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%

Fluoride varnish vs placebo or no treatment

Adverse effects / specific side effects (oral allergic reactions, mucosal irritation, adverse symptoms such as nausea, gagging, vomiting) · Children and adolescents aged 16 years or less
1 finding from 1 review

Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Adverse effects (tooth staining/discoloration, oral soft-tissue signs, adverse symptoms such as nausea/vomiting, enamel etching) · Children and adolescents aged 16 years or less
1 finding from 1 review

Dental caries vs Caries-free status

Alpha diversity (Observed, Chao1, Shannon, and Simpson) · Participants in oral 16S rRNA caries microbiome studies

Across the combined sample set, alpha-diversity metrics were significantly higher in caries than in health, but no pooled effect estimate was reported.

1 finding from 1 review

Dental caries vs Caries-free status

KEGG pathway associations · Participants in oral 16S rRNA caries microbiome studies

Phosphonate and phosphinate metabolism and glyoxylate and dicarboxylate metabolism had the lowest reported adjusted P values (0.04); no pooled effect estimate was reported.

1 finding from 1 review

Dental caries vs Caries-free status

Beta diversity and community composition · Participants in oral 16S rRNA caries microbiome studies

Beta-diversity matrices showed statistically significant ADONIS results, while clustering by study and 16S region was also observed; no pooled effect estimate was reported.

1 finding from 1 review

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

Dental caries and cariogenic bacteria (Streptococcus mutans, Lactobacilli) · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with more cariogenic bacteria and increased dental caries risk compared with non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

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

Electronic cigarette use vs Traditional (conventional) cigarette smokers

Plaque index / periodontal health (relative harm vs conventional smoking) · Adult e-cigarette (ENDS) users (general oral health)

E-cigarette users tend to have a lower plaque index and less periodontal harm than traditional cigarette smokers, although still worse than non-smokers (narrative synthesis; ungraded).

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

Elective radical (comprehensive) neck dissection vs Elective selective neck dissection

Total mortality · Adults with oral cavity cancer
1 finding from 1 review

Elective neck dissection (at time of primary tumour resection) vs Therapeutic (delayed) neck dissection

Adverse events associated with treatment · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes

Elective neck dissection (at time of primary tumour resection) probably leads to higher adverse events associated with treatment compared with therapeutic (delayed) neck dissection (moderate certainty).

1 finding from 1 review

Sentinel node biopsy (neck dissection only if biopsy positive) vs Elective neck dissection

Recurrence · Adults with oral cavity or oropharyngeal cancer
1 finding from 1 review

Sentinel node biopsy (neck dissection only if biopsy positive) vs Elective neck dissection

Locoregional recurrence · Adults with oral cavity or oropharyngeal cancer

Sentinel node biopsy (neck dissection only if biopsy positive) showed no clear difference in locoregional recurrence compared with elective neck dissection (low certainty).

1 finding from 1 review

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Recurrence · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)
1 finding from 1 review