Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

574 questions · 721 findings · 67 reviews · Oral Health

No studies found 93 · 12.9%GRADE not reported 450 · 62.4%Very low 82 · 11.4%Low 73 · 10.1%Moderate 21 · 2.9%High 2 · 0.3%

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Japan

The single Japanese study yielded a degenerate estimate of OR 0.00 (95% CI 0.00 to 0.00; ungraded, single study).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years (studies published 2015 or later)

In studies published from 2015 onward, OHPPs were associated with lower DMFT (OR 0.08, 95% CI 0.01 to 0.53; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Finland

The single Finnish study showed lower DMFT/S with OHPP (OR 0.48, 95% CI 0.41 to 0.56; ungraded, single study).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years (studies published before 2015)

In studies published before 2015, OHPPs were associated with lower DMFT (OR 0.01, 95% CI 0.00 to 0.13; ungraded).

1 finding from 1 review

Early childhood caries (ECC) vs NA (within-white-spot-lesion correlation, not a caries vs caries-free comparison)

Correlation of Veillonella spp. with acidogenic streptococci · Young children with early childhood caries and caries-free controls

Veillonella spp. levels were correlated with acidogenic streptococci in white spot lesions (r²=0.38); no CI was reported.

1 finding from 1 review

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of S. mutans in saliva · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

A few small studies report Streptococcus mutans relative abundance in caries versus caries-free children without pooling; the evidence is ungraded and not meta-analyzed.

1 finding from 1 review

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of Veillonella spp. · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

Evidence on whether Veillonella spp. relative abundance is higher or lower in children with dental caries than caries-free controls is inconsistent across 7 small observational studies; no pooled estimate was produced and the evidence is ungraded.

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs HIV-negative individuals

Dental caries · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, children and adolescents with HIV on antiretroviral therapy had about twice the odds of dental caries versus HIV-negative peers (OR 2.04, 95% CI 1.21 to 3.42; very low certainty).

3 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs HIV-negative individuals

Caries in primary teeth: dmft (3 years) · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, the dmft (primary dentition) index did not differ significantly between HIV+ children on ART and HIV-negative peers (MD 0.92, 95% CI -0.09 to 1.93; very low certainty).

2 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs HIV-negative individuals

Dental caries severity (dmfs index, primary dentition) · Children and adolescents (<18 years) living with HIV (CLWH)

In case-control studies, HIV+ children on ART had a significantly higher dmfs index than HIV-negative peers (MD 5.15, 95% CI 2.20 to 8.11; not separately GRADE-rated).

2 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs HIV-negative individuals

Dental caries in permanent teeth · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, the DMFT index did not differ significantly between HIV+ children on ART and HIV-negative peers (MD 0.60, 95% CI -0.53 to 1.72; very low certainty).

2 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs HIV-negative individuals

Dental caries (by severity) · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, HIV+ children on ART had a significantly higher DMFS index than HIV-negative peers (MD 2.00, 95% CI 1.54 to 2.46; not separately GRADE-rated).

2 findings from 1 review

Individually designed, patient-centred preventive programme: dietary counselling (snacking timing, regular meals, fermentable carbohydrates) plus toothbrushing counselling, delivered by trained dental hygienists (a multi-intervention) vs Basic prevention offered as standard in public dental clinics

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children aged 11 to 12 years with at least one active initial caries lesion, screened in a town in Finland
2 findings from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs Caries-free status

CA VI concentration · Individuals assessed for dental caries (mainly children aged 2-9 years; one study in adults aged 18-24 years)

Salivary CA VI concentration is significantly lower in individuals with dental caries than in caries-free individuals (SMD -0.672, 95% CI -1.011 to -0.332; not GRADE-rated).

1 finding from 1 review

Access to dental care / health services vs Not applicable (single-group prevalence)

Access to/visited dental services prevalence · Children (deciduous and/or permanent dentition) in low- and middle-income countries

About 44% of children in LMICs had access to or had visited dental services (pooled prevalence 0.444, 95% CI 0.277 to 0.618; 5 studies; not GRADE-rated).

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-6 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-6 levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 11.60 pg/mL, 95% CI 6.27 to 16.94; 11 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-8 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-8 levels are higher in children and young adults with active dental caries than in controls but the difference is not statistically significant (SMD 57.20 pg/mL, 95% CI -18.60 to 133.00; 7 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

TNF-α level · Children and young adults (3-25 years)

Salivary TNF-α levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 14.81 pg/mL, 95% CI 4.76 to 24.86; 7 studies); ungraded.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Relative abundance of Veillonella spp. · Young children with early childhood caries and caries-free controls

Veillonella spp. mean relative abundance was higher in ECC children, without a comparative effect estimate or CI.

4 findings from 2 reviews · compare the 2 reviews
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