Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,378 questions · 2,146 findings · 145 reviews

No studies found 167 · 7.8%GRADE not reported 1,674 · 78%Very low 148 · 6.9%Low 113 · 5.3%Moderate 40 · 1.9%High 4 · 0.2%

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Specificity for dental caries diagnosis · Children and adults with primary or permanent dentition

Specificity ranged from 83% to 100% across 13 studies; no meta-analysis or GRADE rating was reported.

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

Traditional screening (referral card given if the inspecting dentist judges the child needs to see a dentist) vs No screening

Dental caries prevalence · School children (aged 4 to 15 years), primary and secondary schools in the UK and India
1 finding from 1 review
  • Milsom 2006 measured prevalence of dental caries as mean number of teeth with active caries in primary teeth (dt) and permanent teeth (DT); post-intervention changes from baseline were not significant, and the authors…
    1 study · 16684 participants
    GRADE not reported

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

GERD vs Healthy individuals without reflux (controls)

Dental caries · Adults with gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR)

Reflux appears associated with a higher prevalence of dental caries than in healthy individuals based on three studies, though to a lesser extent than erosion; evidence is ungraded and not pooled.

1 finding from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from heavily contaminated areas, individual studies gave inconsistent DMFT/dmft differences; the review did not pool them and drew no firm conclusion (ungraded).

4 findings from 1 review
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Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from weakly contaminated areas, individual cross-sectional studies reported mostly higher but inconsistent DMFT/dmft in exposed vs non-exposed children; the review did not pool the data and drew no firm conclusion (ungraded).

4 findings from 1 review
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Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children of mixed ages (mean approximately 12 years; no age separation)

In children of mixed ages from heavily contaminated areas, individual studies reported modestly higher DMFT/dmft in exposed children; the review did not pool them and drew no firm conclusion (ungraded).

5 findings from 1 review
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Residence in low-contamination area (approx. 5-15 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from a low-contamination area, individual studies reported higher DMFT/dmft in exposed than non-exposed children; not pooled (ungraded).

2 findings from 1 review

Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from weakly contaminated areas, individual studies mostly reported higher DMFT/dmft in exposed children but with wide variation; the review did not pool the data (ungraded).

9 findings from 1 review
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Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children of mixed ages (mean approximately 12 years; no age separation)

In children of mixed ages from a weakly contaminated area, one study reported higher DMFT/dmft in exposed than non-exposed children; not pooled (ungraded).

1 finding from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from heavily contaminated areas, individual studies gave conflicting DMFT/dmft differences (some favouring exposed, some non-exposed); the review did not pool them (ungraded).

4 findings from 1 review
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Residence in low-contamination area (approx. 5-15 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from a low-contamination area, one study reported higher DMFT/dmft in exposed than non-exposed children; the estimate was not pooled (ungraded).

1 finding from 1 review

Postnatal passive tobacco exposure (secondhand/household smoke in infancy) vs No passive tobacco exposure (non-exposed children)

Caries presence in primary teeth · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

Postnatal (infancy) tobacco exposure is associated with higher odds of caries in primary dentition (pooled OR 1.72, 95% CI 1.45 to 2.05; 13 studies; high heterogeneity I2=83%); certainty not graded.

1 finding from 1 review

Older adults (population mean age >33.4 years) vs Younger adults (population mean age <=33.4 years)

Caries experience (mean DMFT) · Adults aged 19-60 years

Studies of older adults (mean age >33.4 years) had higher pooled DMFT than younger adults, but the age to DMFT meta-regression was not statistically significant; ungraded observational evidence.

5 findings from 1 review
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Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Any form of one-to-one oral hygiene advice (OHA) vs No OHA

Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition)

It is very uncertain whether any form of one-to-one oral hygiene advice (OHA) changes dental caries compared with no OHA (very low certainty).

1 finding from 1 review