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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · Oral Health

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No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

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

Risk of fragility fractures · Females (all ages)

In females, fragility-fracture risk was U-shaped: lowest ~0.4 mg/L, rising above 0.9 mg/L (RR 0.84 at 0.34, 1.00 at 0.9, 1.13 at 1.1 mg/L vs null); ungraded.

3 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 · Females: drinking-water fluoride 1.1 mg/L vs null
    RR 1.13 [0.93, 1.37]
    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 · Females: drinking-water fluoride 0.34 mg/L vs null
    RR 0.84 [0.67, 1.07]
    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 · Females: drinking-water fluoride 0.9 mg/L vs null
    RR 1.00 [0.79, 1.27]
    Studies not reported
    GRADE not reported

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health-related quality of life · school‐age children and adolescents

Theory-based interventions significantly improved oral health-related quality of life (SMD 7.38; low certainty), with very high heterogeneity.

1 finding from 1 review

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

Absence of secondary caries · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

Ion-releasing and composite restorations show no significant difference in absence of secondary caries in children (high certainty).

1 finding from 1 review

Biodentine vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Vital permanent teeth (mature or immature) with deep or extremely deep caries and asymptomatic pulp or reversible pulpitis, undergoing…

Biodentine and calcium hydroxide did not differ significantly in clinical and radiographic success (OR 3.14, 95% CI 0.91 to 10.86; ungraded subgroup analysis).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 2: loss of dental hard substance adjacent to the restoration · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with loss of dental hard substance adjacent to the restoration, surveyed dentists most often preferred replacement over repair (pooled RR 4.70; p < 0.001); ungraded.

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 6: corrosion · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with corrosion, surveyed dentists most often preferred replacement over repair (pooled RR 1.59; p < 0.001); ungraded.

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 4: marginal discoloration · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

Subgroup (HDI: Very high): pooled preference was replacement over repair for a defective amalgam restoration with marginal discoloration (RR 6.48); significant HDI variation, p = 0.01.

5 findings from 1 review
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Electronic cigarette use vs Non-smokers

IL-1β level · People who use electronic cigarettes

The review reports no significant e-cigarette effect on salivary IL-1β.

3 findings from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

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

Mean DMFT in 12-year-olds rises as national income falls: 0.90 (very high income), 2.38 (high income), 3.30 (middle income) (Figure 2); not GRADE-rated.

3 findings from 1 review