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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%

Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Early childhood caries (ECC) - incidence/risk · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Children exposed to secondary smoking from infancy have a higher incidence of early childhood caries by age 3 (RR 1.45; low certainty).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Bleeding Index (BI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Bleeding index is significantly higher in persons with orofacial cleft than in healthy controls (p<0.0001), but no pooled effect size was reported (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Oral microbiota composition · Individuals assessed for oral microbiota (mainly children and adolescents)

Oral microbiota composition differs between persons with orofacial cleft and healthy controls, synthesized qualitatively across 8 studies but not meta-analyzed (ungraded).

1 finding from 1 review

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Conventional restoration

Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

No eligible studies compared microinvasive techniques with invasive (restorative) treatment; this planned comparison had zero included studies.

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Postmenopausal osteoporosis with pathological fracture · Postmenopausal women (European ancestry)

Genetically predicted periodontitis had no causal effect on postmenopausal osteoporosis with pathological fracture (single-variable MR, OR 1.014).

2 findings from 1 review

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

Hip Fracture · general population

Overall hip-fracture risk showed little association with drinking-water fluoride and a nearly flat dose-response curve (narrow CI); no numeric RR reported in text; 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 · Overall dose-response (0 to highest exposure)
    Curve indicated little association and was nearly flat, with a comparatively narrow 95% confidence band (no numeric RR reported in text)
    Studies not reported
    GRADE not reported

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).

1 finding from 1 review

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Reduced enamel demineralization · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

A single in vitro study found postbiotics reduce enamel demineralization (ungraded).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    One in vitro multispecies-biofilm study reported that a postbiotic (L. reuteri cell-free supernatant) reduced enamel demineralization, indicating a protective effect against caries; no pooled estimate.
    1 study
    GRADE not reported