Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

439 questions · 686 findings · 68 reviews

No studies found 4 · 0.6%GRADE not reported 617 · 89.9%Very low 26 · 3.8%Low 20 · 2.9%Moderate 11 · 1.6%High 8 · 1.2%

Non-syndromic cleft lip and palate (CLP) status and its oral microbiota (exposure/grouping) vs Children and adolescents aged 0-18 years without CLP (controls)

Periodontal conditions (gingival inflammation, bleeding on probing, probing depth, clinical attachment loss) · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

Narrative synthesis of 6 studies suggests children/adolescents with CLP have poorer periodontal status (higher gingival and plaque indices, deeper probing, more bleeding and attachment loss) and harbor periodontopathogens; no pooled estimate and the evidence is ungraded.

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected proportion of caries-free children (5-18 years) · Alaska Native children (below age 18)

A simulation projected 0% of children aged 5-18 would be caries-free under the baseline scenario (certainty not graded).

3 findings from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected mean DMFT (children below 5 years) · Alaska Native children (below age 18)

A simulation projected mean DMFT in children under 5 would fall from 7.4 to 4.9 under the PDHA model (certainty not graded).

1 finding from 1 review

Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with low socioeconomic status (>=22.4% of the population with low SES) vs Populations with higher socioeconomic status (<22.4% of the population with low SES)

Caries experience (mean DMFT) · Adults aged 19-60 years

Populations with a higher proportion of people with low socioeconomic status had higher caries experience (pooled DMFT 15.99 vs 5.50), and meta-regression associated low SES with higher DMFT (about 10.35 more DMFT per unit; p=0.050); ungraded observational evidence.

5 findings from 1 review
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Populations with a lower proportion of university-educated people (<33.78% with university level) vs Populations with a higher proportion of university-educated people (>=33.78% with university level)

Caries experience (mean DMFT) · Adults aged 19-60 years

The proportion of university-educated people was not associated with caries experience (DMFT); pooled DMFT was similar across subgroups and the meta-regression was non-significant; ungraded observational evidence.

5 findings from 1 review
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HDI (quantitative) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with a low level of schooling (>=33.60% of the population with low schooling) vs Populations with a higher level of schooling (<33.60% of the population with low schooling)

Caries experience (mean DMFT) · Adults aged 19-60 years

Population level of schooling was not significantly associated with caries experience (DMFT) in subgroup meta-analysis or meta-regression; ungraded observational evidence with very high heterogeneity.

5 findings from 1 review
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Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Mean DMFT (decayed, missing, filled permanent teeth) · Institutionalized orphan children (roughly 3 to 18 years)

Permanent-teeth caries experience (DMF) was marginally higher in institutionalized children but essentially similar to parented children (pooled MD 0.09, not significant; very low certainty).

1 finding from 1 review

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Dental caries prevalence · Institutionalized orphan children (roughly 3 to 18 years)

Institutionalized orphan children may be at higher risk of dental caries than parented children (pooled RR 1.19), but the estimate is imprecise and not statistically significant (very low certainty).

1 finding from 1 review

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Caries in primary teeth: dmft (3 years) · Institutionalized orphan children (roughly 3 to 18 years)

Primary-teeth caries experience (dmf) was higher in institutionalized children than parented children but not significantly so (pooled MD 0.64; very low certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Percentage of bleeding on probing (BOP) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly increased bleeding on probing versus healthy controls (MD 16.57%, 95% CI 12.89 to 20.25; low certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary flow rate (stimulated) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Stimulated salivary flow rate was significantly lower in anorexia nervosa patients than controls, but only unstimulated flow was meta-analyzed; this outcome is ungraded.

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary pH · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly lower salivary pH than healthy controls (MD -0.39, 95% CI -0.54 to -0.24; low certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary alpha-amylase · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

There is no significant difference in salivary alpha-amylase between anorexia nervosa patients and healthy controls (MD 6.32 U/l, 95% CI -6.14 to 18.79; low certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Salivary flow rate (unstimulated) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa probably reduces unstimulated salivary flow rate versus healthy controls (MD -0.27 ml/min, 95% CI -0.31 to -0.24; moderate certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Gingival (marginal) recession · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Gingival (marginal) recession was significantly higher in anorexia nervosa patients than controls in both reporting studies, but was not pooled or graded (ungraded).

1 finding from 1 review