Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,315 questions · 23,557 findings · 2,311 reviews

No studies found 4,183 · 17.8%GRADE not reported 3,930 · 16.7%Very low 5,371 · 22.8%Low 5,787 · 24.6%Moderate 3,320 · 14.1%High 966 · 4.1%

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

Plaque index (PI) / oral hygiene · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users tend to have a higher plaque index (more biofilm accumulation) than non-smokers (narrative synthesis of systematic reviews; ungraded).

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

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

Periodontitis / periodontal disease and periodontal parameters · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users appear more likely to develop periodontal disease and worse periodontal parameters than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Development of >=1 new carious lesion (caries incidence) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

In preclinical animal models, anticaries vaccines significantly reduced dental caries risk (pooled RR 0.53, 95% CI 0.46 to 0.62; random-effects), but the evidence is ungraded and limited to short-term animal studies.

1 finding from 1 review

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

ADGRL2 gene (aggregate gene-based signal, MAGMA) vs Genome-wide gene background (FDR threshold)

Dental caries (self-reported history) · Japanese adults (present-study direct-to-consumer genetic testing cohort); self-reported disease cases vs controls

Gene-based analysis found ADGRL2 significantly associated with dental caries (FDR q<0.05); ungraded.

1 finding from 1 review
  • Genome-wide association meta-analysis identifies two novel loci associated with dental caries. 2024 All outcomes
    Lifelong (germline genotype) · Population-based genetic association study (Japanese direct-to-consumer genetic testing cohort) · MAGMA gene-based test (present study)
    Gene-based association analysis (MAGMA): ADGRL2 was the only gene associated with dental caries at false-discovery-rate q<0.05 (no effect size reported).
    1 study · 45525 participants
    GRADE not reported

Nocturnal breastfeeding vs No nocturnal breastfeeding

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding one study, nocturnal breastfeeding was associated with higher ECC risk (RR 3.05, 95% CI 2.40 to 3.87; I²=33%).

2 findings from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Number of ibuprofen tablets required · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in number of ibuprofen tablets required compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

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

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Percussion pain at 24 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in percussion pain at 24 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

2 findings from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Pain at 24 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

It is very uncertain whether postoperative systemic antibiotics… changes pain at 24 hours compared with matched placebo, partial or total chemo-mechanical debridement and… (very low certainty).

1 finding from 1 review

Extraction of the permanent first molar vs Not applicable (single-group prevalence)

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

In the maxilla, spontaneous space closure occurred in about 85% of cases (9 studies; prevalence not GRADE-rated).

3 findings from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Swelling (mean) · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in swelling at 48 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

4 findings from 1 review
Show 1 more finding

Breastfeeding <24 months vs Breastfeeding for ≥24 months

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding Peres et al. (2017), breastfeeding for less than 24 months was associated with fewer caries (RR 0.49, 95% CI 0.39 to 0.62; I²=6%).

2 findings 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

Breastfeeding vs No breastfeeding

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding five studies, breastfeeding was associated with lower ECC risk in cohort studies (RR 0.82, 95% CI 0.71 to 0.95; I²=0%).

3 findings from 1 review

Breastfeeding <12 months vs Breastfeeding for ≥12 months

Early childhood caries (ECC) · Preschool children (<6 years)

Breastfeeding for <12 vs ≥12 months was associated with significantly fewer caries (RR 0.65, 95% CI 0.50-0.86), indicating breastfeeding beyond 12 months increases ECC risk (substantial heterogeneity; ungraded).

2 findings from 1 review

Surgery plus Heister jaw opener vs Surgery plus wooden tongue depressors

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

It is very uncertain whether surgery plus Heister jaw opener changes maximal mouth opening (interincisal distance) compared with surgery plus wooden tongue depressors (very low certainty).

2 findings from 1 review