Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

99 questions · 120 findings · 17 reviews

No studies found 1 · 0.8%GRADE not reported 92 · 76.7%Very low 21 · 17.5%Low 3 · 2.5%Moderate 3 · 2.5%High 0 · 0%

Restorative dental treatment under general anesthesia vs Before treatment (before-after)

Oral health-related quality of life (child and family) · Preschool children in the United Arab Emirates receiving dental general anesthesia

One study found restorative dental treatment under general anesthesia significantly improved oral health-related quality of life for preschool children and their families (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Composite resin with etch-and-rinse (total-etch) adhesion vs Composite resin with self-etch adhesion (same universal adhesive)

Treatment failure (annual failure rate) · Children with moderately deep dentine caries in primary molars, no pulp therapy

Etch-and-rinse adhesion failed more than self-etch (19.5% vs 7.0% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional ceramic brackets

Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Adhesive precoated flash-free brackets showed no demineralization difference, with certainty not graded.

1 finding from 1 review

One-step adhesive bonding system (GC Ortho Connect) vs Conventional three-step bonding system (3M Transbond XT)

White spot lesion incidence, area, and depth · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

GC Ortho Connect had more frequent, larger, and deeper WSLs, with certainty not graded.

1 finding from 1 review

Indirect bonding using flowable composite adhesive (Opal Bond MV) vs Direct bonding (conventional, Transbond XT)

White spot lesion formation (QLF: fluorescence loss, lesion area) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Indirect bonding with a flowable adhesive favored less QLF-measured demineralization, with certainty not graded.

1 finding from 1 review

Indirect bonding using flowable composite adhesive (Opal Bond MV) vs Direct bonding (conventional, Transbond XT)

White spot lesion formation (QLF: fluorescence loss, lesion area) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

A single RCT found indirect bonding with flowable composite reduced white spot lesion formation versus direct bonding (ungraded).

1 finding from 1 review

Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight)

Early childhood caries (ECC) · Children (approx. 4-18 years)

In the Region: Asian countries subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.70, 95% CI 1.25 to 2.32; ungraded).

17 findings from 1 review
Show 14 more findings

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Proposed inhibition of S. mutans adhesion to tooth surface (mechanism; direct adherence endpoint confirmed only in Ahn 2018) · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

Postbiotics inhibit S. mutans adhesion to tooth surfaces in vitro (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    Postbiotics (mainly biosurfactants and lipoteichoic acid) interfered with S. mutans adhesion to tooth/hydroxyapatite surfaces in 5 in vitro studies; no pooled estimate.
    5 studies
    GRADE not reported

Lactobacillus-derived postbiotics vs Not specified

Virulence-gene expression related to adhesion acid production and exopolysaccharide synthesis · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

No meta-analysis was conducted; the narrative synthesis reported reduced expression of Streptococcus mutans virulence genes.

1 finding from 1 review

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

Most in vitro studies indicate e-cigarette aerosol/e-liquid (especially flavored/high-concentration) disrupts normal oral flora and favors cariogenic S. mutans growth and biofilm, plausibly increasing caries risk; not pooled (ungraded, narrative).

1 finding from 1 review

Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride)

Bacterial adhesion (inhibition) · Streptococcus mutans (in vitro cultures and biofilms)

Grape seed extract inhibits S. mutans adhesion to hydroxyapatite in vitro (2 studies; ungraded).

1 finding from 1 review

Cranberry extract or cranberry flavonoid fractions vs No extract or vehicle control; other antimicrobial agents

Bacterial adhesion or initial colonization · Streptococcus mutans (in vitro cultures and biofilms)

No meta-analysis was conducted; three included studies reported reduced adhesion or initial colonization with cranberry extract or fractions.

1 finding from 1 review

Cranberry extract / juice and proanthocyanidin (flavonoid) fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride)

Bacterial adhesion (inhibition) · Streptococcus mutans (in vitro cultures and biofilms)

Cranberry extract inhibits S. mutans adhesion / initial colonization in vitro (3 studies; ungraded).

1 finding from 1 review

Grape seed extract or grape seed flavonoid fractions vs No extract or vehicle control; other antimicrobial agents

Bacterial adhesion · Streptococcus mutans (in vitro cultures and biofilms)

No meta-analysis was conducted; two included studies reported reduced Streptococcus mutans adhesion with grape seed extract or fractions.

1 finding from 1 review

Malocclusion vs No malocclusion

Impaired OHRQoL measured with CPQ 11-14 (quantitative synthesis / meta-analysis) · Adolescents (10-19 years)

Malocclusion (DAI) probably increases the prevalence of impaired OHRQoL (CPQ 11-14) by about 15% in adolescents (RR/PR 1.15, 95% CI 1.12-1.18; moderate certainty).

1 finding from 1 review

Gum chewing (sugar-free) vs No chewing gum

Salivary flow rate · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

Across 19 studies the effect of gum chewing on stimulated and/or unstimulated salivary flow rate was mixed (9 positive, 10 no effect); this broad outcome was not meta-analyzed.

1 finding from 1 review

Malocclusion vs No malocclusion

Poor oral health-related quality of life (OHRQoL) · Adolescents (10-19 years)

Malocclusions probably have a negative effect on OHRQoL in adolescents, after adjustment for confounders (moderate certainty).

1 finding from 1 review

Experimental orthodontic composite containing nano-hydroxyapatite (n-HAP) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel surface microhardness · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, a nano-hydroxyapatite-containing orthodontic composite showed significant enamel remineralization versus control in a single study (ungraded).

1 finding from 1 review

Antibacterial S. mutans reduction only in Farzanegan (chitosan+TiO2); Mollabashi (TiO2-only) showed no significant antibacterial effect - not attributable to TiO2 alone vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Streptococcus mutans count · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

The antibacterial (S. mutans) effect of TiO2 nanoparticles was conflicting across two RCTs (ungraded).

1 finding from 1 review