Perceptual speech assessment: residual post-operative velopharyngeal insufficiency · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic submucous cleft palate
1 finding from 1 review
Five (14%) of the participants in group 1 (MIPP) and four (11%) in group 2 had residual post-operative velopharyngeal insufficiency, P > 0.05. The report provided no details on post-operative speech assessment other…
1 study · 72 participants
GRADE not reported
Gingival index (GI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)
Persons with orofacial cleft have a higher gingival index than healthy controls (MD 0.15, 95% CI 0.11 to 0.19; low certainty).
1 finding from 1 review
Clinical attachment level (CAL) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)
Clinical attachment level loss is greater in persons with orofacial cleft than in healthy controls (p<0.00001), but no pooled effect size was reported (ungraded).
1 finding from 1 review
Risk of fragility fractures · Females aged over 50 years
In females over 50, fragility-fracture risk rose steeply from ~0.5 mg/L: RR 0.98 at 0.25, 1.00 at 0.45, and 1.26 (95% CI 1.10-1.46) at 1.0 mg/L drinking-water fluoride 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 outcomesLong-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 over 50 years: drinking-water fluoride 0.45 mg/L vs null
RR 1.00 [0.80, 1.24]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-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 over 50 years: drinking-water fluoride 0.25 mg/L vs null
RR 0.98 [0.83, 1.14]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-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 over 50 years: drinking-water fluoride 1.0 mg/L vs null
RR 1.26 [1.10, 1.46]
Studies not reported
GRADE not reported
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
Probing pocket depth · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)
Persons with orofacial cleft have a greater probing pocket depth than healthy controls (MD 0.88, 95% CI 0.82 to 0.95; low certainty).
1 finding from 1 review
Lumbar spine bone mineral density (BMD) · Females aged over 50 years
In females over 50, spine BMD showed an inverted U-shaped curve with a downward trend beginning at lower fluoride concentrations than in the overall analysis; no numeric MD reported in text; ungraded.
1 finding from 1 review
Plaque · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)
Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; low certainty).
1 finding from 1 review
Lactobacillus spp. mean levels/counts · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)
No significant difference in Lactobacillus spp. presence was reported; GRADE was not reported.
1 finding from 1 review
Streptococcus mutans count · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)
No difference in mean Streptococcus mutans presence was reported; GRADE was not reported.
1 finding from 1 review
Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
Relaxation showed no clear difference in pain intensity compared with occlusal (oral) appliance; GRADE not reported.
1 finding from 1 review
Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomesTreatment completion · Adolescents (12-19 years)
Not pooled. Wahlund 2015: MD 3.70 (95% CI -1.21 to 8.61), n=57 (relaxation 28, appliance 29); Wahlund 2003: MD not reported, n=83 (relaxation 41, appliance 42). Both studies were in adolescents; the occlusal appliance…
2 studies · 140 participants
GRADE not reported
Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.
1 study · 101 participants
Very low
Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.
1 finding from 1 review
Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
Quality of life · People aged 12 years and over with painful TMD lasting 3 months or longer
The review found no eligible studies for this question.
1 finding from 1 review
Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer
Cognitive behavioural therapy (CBT) may leads to lower pain intensity at follow-up (12 months) compared with usual care, waiting list or no treatment (control) (low certainty).
2 findings from 1 review
Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
Hypnosis showed no clear difference in pain intensity compared with relaxation; GRADE not reported.
1 finding from 1 review
Not pooled (clinical heterogeneity). Abrahamsen 2011: MD -1.00 (95% CI -2.27 to 0.27), n=38 (hypnosis 19, relaxation 19); Stam 1984: MD not reported, n=27 (hypnosis 12, relaxation 15).
2 studies · 65 participants
GRADE not reported
Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
Habit reversal treatment led to lower pain intensity compared with waiting-list control; GRADE not reported.
1 finding from 1 review