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Evidence found and GRADE certainty

781 questions · 1,089 findings · 92 reviews · Dental caries

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No studies found 77 · 7.1%GRADE not reported 781 · 71.7%Very low 86 · 7.9%Low 97 · 8.9%Moderate 38 · 3.5%High 10 · 0.9%

Partial pulpotomy with immediate (same-visit) permanent restoration vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Immediate permanent restoration was associated with a pooled success rate of 89.9%.

1 finding from 1 review

Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Early childhood caries (ECC) - incidence/risk · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Children exposed to secondary smoking from infancy have a higher incidence of early childhood caries by age 3 (RR 1.45; low certainty).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Bleeding Index (BI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Bleeding index is significantly higher in persons with orofacial cleft than in healthy controls (p<0.0001), but no pooled effect size was reported (ungraded).

1 finding from 1 review

Out-of-pocket health expenditure vs Lower vs higher out-of-pocket expenditure categories

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

Lower out-of-pocket health expenditure was associated with better OHRQoL (83.9, 95% CI 75.2 to 92.6 vs 67.5, 95% CI 58.5 to 76.5); the difference was statistically significant (ungraded).

2 findings from 1 review

Low periodontal-disease prevalence vs Not applicable

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

No statistically significant difference in OHRQoL was reported by periodontal-disease prevalence.

1 finding from 1 review

Dental caries vs Caries-free status

Prevalence (detection frequency) of S. mutans in plaque · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

S. mutans prevalence in plaque is significantly higher in caries-active than caries-free individuals (pooled OR 2.58, 95% CI 1.65 to 4.02; I2=16%); ungraded.

1 finding from 1 review

Postbiotic toothpaste vs Fluoride toothpaste alone

Increased salivary pH · children aged 6‐12 years

Postbiotic toothpaste raises salivary pH in one pediatric RCT (ungraded).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    4 weeks · Clinical; salivary/plaque sampling
    Postbiotic toothpaste significantly increased salivary pH versus fluoride toothpaste in children (Basir 2022); postbiotics are also proposed to buffer acidic pH; no pooled estimate.
    1 study
    GRADE not reported

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Probing pocket depth · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a greater probing pocket depth than healthy controls (MD 0.88, 95% CI 0.82 to 0.95; low certainty).

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Retention [ · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in restoration retention (high certainty).

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Proper surface texture or luster · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in surface texture or luster (high certainty).

1 finding from 1 review

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

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

Postbiotic products (postbiotic toothpaste; heat-killed/postbiotic oral lozenges; inactivated-bacteria tablets) vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Streptococcus mutans count · Humans at risk of dental caries (children aged 6-12 years; adults with dental caries)

Postbiotic products reduce salivary S. mutans counts in human trials, though not always significantly (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Daily for 14 days to 4 weeks · Clinical; salivary/plaque sampling
    Three RCTs reported reduced salivary S. mutans counts after postbiotic intervention; the reduction was statistically significant in Lin 2022 but non-significant in Basir 2022; no pooled estimate.
    3 studies
    GRADE not reported

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of Veillonella spp. · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

Evidence on whether Veillonella spp. relative abundance is higher or lower in children with dental caries than caries-free controls is inconsistent across 7 small observational studies; no pooled estimate was produced and the evidence is ungraded.

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Plaque · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; low certainty).

1 finding from 1 review