Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

238 questions · 268 findings · 39 reviews · Oral Health

No studies found 55 · 20.5%GRADE not reported 154 · 57.5%Very low 23 · 8.6%Low 23 · 8.6%Moderate 13 · 4.9%High 0 · 0%

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-6 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-6 levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 11.60 pg/mL, 95% CI 6.27 to 16.94; 11 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-8 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-8 levels are higher in children and young adults with active dental caries than in controls but the difference is not statistically significant (SMD 57.20 pg/mL, 95% CI -18.60 to 133.00; 7 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

TNF-α level · Children and young adults (3-25 years)

Salivary TNF-α levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 14.81 pg/mL, 95% CI 4.76 to 24.86; 7 studies); ungraded.

1 finding from 1 review

Dental caries vs Caries-free status

Relative abundance of S. mutans in saliva · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

The relative abundance of S. mutans in saliva is significantly higher in caries-active than caries-free individuals (pooled SMD 1.48, 95% CI 0.45 to 2.50), but heterogeneity is very high (I2=90%); ungraded.

1 finding from 1 review

Dental caries vs Caries-free status

Oral microbial community composition and diversity (other caries-associated taxa; alpha- and beta-diversity) · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

No oral microbial taxon other than S. mutans was consistently associated with caries; alpha-diversity mostly did not differ between caries-active and caries-free groups and beta-diversity findings were mixed (ungraded, narrative).

1 finding from 1 review
  • Streptococcus mutans and Caries: A Systematic Review and Meta-Analysis. 2025 All outcomes
    Cross-sectional · Clinical oral-microbiome studies; saliva and/or supragingival plaque samples; 7 countries; DNA/RNA-based sequencing or microarray
    Narrative synthesis (no pooled estimate): no bacterial genus or species other than S. mutans was consistently (reported in more than 2 studies) associated with caries-active status (Table 3; 15 of 19 studies for…
    Studies not reported
    GRADE not reported

Dental caries vs Caries-free status

Prevalence (detection frequency) of S. mutans in plaque · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

S. mutans prevalence in plaque is significantly higher in caries-active than caries-free individuals (pooled OR 2.58, 95% CI 1.65 to 4.02; I2=16%); ungraded.

1 finding 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

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

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

Among HIV+ children, HAART was associated with a significantly higher DMFT index than no HAART in case-control studies (MD 2.02, 95% CI 1.24 to 2.80; ungraded).

1 finding from 1 review

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

Caries in primary teeth: dmft (3 years) · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART versus no HAART showed no significant difference in the dmft index in case-control studies (MD 0.66, 95% CI -0.26 to 1.58; ungraded).

1 finding from 1 review

Bio-active restorative materials vs Any conventional restorative material

Treatment failure (planned; no eligible studies) · Children with carious primary teeth after vital or non-vital pulp therapy

No eligible studies were found evaluating bio-active restorative materials for restoring carious primary teeth after pulp therapy.

1 finding from 1 review

Bio-active restorative materials vs Any restorative material or technique

Not applicable (no eligible studies) · Children with carious primary teeth (no pulp therapy)

No eligible RCTs assessed new bio-active restorative materials in carious primary teeth; this is an evidence gap identified by the review.

1 finding from 1 review

Active rinse (zinc acetate + chlorhexidine + sodium fluoride), with or without tongue scraping vs Negative control rinse, with or without tongue scraping

OLT and VSC scores · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…
1 finding from 1 review
  • Interventions for managing halitosis 2019 · Cochrane All outcomes
    Ademovski 2012 (4-arm cross-over trial) compared an active rinse (with/without tongue scraping) versus a negative control rinse (with/without tongue scraping); OLT and VSC. The authors did not report the correlation…
    1 study
    GRADE not reported

Orthodontic adhesives containing bioactive glass (BAG) particles/nanoparticles (including fluoride- or Ga-doped BAG) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Ion release (fluoride, calcium, phosphate) · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, among the 5 BAG ion-release studies only Ga-doped BAG (GaMBN, Song [31]) reported a significant increase (phosphate, up to 14 days); a general significant fluoride/calcium/phosphate increase across all 5 is not supported (ungraded).

1 finding from 1 review

Orthodontic adhesives containing bioactive glass (BAG) particles/nanoparticles (including Ag-, Zn-, fluoride-, or Ga-doped BAG) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel remineralization / anti-demineralization extent · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, most bioactive glass-containing orthodontic adhesives (9 of 13 studies) showed significant enamel remineralization/anti-demineralization versus control, but the evidence is weak (predominantly high risk of bias, methodological heterogeneity, no meta-analysis; ungraded).

1 finding from 1 review

Ultrasonic instrumentation used alone (any ultrasonic device designed specifically for root canal treatment and capable of the active or passive removal of dentine within the root canal) vs Hand instrumentation used alone (files and reamers used manually)

Outcome not reported · People over 18 years of age with single or multiple permanent teeth with a completely formed apex and no evidence of internal resorption,…

The review found no eligible studies for this question.

1 finding from 1 review

Hand instrumentation in conjunction with (as an adjunct to) an ultrasonic device designed specifically for root canal treatment and capable of the active or passive removal of dentine within the root canal vs Hand instrumentation used alone (files and reamers used manually)

Outcome not reported · People over 18 years of age with single or multiple permanent teeth with a completely formed apex and no evidence of internal resorption,…

The review found no eligible studies for this question.

1 finding from 1 review

38% SDF (every 6 months) vs no treatment

Inactive (arrested) carious lesions on permanent first molars · Children with dental caries in permanent (first) molars

Six-monthly SDF produced significantly more inactive (arrested) lesions than no treatment in children's permanent molars (0.3 vs 0.1; p<0.05; ungraded).

1 finding from 1 review

Periodontal treatment: scaling and root planing (SRP) plus advice vs Community care: advice only

Serum high-sensitivity C-reactive protein (hs-CRP) · Patients with cardiovascular disease and chronic periodontitis
1 finding from 1 review