Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

624 questions · 782 findings · 62 reviews

No studies found 13 · 1.7%GRADE not reported 657 · 84%Very low 76 · 9.7%Low 23 · 2.9%Moderate 13 · 1.7%High 0 · 0%

Less frequent tooth brushing (< twice daily) vs More frequent tooth brushing (>= twice daily)

Dental caries · Healthy children and adolescents in the United Arab Emirates

More frequent tooth brushing was generally protective against caries, though findings were somewhat inconsistent across studies (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Lower family socioeconomic status / income vs Higher socioeconomic position

Dental caries · Healthy children and adolescents in the United Arab Emirates

Evidence on socioeconomic status/income and caries was inconsistent: some studies linked lower income to higher caries while others found no association (narrative synthesis; not GRADE-rated).

1 finding from 1 review

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

Percentage of bleeding on probing (BOP) · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in bleeding on probing between SSc patients and controls (SMD 1.05, CI includes 0); certainty ungraded.

1 finding from 1 review

Dental plaque assessment (plaque score/index) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Plaque · Children in the United Arab Emirates (Ajman, Sharjah)

Dental plaque levels were high and associated with frequent snacking and less frequent tooth brushing, and higher plaque was linked to more caries (narrative synthesis; not GRADE-rated).

1 finding from 1 review

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

Periodontitis (clinical attachment loss) · Adults (general and hospital populations assessed in case-control studies)

Attachment loss is significantly increased in systemic sclerosis patients (SMD 2.58) with very high heterogeneity; certainty ungraded.

1 finding from 1 review

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

Patient outcomes: mean number of filled teeth per 0- to 15-year-old · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in number of filled teeth between SSc patients and controls (SMD -0.12, CI includes 0); certainty ungraded.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

S. mutans counts (5th-root transformed) · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in S. mutans counts between aligners and fixed appliances in adolescents at 1 month (MD -2.22, 95% CI -6.82 to 2.38; ungraded).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary Lactobacilli counts · Patients with drooling (sialorrhea) due to neurological disease

Salivary Lactobacilli counts were unchanged in two studies but significantly increased in one study one month after BoNT (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant Lactobacilli increase at 1 month; Wu 2011 and 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    No statistically significant changes in Lactobacilli CFU counts were reported by Wu et al. or by Tiigimae-Saar 2017. However, the 2018 study found that Lactobacilli CFU counts were significantly increased one month…
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary osmolality (hydration level) · Patients with drooling (sialorrhea) due to neurological disease

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary S. mutans level · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Development of >=1 new carious lesion (caries incidence) · Patients with drooling (sialorrhea) due to neurological disease

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

2 findings from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary buffering capacity · Patients with drooling (sialorrhea) due to neurological disease

Salivary buffering capacity did not decrease after BoNT; one of two quasi-experimental studies reported a significant increase (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant buffering increase at 1 month; 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The quasi-experimental studies of Tiigimae-Saar found different results concerning the changes in buffering capacity. For the analysis carried out in 2017, no statistically significant change was observed. By contrast,…
    2 studies
    GRADE not reported