Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

239 questions · 315 findings · 44 reviews

No studies found 0 · 0%GRADE not reported 284 · 90.2%Very low 16 · 5.1%Low 8 · 2.5%Moderate 7 · 2.2%High 0 · 0%

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

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

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 Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review

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 Japan

The single Japanese study yielded a degenerate estimate of OR 0.00 (95% CI 0.00 to 0.00; ungraded, single study).

1 finding from 1 review

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 (studies published 2015 or later)

In studies published from 2015 onward, OHPPs were associated with lower DMFT (OR 0.08, 95% CI 0.01 to 0.53; ungraded).

1 finding from 1 review