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Evidence found and GRADE certainty

2,066 questions · 3,346 findings · 178 reviews · Dental caries

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No studies found 48 · 1.4%GRADE not reported 2,789 · 83.4%Very low 208 · 6.2%Low 129 · 3.9%Moderate 136 · 4.1%High 36 · 1.1%

Dental caries vs Caries-free status

Relative abundance of S. mutans in saliva · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

The relative abundance of S. mutans in saliva is significantly higher in caries-active than caries-free individuals (pooled SMD 1.48, 95% CI 0.45 to 2.50), but heterogeneity is very high (I2=90%); ungraded.

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Serum IgG antibody response (immunogenicity) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines elicited increased serum IgG antibody responses across the animal studies (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

All European countries pooled (overall) vs None (overall pooled prevalence)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Across European countries the overall pooled mean DMFT in 12-year-olds was 2.10 (95% CI 1.63 to 2.57), with very high between-country heterogeneity (I2=100%); not GRADE-rated.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · general population

Hip BMD increased with fluoride in both sexes (linearly in males, non-linearly above ~1.2 mg/L in females); no numeric MD reported in text for the main analysis; ungraded.

1 finding from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Both sexes, main dose-response
    Hip BMD increased in both sexes, linearly in males and non-linearly (starting above 1.2 mg/L) in females (no numeric MD reported in text for main analysis)
    Studies not reported
    GRADE not reported

Older child age (months) vs Younger age (reference)

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

Age 48-59 months was associated with higher odds of ECC (OR 2.602).

2 findings from 1 review

Timing of first dental visit vs Reference visit timing

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

An early first dental visit was associated with much lower odds of ECC (OR 0.042).

2 findings from 1 review

Flavonoids (e.g., quercetin, proanthocyanidin) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Etch-and-Rinse adhesive + biological ACAD protocol network, Flavonoids showed 12.771 MPa lower 24 h bond strength than Calcium Phosphate (MD -12.771, 95% CI -20.538 to -5.003; Moderate certainty).

2 findings from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Mean DMFT (decayed, missing, filled permanent teeth) · Adults with epilepsy

In adults, epilepsy is associated with a significantly higher DMFT than controls (SMD 0.548, P < .001; ungraded subgroup analysis).

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Proper anatomic form · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in anatomic form (high certainty).

1 finding from 1 review