Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

94 questions · 119 findings · 14 reviews · All outcomes

No studies found 10 · 8.4%GRADE not reported 84 · 70.6%Very low 12 · 10.1%Low 11 · 9.2%Moderate 2 · 1.7%High 0 · 0%

Early childhood caries (ECC) vs Caries-free controls

Number of detected salivary bacterial genera · Young children with early childhood caries and caries-free controls

Fewer salivary bacterial genera were reported in the caries-affected group, without a comparative effect estimate or CI.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Relative abundance of dominant salivary microbial community (7 genera) · Young children with early childhood caries and caries-free controls

The reported multi-genus community had similar relative abundance in caries-affected and caries-free children, without a comparative effect estimate or CI.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Streptococcus mutans and Veillonella spp. levels · Young children with early childhood caries and caries-free controls

Veillonella spp. levels were reported as substantially greater in caries subjects, but the review gave no numerical effect estimate or CI.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Relative abundance of Veillonella spp. · Children under 6 years with severe early childhood caries and caries-free controls

Veillonella spp. mean relative abundance was lower in the S-ECC group; no comparative effect estimate or CI was reported.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Relative abundance of S. mutans in saliva · Children under 6 years with severe early childhood caries and caries-free controls

S. mutans median relative abundance was higher in the S-ECC group, without a comparative effect estimate or CI.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Streptococcus relative abundance · Children under 6 years with severe early childhood caries and caries-free controls

Streptococcus mean relative abundance was slightly higher in the S-ECC group; no comparative effect estimate or CI was reported.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Veillonella spp. and Streptococcus mutans interaction · Children under 6 years with severe early childhood caries and caries-free controls

The study reported a possible role for Veillonella spp. in supporting cariogenic species, without a quantitative effect estimate.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Veillonella dispar relative abundance · Children under 6 years with severe early childhood caries and caries-free controls

Veillonella dispar median relative abundance was higher in the S-ECC group, without a comparative effect estimate or CI.

1 finding from 1 review

Growth stunting (linear growth retardation, low height-for-age) vs Children without growth stunting (normal height-for-age)

Early childhood caries (ECC) · Children aged ≤6 years (early childhood)

One Nigerian cross-sectional study reported a significant adjusted association between nutritional (stunting) status and ECC (APR 0.14, 95% CI 0.03-0.69); ungraded.

4 findings from 1 review
Show 1 more finding

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of S. mutans in saliva · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

A few small studies report Streptococcus mutans relative abundance in caries versus caries-free children without pooling; the evidence is ungraded and not meta-analyzed.

1 finding from 1 review

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of Veillonella spp. · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

Evidence on whether Veillonella spp. relative abundance is higher or lower in children with dental caries than caries-free controls is inconsistent across 7 small observational studies; no pooled estimate was produced and the evidence is ungraded.

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children with average age >3 years

No significant association between cesarean vs vaginal delivery and ECC among children with average age >3 years (OR 1.24, 95% CI 0.89-1.71).

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children with average age ≤3 years

No significant association between cesarean vs vaginal delivery and ECC among children with average age ≤3 years (OR 0.86, 95% CI 0.67-1.10).

1 finding from 1 review

Mixed breast- and bottle-feeding vs Bottle feeding

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between mixed breast-and-bottle-fed and bottle-fed-only children (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Higher parental education (tertiary) vs Parental high school (secondary) education

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

Parental tertiary education (vs high-school education) was associated with about 1.8 times higher odds of early childhood caries in South Africa (OR 1.77, 95% CI 1.22-2.57; 2 studies; not GRADE-rated).

1 finding from 1 review

Bottle-feeding only vs Breastfeeding only

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between bottle-fed-only and breast-fed-only children (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Low parental socioeconomic status (SES) vs High parental socioeconomic status (SES)

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between children of low- versus high-SES parents (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Early childhood caries experience (mean dmft) · Nigerian children with primary dentition (approximately 6 months to 5 years)

In primary dentition, high-frequency sugar consumption was associated with slightly higher, non-significant odds of caries (OR 1.13, 95% CI 0.23 to 5.44), with high heterogeneity (I2=83%; ungraded).

1 finding from 1 review

Breastfeeding for more than 24 months vs Not breastfed at the same age or breastfed for a shorter duration

Early childhood caries (ECC) - incidence/risk · Children with exclusively primary dentition (age ≤71 months)

Breastfeeding beyond 24 months is associated with an increased risk (incidence) of early childhood caries versus not breastfeeding at the same age (RR 2.44, 95% CI 1.97 to 3.02; low certainty).

1 finding from 1 review