Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

574 questions · 721 findings · 67 reviews

No studies found 93 · 12.9%GRADE not reported 450 · 62.4%Very low 82 · 11.4%Low 73 · 10.1%Moderate 21 · 2.9%High 2 · 0.3%

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Sensitivity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Inter-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Inter-examiner reliability ranged from kappa 0.44 to 0.91 across 13 studies (moderate to almost perfect agreement); certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Negative predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Negative predictive value was reported in 10 studies and ranged widely across studies (about 31% to 99.5%); no pooled estimate and certainty not graded.

1 finding from 1 review

Non-syndromic cleft lip and palate (CLP) status and its oral microbiota (exposure/grouping) vs Children and adolescents aged 0-18 years without CLP (controls)

Dental caries · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

Pooling 3 studies, children/adolescents with CLP were about 2.03 times more likely to have dental caries than non-CLP controls (p<0.005; low heterogeneity), though most included studies were at high risk of bias; the evidence is ungraded.

1 finding from 1 review

Fluoride toothpaste vs Not applicable (single-group prevalence)

Fluoride toothpaste use prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 39% of children with caries in LMICs used fluoride toothpaste (pooled prevalence 0.391, 95% CI 0.166 to 0.644; 2 studies; not GRADE-rated).

1 finding from 1 review

Female sex vs Not applicable (single-group prevalence)

Female sex prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

Among children with caries in LMICs, about half were female (pooled prevalence 0.497, 95% CI 0.475 to 0.519; 6 studies; I2=0%; not GRADE-rated).

1 finding from 1 review

Sugary drinks/sweets consumption vs Not applicable (single-group prevalence)

Sugary drinks/sweets consumption prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 70% of children with caries in LMICs consumed sugary drinks/sweets (pooled prevalence 0.697, 95% CI 0.478 to 0.877; 7 studies; very high heterogeneity; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

Low SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 36% of children with caries in LMICs were of low SES (pooled prevalence 0.359, 95% CI 0.167 to 0.578; 4 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Not applicable (single-group prevalence)

No formal maternal education prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 10% of children with caries in LMICs had mothers with no formal education (pooled prevalence 0.101, 95% CI 0.033 to 0.201; 3 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Not applicable (single-group prevalence)

Primary maternal education prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 42% of children with caries in LMICs had mothers with primary education (pooled prevalence 0.425, 95% CI 0.280 to 0.576; 7 studies; not GRADE-rated).

1 finding from 1 review

Good brushing habits (>=2 daily tooth brushing) vs Not applicable (single-group prevalence)

Good brushing habits prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 57% of children with caries in LMICs had good brushing habits (pooled prevalence 0.569, 95% CI 0.354 to 0.771; 7 studies; very high heterogeneity; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Not applicable (single-group prevalence)

Secondary/higher maternal education prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 45% of children with caries in LMICs had mothers with secondary or higher education (pooled prevalence 0.450, 95% CI 0.330 to 0.572; 7 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

Middle SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 35% of children with caries in LMICs were of middle SES (pooled prevalence 0.353, 95% CI 0.180 to 0.550; 7 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

High SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 25% of children with caries in LMICs were of high SES (pooled prevalence 0.245, 95% CI 0.162 to 0.339; 5 studies; not GRADE-rated).

1 finding from 1 review

Referral letter based on the common-sense model (CSM) plus dental information guide (DIG) vs Referral letter based on the common-sense model (CSM) alone

Proportion of children with treated/untreated caries (receipt of dental care) · School children, primary schools in the USA

It is very uncertain whether referral letter based on the common-sense model (CSM) plus dental… changes proportion of children with treated/untreated caries (receipt of… compared with referral letter based on the common-sense model (CSM) alone (very low certainty).

1 finding from 1 review

Referral letter based on the common-sense model (CSM) of self-regulation plus dental information guide (DIG) vs Standard referral letter

Proportion of children with treated/untreated caries (receipt of dental care) · School children, primary schools in the USA

It is very uncertain whether referral letter based on the common-sense model (CSM) of… changes proportion of children with treated/untreated caries (receipt of… compared with standard referral letter (very low certainty).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Caries presence in primary teeth · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes children with caries in the primary teeth at 3 years compared with placebo or no treatment (very low certainty).

2 findings from 1 review

Simple childhood caries prediction models with at least two predictors vs No competing model

Dental caries discrimination (area under the curve) · Children or adolescents

The Luo (2021) model had an AUC of 0.77 (95% CI 0.76 to 0.77).

6 findings from 1 review
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Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in the United Kingdom

In UK studies, OHPPs were associated with lower DMFT/S (OR 0.04, 95% CI 0.00 to 0.58; ungraded).

1 finding from 1 review