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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

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No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Electronic cigarette use vs Non-smokers (non-users)

Self-reported gingivitis · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with self-reported gingivitis compared with non-smokers (single included review; ungraded).

1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard (histology; some ICDAS/radiography)

Occlusal caries detection: specificity · Extracted human teeth (in vitro); permanent and primary teeth, occlusal surfaces

In vitro, QLF pooled specificity for occlusal caries in permanent teeth was 0.66 (3 studies; ungraded).

3 findings from 1 review

HAART (highly active antiretroviral therapy, >=3 drugs) vs HIV-positive not receiving HAART (standard ART or HAART-naive)

Dental caries · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART versus no HAART showed no significant difference in the odds of dental caries by DMFT in cross-sectional studies (OR 1.29, 95% CI 0.59 to 2.84; ungraded).

2 findings from 1 review

High 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

Calcium-based agent vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Calcium vs Fluorine showed no significant difference in 24 h bond strength (MD -0.523, 95% CI -5.404 to 4.358; Low certainty).

1 finding from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Mean DMFT (decayed, missing, filled permanent teeth) · Children and adolescents with epilepsy

In children/adolescents, the higher DMFT with epilepsy is not statistically significant (SMD 0.334, 95% CI -0.140 to 0.827, P = .164; ungraded subgroup).

1 finding from 1 review

Fluoride agent (e.g., NaF/SDF/KF/CaF2) vs No biomimetic remineralization (control)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Etch-and-Rinse adhesive + biological ACAD protocol network, Fluorine showed 4.197 MPa higher 24 h bond strength than Control (MD 4.197, 95% CI 1.080 to 7.314; Moderate certainty).

3 findings from 1 review

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

Dental caries in permanent teeth · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, the DMFT index did not differ significantly between HIV+ children on ART and HIV-negative peers (MD 0.60, 95% CI -0.53 to 1.72; very low certainty).

2 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Lumbar spine and pelvis fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on fracture of lumbar spine and pelvis (multivariable MR, OR 1.060).

2 findings from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Mean DMFT (decayed, missing, filled permanent teeth) · people with epilepsy

People with epilepsy have a significantly higher DMFT (permanent-teeth caries) index than controls (SMD 0.403, 95% CI 0.057 to 0.749; 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 (all ages)

In females (low-to-moderate risk-of-bias studies), spine BMD rose then plateaued ~0.5 mg/L: MD 0.02 g/cm2 (95% CI -0.02-0.07) at 0.20 mg/L and 0.06 (-0.01-0.12) across 0.7-2.35 mg/L vs null; ungraded.

2 findings 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, low-to-moderate risk-of-bias studies: 0.7-2.35 mg/L vs null
    MD 0.06 [-0.01, 0.12]
    Studies not reported
    GRADE not reported
  • 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, low-to-moderate risk-of-bias studies: 0.20 mg/L vs null
    MD 0.02 [-0.02, 0.07]
    Studies not reported
    GRADE not reported

Electronic cigarette use vs Non-smokers

Peri-implant clinical and radiographic parameters (plaque index, probing depth, bone loss, pro-inflammatory profile) · Adult e-cigarette (ENDS) users with dental implants (incl. male implant-supported prosthesis patients)

Among dental implant patients, e-cigarette users show worse peri-implant parameters (more plaque, worse clinical and radiographic outcomes) than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review
  • An Umbrella Review of E-Cigarettes' Impact on Oral Microbiota and Biofilm Buildup. 2025 All outcomes
    Dental implant / peri-implant care · Implant/peri-implant populations: Vamos (implant patients), Youssef (male implant patients only), Yang (broad SR incl. peri-implant)
    Narrative synthesis: e-cigarette users with dental implants showed a higher peri-implant plaque index and worse clinico-radiographic and immunological peri-implant parameters than non-smokers (worse than non-smokers…
    3 studies
    GRADE not reported