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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

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No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

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

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

Mesoporous silica (SiO2) vs No biomimetic remineralization (control)

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

In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs Control showed no significant difference in 24 h bond strength (MD 0.840, 95% CI -5.270 to 6.950; Low certainty).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Postmenopausal osteoporosis with pathological fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Early childhood caries (ECC) vs Caries-free controls

Streptococcus mutans and Veillonella spp. levels · Young children with early childhood caries and caries-free controls

Veillonella spp. levels were reported as substantially greater in caries subjects, but the review gave no numerical effect estimate or CI.

1 finding from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Dental caries increment, DMFT/dmft (whole-tooth level) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing has no statistically significant effect on whole-tooth caries (DMFT/dmft SMD 0.05, 95% CI -0.27 to 0.37; ungraded).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 3: secondary caries · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with secondary caries, surveyed dentists most often preferred replacement over repair (pooled RR 6.94; p < 0.001); ungraded.

1 finding from 1 review

Dental treatments, care, and services (the decision context)

Delay of dental care during the COVID-19 pandemic · (Potential) patients with freedom of choice regarding dental treatments, including parents and caregivers deciding for children or…

In one mixed-methods study, 38.1% of dental-care respondents reported delays during the COVID-19 pandemic.

1 finding from 1 review

Dental caries vs Caries-free status

Oral microbial community composition and diversity (other caries-associated taxa; alpha- and beta-diversity) · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

No oral microbial taxon other than S. mutans was consistently associated with caries; alpha-diversity mostly did not differ between caries-active and caries-free groups and beta-diversity findings were mixed (ungraded, narrative).

1 finding from 1 review
  • Streptococcus mutans and Caries: A Systematic Review and Meta-Analysis. 2025 All outcomes
    Cross-sectional · Clinical oral-microbiome studies; saliva and/or supragingival plaque samples; 7 countries; DNA/RNA-based sequencing or microarray
    Narrative synthesis (no pooled estimate): no bacterial genus or species other than S. mutans was consistently (reported in more than 2 studies) associated with caries-active status (Table 3; 15 of 19 studies for…
    Studies not reported
    GRADE not reported

Early childhood caries (ECC) vs NA (within-white-spot-lesion correlation, not a caries vs caries-free comparison)

Correlation of Veillonella spp. with acidogenic streptococci · Young children with early childhood caries and caries-free controls

Veillonella spp. levels were correlated with acidogenic streptococci in white spot lesions (r²=0.38); no CI was reported.

1 finding from 1 review

Partial pulpotomy with immediate (same-visit) permanent restoration vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Immediate permanent restoration was associated with a pooled success rate of 89.9%.

1 finding from 1 review

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

Wrist fractures · general population

Wrist-fracture risk declined nearly linearly with increasing fluoride: RR 1.00 at 0.01 mg/L to 0.84 at 1.5 mg/L drinking-water fluoride vs null; ungraded.

2 findings 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 · Drinking-water fluoride 1.5 mg/L vs null
    RR 0.84 [0.43, 1.65]
    Studies not reported
    GRADE not reported
  • 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 · Drinking-water fluoride 0.01 mg/L vs null
    RR 1.00 [0.99, 1.01]
    Studies not reported
    GRADE not reported

Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded.

2 findings from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Pulp sensibility (EPT/cold response) · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Pulp sensibility (EPT/cold) responses at 1 year were more frequent after partial than full pulpotomy (single RCT; ungraded).

1 finding from 1 review