 1 review

CD4+ T-cell count below 250 cells/mm3 vs CD4+ T-cell count >=250 cells/mm3

HIV-related oral lesions · Children and adolescents living with HIV on ART/HAART

Lower CD4+ counts (<250 cells/mm3) were associated with roughly twice the odds of HIV-related oral lesions in two studies (not pooled).

1 finding from 1 review
  • Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
    Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · CD4+ T-cell count <250 cells/mm3 vs higher
    CLWH with CD4+ <250 cells/mm3 were about twice as likely to have HIV-related oral lesions: Baghirath 2013 OR 1.916 (95% CI 0.613 to 2.513), p=0.001; Divakar 2015 OR 1.999 (95% CI 0.129 to 3.688), p=0.001. Not pooled.
    2 studies
    GRADE not reported

Atraumatic restorative treatment vs Silver diamine fluoride

Oral health-related quality of life · Children with dental caries

The network estimate found no statistically significant difference in oral health-related quality of life between atraumatic restorative treatment and silver diamine fluoride.

2 findings from 1 review

Combined antiretroviral therapy (cART) vs No antiretroviral medication (treatment-naive)

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

cART was associated with a significantly lower prevalence of oral candidiasis in CLWH (very low certainty).

1 finding from 1 review

Monotherapy or dual antiretroviral therapy vs No antiretroviral medication (treatment-naive)

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Oral candidiasis prevalence did not differ significantly between treatment-naive CLWH and those on monotherapy or dual therapy (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Poor (inadequate) oral hygiene (prevalence) · Children or adolescents

No significant difference in oral hygiene between CLWH on ART and healthy controls (OR 1.23, 95% CI 0.73 to 2.07; single study).

1 finding from 1 review

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

Oral health-related quality of life · Children with dental caries

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).

1 finding from 1 review

ART/HAART duration <3 years vs ART/HAART duration >=3 years

Oral candidiasis · Children and adolescents living with HIV on ART/HAART

Oral candidiasis prevalence differed by ART duration (OR 17.93, 95% CI 3.69 to 83.12).

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

ART was associated with lower oral candidiasis prevalence.

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between CLWH with and without ART (very low certainty).

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Oral hairy leukoplakia prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in oral hairy leukoplakia between CLWH with and without ART (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Oral hairy leukoplakia (WHO clinical stage 3) · Children or adolescents

No difference in oral hairy leukoplakia between groups (pooled OR 1.00, 95% CI 0.06 to 16.19); lesion essentially absent in both.

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Oral candidiasis (WHO clinical stage 3) · Children or adolescents

CLWH on ART had markedly higher prevalence of oral candidiasis than healthy controls (pooled OR 16.94, 95% CI 5.06 to 56.70).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Oral hairy leukoplakia prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No eligible studies compared oral hairy leukoplakia between different ART regimens.

1 finding from 1 review

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

Oral health-related quality of life · Children with dental caries

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).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

cART was associated with a significantly lower prevalence of oral candidiasis than monotherapy or dual therapy (very low certainty).

1 finding from 1 review

3-month school-based supervised daily tooth-brushing program with fluoridated toothpaste (multilevel: trained school nurses plus parental involvement) vs Pre-intervention

Visible plaque and oral-hygiene behavior · Schoolchildren aged 4-6 years in the United Arab Emirates (Dubai)

One pre-post study of a school-based supervised tooth-brushing program found visible plaque fell from 76.8% to 36.7% with positive behavior change (narrative synthesis; not GRADE-rated).

1 finding from 1 review