What do systematic reviews say?

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Dental erosion was more prevalent in anorexia nervosa patients than controls (low erosive-wear severity), but was not pooled or graded (ungraded).

• The influence of anorexia nervosa on oral health and related parameters potentially relevant to orthodontic treatment:… 2025 All outcomes

  Clinical dental/oral examination; case-control studies and controlled clinical trials in Europe (mainly Poland, Italy, France, Germany), Australia and the USA
  Significant prevalence of dental erosion in anorexic patients vs controls, though BEWE scores indicated low erosive-wear risk (Mascitti BEWE 5.2+/-4.5; Paszynska 16.2% at BEWE 3-8); not meta-analyzed
  2 studies · 270 participants
  GRADE not reported

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Anorexia nervosa patients tended to have higher plaque accumulation than healthy controls (significant in 2 of 3 studies), but results were not pooled or graded (ungraded).

• The influence of anorexia nervosa on oral health and related parameters potentially relevant to orthodontic treatment:… 2025 All outcomes

  Clinical dental/oral examination; case-control studies and controlled clinical trials in Europe (mainly Poland, Italy, France, Germany), Australia and the USA
  In 2 of 3 studies anorexic patients had significantly higher plaque accumulation than controls (Pallier 78.8% vs 53.0%, p<0.01; Paszynska 43.8% vs 13.7%, p<0.001; Milosevic 84% vs 72%, NS); not meta-analyzed
  3 studies · 394 participants
  GRADE not reported

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

• The influence of anorexia nervosa on oral health and related parameters potentially relevant to orthodontic treatment:… 2025 All outcomes

  Clinical dental/oral examination; case-control studies and controlled clinical trials in Europe (mainly Poland, Italy, France, Germany), Australia and the USA
  MD 2.00 [0.87, 3.13]
  4 studies · 406 participants
  Low

Oral cytology (e.g. OralCDx brush biopsy, CytID) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Oral cytology (e.g. brush biopsy) was added to the list of eligible index tests in this update; no eligible studies evaluated it (evidence gap).
  0 studies
  No studies found

COE with blood/salivary (biomarker) analysis vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  There were no eligible studies evaluating blood or salivary sample analysis (which tests for the presence of biomarkers for OPMD and OSCC).
  0 studies
  No studies found

Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 4 (no pooled analysis): specificity 0.99 (95% CI 0.99 to 1.00), 1.00 (95% CI 0.91 to 1.00), and 0.72 (95% CI 0.63 to 0.80) across the 3 studies. Certainty VERY LOW.
  3 studies · 3600 participants
  Very low

Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 4 (no pooled analysis): sensitivity 0.85 (95% CI 0.81 to 0.88), 0.82 (95% CI 0.57 to 0.96), and 0.94 (95% CI 0.70 to 1.00) across the 3 studies. Prevalence 12.2% to 30.9%. Certainty VERY LOW.
  3 studies · 3600 participants
  Very low

Brush biopsy (oral cytology) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Sensitivity 0.90 [0.82, 0.94]
  20 studies
  Moderate

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Specificity 0.91 [0.90, 0.91]
  1 study · 4080 participants
  Moderate
• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Specificity 0.92 [0.91, 0.93]
  1 study · 3895 participants
  Moderate

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs COE with vital rinsing (toluidine blue/tolonium chloride)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE with vital rinse vs COE with light-based detection) not populated in this version.
  0 studies
  No studies found

Blood and saliva analysis (biomarker tests) vs Surgical or punch biopsy with histological assessment

The review found no eligible studies for this question.

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  No eligible studies assessed the diagnostic test accuracy of blood and saliva analysis; potentially eligible biomarker studies were excluded as case-control designs.
  0 studies
  No studies found

COE with blood/salivary (biomarker) analysis vs COE with vital rinsing (toluidine blue/tolonium chloride)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE with vital rinse vs COE with blood/salivary analysis) not populated in this version.
  0 studies
  No studies found

Light-based detection and/or oral spectroscopy (e.g. ViziLite, VELscope, Microlux DL, Identafi 3000) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Specificity 0.50 [0.32, 0.68]
  23 studies
  Very low

Vital staining (e.g. toluidine blue, tolonium chloride) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Specificity 0.68 [0.58, 0.77]
  20 studies
  Very low

COE with blood/salivary (biomarker) analysis vs Conventional oral examination (COE) alone

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE vs COE with blood/salivary analysis) not populated in this version.
  0 studies
  No studies found

Vital staining (e.g. toluidine blue, tolonium chloride) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Sensitivity 0.86 [0.79, 0.90]
  20 studies
  Low

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  There were no eligible studies evaluating light-based detection.
  0 studies
  No studies found

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

COE with vital rinsing (toluidine blue/tolonium chloride) showed no clear difference in detection rate of oral pre-malignant and malignant lesions after… compared with conventional oral examination (COE) alone (moderate certainty).

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Rate ratio 1.05 [0.74, 1.41]
  1 study · 7975 participants
  Moderate

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Specificity 0.71 [0.53, 0.84]
  9 studies
  Very low

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Conventional oral examination (COE) alone

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE vs COE with light-based detection) not populated in this version.
  0 studies
  No studies found