Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

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

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%

Not applicable (single-group prevalence) vs Not applicable

Dental caries prevalence · Children aged 12 years (plus or minus one year) in Africa

The pooled dental-caries prevalence was 0.3657 (95% CI 0.3065 to 0.4250); GRADE was not reported.

2 findings from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of SMIM10L1 (chr12p13.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of SMIM10L1 was significantly associated with ECC in the TWAS (p = 1.70e-7); genetic association, ungraded.

1 finding from 1 review

Amalgam restoration vs Composite resin, compomer, conventional glass-ionomer cement, or resin-modified GIC (head-to-head RCT comparators)

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Amalgam restorations in primary teeth showed a wide annual failure rate (1-28%) across 4 RCTs; the evidence is of low quality (high risk of bias; ungraded).

1 finding from 1 review

Caries assessment at dentine threshold (cavitation into dentine) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries prevalence · European adolescents aged 12–19 years

Caries prevalence at the dentine threshold was about 56% (pooled 0.56, 95% CI 0.43 to 0.68; 15 studies; not GRADE-rated).

7 findings from 1 review
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Glass ionomer-based sealant vs No sealant (control/no treatment)

Development of >=1 new carious lesion (caries incidence) · Children with caries-free primary first molars (with or without caries on other teeth), aged 1-5 years (paediatric clinic/dental school,…

Glass ionomer-based sealant may leads to lower development of >=1 new carious lesion (caries incidence) compared with no sealant (low certainty).

2 findings from 1 review

Caries assessment at enamel threshold vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries prevalence · European adolescents aged 12–19 years

Enamel-threshold caries prevalence in subgroup 'Region: non-Scandinavian' was 0.74 (95% CI 0.53 to 0.96; 11 studies).

11 findings from 1 review
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Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Oral hygiene measured by mean gingival scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

1 finding from 1 review

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 6-8 years, DMFT scores were significantly reduced (SMD -0.11); subgroup not separately GRADE-rated.

8 findings from 1 review
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Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Annual increment in DMFS (D3) · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Oral-health-education interventions significantly reduced net increment in DMFS (SMD -1.05); no significant subgroup difference vs other interventions (P=0.74).

5 findings from 1 review
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Caries distribution assessment (individual, tooth and surface levels) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Caries distribution (individual/tooth/surface level) · European adolescents aged 12–19 years

Caries distribution was skewed at individual, tooth and surface levels and too heterogeneous to meta-analyze (narrative synthesis of 11 studies; not GRADE-rated).

1 finding from 1 review

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

Fluoride-releasing resin-based sealant vs No sealant (control/no treatment)

Mean caries increment (mean number of new cavitated occlusal lesions) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department, dental hospital, France)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    24 months
    Mean number of new cavitated occlusal lesions 0.23 (SD 0.06) in sealed molars vs 0.29 (SD 0.06) in control molars (Wilcoxon matched-pairs signed-rank test P = 0.42)
    1 study · 85 participants
    GRADE not reported

Sociodemographic / socioeconomic factors (single-parent family, low parental education, family income, socioeconomic status) vs Absence of the factor / reference socioeconomic category

Caries increment in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Evidence on the association between sociodemographic/socioeconomic factors and permanent-teeth caries is weak and inconsistent (3 studies; could not be pooled; not GRADE-rated).

1 finding from 1 review

High-viscosity glass-ionomer cement (HVGIC) restoration (conventional restorative approach) vs Compomer, composite resin, or another HVGIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

High-viscosity GIC had a wide annual failure rate (2.9-25.6%) and was outperformed by compomer/composite in some trials (3 RCTs); low quality of evidence (ungraded).

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable

Caries experience (mean DMFT) · Children aged 12 years (plus or minus one year) in Africa

The pooled mean DMFT score was 1.0900 (95% CI 0.9143 to 1.2657); GRADE was not reported.

2 findings from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs76823412 (8:134690570; nearest gene(s) ST3GAL1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs8091366 near CHST9, KCTD1 showed suggestive (not genome-wide significant) association with ECC (Z = 4.476, p = 7.60e-6); genetic association, ungraded.

2 findings from 1 review