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Evidence found and GRADE certainty

678 questions · 854 findings · 51 reviews · Dental caries

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No studies found 38 · 4.4%GRADE not reported 675 · 79%Very low 61 · 7.1%Low 47 · 5.5%Moderate 32 · 3.7%High 1 · 0.1%

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Use of toothbrush and toothpaste for mouth cleaning · Adult residents of slums and non-slum urban settings of LMICs

Toothbrush/paste is the commonest cleaning method but is used less in slum/disadvantaged/rural groups than urban/non-slum groups; ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Pattern of dental service utilisation and barriers · Adult residents of slums and non-slum urban settings of LMICs

Dental service use is low, episodic and pain-driven, with widespread self-care and cost/funding barriers; ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Frequency of mouth cleaning · Adult residents of slums and non-slum urban settings of LMICs

Twice-daily cleaning (recommended) is uncommon; most clean once, in the morning; ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Oral disease burden, slum vs non-slum urban comparison · Adult residents of slums and non-slum urban settings of LMICs

Where compared, oral disease burden is generally higher in slums than non-slum urban/national populations (5 studies; 1 found no difference); ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Dental caries prevalence · Adult residents of slums and non-slum urban settings of LMICs

Dental caries prevalence in LMIC urban/slum populations ranges widely (13%-76%); not GRADE-rated (narrative synthesis).

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Self-perceived (self-rated) oral health status · Adult residents of slums and non-slum urban settings of LMICs

Most participants perceive their oral health as satisfactory (one study 39%), more so among younger, male, higher-SES and employed people; ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Use of alternative/indigenous mouth-cleaning implements · Adult residents of slums and non-slum urban settings of LMICs

Indigenous/alternative cleaning tools and home remedies are widely used, more so in rural/slum groups; ungraded.

1 finding from 1 review

Cariogram multivariable caries-risk model (including modified/reduced-predictor versions) vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance of the Cariogram for caries increment (positive likelihood ratio, LR+) · Children/adolescents (coronal caries) and older adults (root caries); populations from areas with varying caries risk

Modified Cariogram models showed modest positive likelihood ratios (LR+ ~1.1-3.8) for predicting caries increment, generally below the useful threshold; no pooled estimate; ungraded.

1 finding from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents and older adults; multiple countries · Model validation studies
    Six validation studies (5 coronal, 1 root) evaluated modified Cariogram models (not the original model per se). Review-stated LR+ range 1.1-3.8 (with one exception). LR+ was not substantially changed by excluding the…
    6 studies
    GRADE not reported

Cariogram multivariable caries-risk model (including modified/reduced-predictor versions) vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance of the Cariogram for caries increment (negative likelihood ratio, LR-) · Children/adolescents (coronal caries) and older adults (root caries); populations from areas with varying caries risk

Modified Cariogram models showed negative likelihood ratios of about 0.5-0.61, above the useful rule-out threshold; no pooled estimate; ungraded.

1 finding from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents and older adults; multiple countries · Model validation studies
    Review-stated LR- range 0.5-0.61 across the Cariogram validation models (with one exception). Model performance was largely unaffected by removing the predictors mutans streptococci in saliva, saliva secretion and…
    6 studies
    GRADE not reported

Periodontal disease assessed by loss of attachment (LOA / clinical attachment loss) vs Individuals without periodontal disease (by LOA)

Oral health-related quality of life · Indian adults and elderly (general, police, teachers, institutionalised)

No difference in OHRQoL was seen between groups for periodontal disease by LOA on OHIP-14/OIDP (pooled SMD -0.04, CI includes 0); ungraded.

3 findings from 1 review

Prosthetic need vs Individuals without prosthetic need

Oral health-related quality of life · Indian elderly and general-population adults

Prosthetic need was significantly associated with poorer OHRQoL in both included studies (moderate certainty).

3 findings from 1 review

Atraumatic restorative treatment with GIC vs Conventional restoration

Restoration failure · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement

ART with GIC was reported to increase the odds of restoration failure versus conventional restoration (OR 1.60; ungraded).

1 finding from 1 review

Atraumatic restorative treatment with GIC vs Conventional treatment

Pain during the procedure (primary analysis) · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement

The reported estimate for procedural pain with ART versus conventional treatment was inconclusive (ungraded).

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Probing pocket depth · Adults (general and hospital populations assessed in case-control studies)

Probing depth is significantly increased in systemic sclerosis patients (SMD 3.10) with very high heterogeneity; certainty ungraded.

3 findings from 1 review

Non-selective carious tissue removal and conventional restoration (CR) vs Selective carious tissue removal (selective excavation, SE)

Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

It is very uncertain whether non-selective carious tissue removal and conventional restoration (CR) changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).

3 findings from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Sites with probing depth >= 4 mm · Adults (general and hospital populations assessed in case-control studies)

Sites with probing depth >= 4 mm are significantly more frequent in SSc patients (SMD 2.07); certainty ungraded.

1 finding from 1 review

Intervention not reported

Dental caries prevalence · General population (children and adults) in East Africa

Caries prevalence in permanent dentition (>=12 years) was 50.2% (95% CI 38.4 to 62.1); certainty not graded.

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs None (descriptive prevalence meta-analysis)

Dental caries prevalence · General Pakistani population (all ages and both sexes; predominantly children and adolescents)

In permanent dentition, the pooled prevalence of dental caries was 57.2% (95% CI 26.3 to 85.3); ungraded.

10 findings from 1 review
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Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

Failure of therapy · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).

1 finding from 1 review