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Evidence found and GRADE certainty

4,410 questions · 8,901 findings · 1,091 reviews

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No studies found 1,687 · 19%GRADE not reported 1,469 · 16.5%Very low 1,969 · 22.1%Low 2,060 · 23.1%Moderate 1,302 · 14.6%High 414 · 4.7%

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Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Lumbar spine bone mineral density (BMD) · Females aged over 50 years

In females over 50, spine BMD showed an inverted U-shaped curve with a downward trend beginning at lower fluoride concentrations than in the overall analysis; no numeric MD reported in text; ungraded.

1 finding from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females >50, spine BMD dose-response
    Inverted U-shaped curve with a downward trend starting at lower fluoride concentrations than the overall analysis (no numeric MD reported in text)
    Studies not reported
    GRADE not reported

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

Forearm fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 6: superficial discoloration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with superficial discoloration, surveyed dentists most often preferred repair over replacement (pooled RR 0.28; p < 0.001); ungraded.

1 finding from 1 review

Country-level dental caries prevalence (Global Burden of Disease) vs Low vs high dental caries prevalence

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

Lower country-level dental caries prevalence was associated with better OHRQoL (low-prevalence pooled mean 81.5, 95% CI 76.5 to 86.6, higher than high-prevalence countries); statistically significant (ungraded).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 7: non-stable (mobile) restoration · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with non-stable (mobile) restoration, surveyed dentists most often preferred replacement over repair (pooled RR 24.22; p < 0.001); ungraded.

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 7: non-stable (mobile) restoration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with non-stable (mobile) restoration, surveyed dentists most often preferred replacement over repair (pooled RR 12.17; p < 0.001); ungraded.

1 finding from 1 review

Thermoelastic copper NiTi (CuNiTi) arch wire vs Conventional (stabilised) NiTi arch wire

Time to next/working arch wire · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Thermoelastic copper NiTi (CuNiTi) arch wire showed no clear difference in time to next/working arch wire compared with conventional NiTi arch wire; GRADE not reported.

1 finding from 1 review

Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight)

Early childhood caries (ECC) · Children (approx. 4-18 years)

In the Region: Asian countries subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.70, 95% CI 1.25 to 2.32; ungraded).

17 findings from 1 review
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Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (mean number of new lesions per subject) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

Patients developed on average about 2.29 new ICLs during fixed orthodontic treatment (95% CI 1.12-3.46; very low certainty; very high heterogeneity).

1 finding from 1 review

Single-strand superelastic NiTi arch wire vs Coaxial superelastic NiTi arch wire

Alignment rate · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Single-strand superelastic NiTi arch wire probably leads to lower alignment rate compared with coaxial superelastic NiTi arch wire (moderate certainty).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of tooth surfaces developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 15% of tooth surfaces developed new ICLs during fixed orthodontic treatment (pooled 0.15, 95% CI 0.08-0.26; very low certainty; extreme heterogeneity).

1 finding from 1 review

High-dose vitamin D3 supplementation during pregnancy (2400 IU/day from pregnancy week 24 to 1 week postpartum, in addition to the recommended 400 IU/day) vs Low-dose (standard) vitamin D supplementation as recommended in national pregnancy guidelines

Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether high-dose vitamin D3 supplementation during pregnancy (2400 IU/day… changes caries presence in primary teeth compared with low-dose (standard) vitamin D supplementation as recommended in… (very low certainty).

1 finding from 1 review

Significant salivary microbial (Lactobacillus) load vs No/low significant microbial load

Dental caries · Primary school children in Ethiopia

A significant salivary microbial (Lactobacillus) load was associated with higher odds of dental caries (OR 3.82, 95% CI 3.439-4.192; ungraded).

1 finding from 1 review

High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Early childhood caries experience (mean dmft) · Nigerian children with primary dentition (approximately 6 months to 5 years)

In primary dentition, high-frequency sugar consumption was associated with slightly higher, non-significant odds of caries (OR 1.13, 95% CI 0.23 to 5.44), with high heterogeneity (I2=83%; ungraded).

1 finding from 1 review