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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

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No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 8: disruption of occlusal integrity · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with disruption of occlusal integrity, surveyed dentists most often preferred repair over replacement (pooled RR 0.37; p < 0.001); ungraded.

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Combined salivary IL-1β, IL-6, IL-8, and TNF-α levels · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Combining all four salivary cytokines, the meta-analysis found no effect of e-cigarette use on salivary proinflammatory marker levels (low between-marker heterogeneity, I2=31%); the pooled estimate appears only in Figure 3F (unavailable) and is ungraded.

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary pH · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly lower salivary pH than healthy controls (MD -0.39, 95% CI -0.54 to -0.24; low certainty).

1 finding from 1 review

Unemployment rate 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 unemployment rate.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · Females (all ages)

In females (low-to-moderate risk-of-bias studies), hip BMD rose monotonically above ~0.9 mg/L: MD 0.04 g/cm2 (95% CI -0.03-0.12) up to ~2.3 mg/L and 0.09 (-0.09-0.27) at 4.0 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: up to ~2.3 mg/L vs null
    MD 0.04 [-0.03, 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: 4.0 mg/L vs null
    MD 0.09 [-0.09, 0.27]
    Studies not reported
    GRADE not reported

Electronic cigarette use vs Non-smokers

Untreated dental caries and caries risk · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

Across individual cross-sectional studies, e-cigarette users tended to have more untreated caries and higher caries risk than non-smokers (per-study OR ~2.0-4.2), but results were not pooled (ungraded, narrative).

1 finding from 1 review

Intervention not reported

Amalgam: Preference for replacement over repair - Scenario 1: partial loss or fracture of the restoration

The intervention led to higher amalgam: Preference for replacement over repair - Scenario 1:…; GRADE not reported.

1 finding from 1 review

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

Absence of sensibility (post-operative sensitivity) · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in post-operative sensitivity (high certainty).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 5: open margin · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with open margin, surveyed dentists most often preferred replacement over repair (pooled RR 5.14; p < 0.001); ungraded.

1 finding from 1 review

Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs HEMA/EGDMA-based desensitizer

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, Peptide vs HEMA showed no significant difference in 24 h bond strength (MD -0.369, 95% CI -6.728 to 5.990; Low certainty).

1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard

detection of occlusal caries · human primary or permanent teeth with dental caries lesions

QLF had pooled sensitivity of 0.86 and specificity of 0.80 for occlusal caries (permanent dentition, in vivo).

2 findings from 1 review

Health expenditure per capita vs Higher vs lower per-capita health expenditure categories

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

OHRQoL did not differ significantly across per-capita health-expenditure categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review