Dental caries · Individuals in East Africa assessed for dental caries
Frequent carbohydrate intake was associated with significantly higher odds of dental caries (OR 1.575, 95% CI 1.13 to 3.051); certainty not graded.
1 finding from 1 review
Dental caries · Healthy children and adolescents in the United Arab Emirates
Higher snacking and soft-drink/sugar consumption were associated with more caries in most studies, though one study found no association with sweet-consumption frequency (narrative synthesis; not GRADE-rated).
1 finding from 1 review
Soft drink consumption (Khadri et al.: 0.31, 95% CI 0.14-0.47) and a high extent of snacking (Hashim et al.: high vs low snack level aRR 1.46, 95% CI 1.26-1.70; snacking >=3x vs once daily aRR 1.25, 1.00-1.57) were…
Studies not reported
GRADE not reported
Caries development in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)
Early-childhood oral hygiene and dietary habits show inconsistent associations with permanent-teeth caries, often losing significance after adjustment for past caries (2 studies; not pooled; not GRADE-rated).
1 finding from 1 review
Enamel/dental hard-tissue changes and e-liquid cariogenic properties (demineralization, colour change, pH, sugar content, metals) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…
In vitro evidence suggests e-liquids are often acidic and sugar-containing and can alter enamel/dentin colour and properties, supporting a plausible cariogenic effect, but findings are heterogeneous and not pooled (ungraded, narrative).
1 finding from 1 review
Change in Mutans streptococci (MS) and Lactobacilli in saliva · Schoolchildren (6-9 years), high caries risk
The single stevia trial (Cocco 2019) reported a significant reduction in salivary Mutans streptococci and lactobacilli, but gave no effect size and was not GRADE-rated.
1 finding from 1 review
Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. 2024 All outcomes42 days · Schoolchildren in Italy, high caries risk; sweetener delivered as a daily snack · Single study (Cocco 2019); not pooled
Cocco 2019 (the only high-intensity sweetener trial): the stevia snack showed a significant decrease in MS (P < .01) and in lactobacilli (P = .03) versus baseline, whereas the white-sugar snack showed no significant…
1 study · 271 participants
GRADE not reported
Effects of non-stevia high-intensity sweeteners (aspartame, sucralose, saccharin) on cariogenic bacteria in dental plaque or saliva · healthy people
No eligible studies evaluated high-intensity sweeteners such as aspartame, sucralose, or saccharin for their effect on cariogenic bacteria.
1 finding from 1 review
Change in Mutans streptococci (MS) count in saliva · healthy people
Xylitol significantly reduced Mutans streptococci in saliva compared with no intervention (SMD -1.47, 95% CI -1.94 to -0.99; 3 trials), though heterogeneity was very high (I2=98%); not GRADE-rated.
1 finding from 1 review
Intervention not reported
Change in prevalence of salivary Streptococcus sobrinus
1 finding from 1 review
Intervention not reported
Change in Lactobacillus spp. in dental plaque
1 finding from 1 review
Intervention not reported
Adverse events
1 finding from 1 review
Tooth decay-free children · Alaska children aged 5 to 18 years
The robust prevention PDHA model was projected to yield more than 50% tooth decay-free children versus 8% with other PDHA models, without a GRADE rating.
1 finding from 1 review
Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children
High-intensity community education was associated with a 33% reduction in BBTD prevalence, without a GRADE rating.
3 findings from 1 review
Percent reduction in BBTD prevalence 33
1 study
GRADE not reported
Percent reduction in BBTD prevalence 18
1 study
GRADE not reported
Percent reduction in BBTD prevalence 27
1 study
GRADE not reported
Projected Significant Caries (SiC) index · Alaska Native children (below age 18)
A simulation projected a 50% drop in the Significant Caries index for children (12.3 to 6.1) under the PDHA model (certainty not graded).
2 findings from 1 review
Projected proportion of caries-free children (5-18 years) · Alaska Native children (below age 18)
A simulation projected 0% of children aged 5-18 would be caries-free under the baseline scenario (certainty not graded).
3 findings from 1 review
Technical performance / deficient restorations (DHATs vs dentists) · Alaska Native dental patients (children aged 6-17 and adults) and their caregivers
DHATs had a lower amalgam restoration deficiency rate than dentists (12% vs 22%; certainty not graded).
3 findings from 1 review
Clinical care quality · Alaska dental health aide therapists
Four newly trained DHATs met stated clinical care standards in a qualitative evaluation, without a GRADE rating.
1 finding from 1 review
Clinic-based dental care utilization · Alaska children
The PDHA program was projected to increase clinic-based dental care utilization from 75% to 90%, without a GRADE rating.
1 finding from 1 review
Projected receipt of school-based prevention services · Alaska Native children (below age 18)
A simulation projected that over 90% of children would receive school-based prevention services under the PDHA model, up from 53% (certainty not graded).
1 finding from 1 review
Amalgam restoration deficiency · Alaska dental health aide therapists
Amalgam restoration deficiency was 12% for DHATs versus 22% for dentists, without a GRADE rating.
1 finding from 1 review
Caregiver satisfaction · Caregivers of Alaska Native children aged 6 to 17 years
More than 90% of caregivers reported being usually or always satisfied with DHAT care, without a GRADE rating.
1 finding from 1 review