Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

238 questions · 623 findings · 27 reviews · Dental caries

No studies found 7 · 1.1%GRADE not reported 568 · 91.2%Very low 25 · 4%Low 13 · 2.1%Moderate 10 · 1.6%High 0 · 0%

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

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

Anorexia nervosa patients tended to have higher plaque accumulation than healthy controls (significant in 2 of 3 studies), but results were not pooled or graded (ungraded).

1 finding from 1 review

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

Caries experience · 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 higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

1 finding from 1 review

High-intensity sweeteners other than stevia (aspartame, sucralose, saccharin) in food products vs Any comparator (dietary sugar, no treatment, or other sweetener)

Effects of non-stevia high-intensity sweeteners (aspartame, sucralose, saccharin) on cariogenic bacteria in dental plaque or saliva · healthy people

No eligible studies evaluated high-intensity sweeteners such as aspartame, sucralose, or saccharin for their effect on cariogenic bacteria.

1 finding from 1 review

Consumption of xylitol chewing gum by women (mothers) vs no intervention

Change in Mutans streptococci (MS) count in saliva · healthy people

Xylitol significantly reduced Mutans streptococci in saliva compared with no intervention (SMD -1.47, 95% CI -1.94 to -0.99; 3 trials), though heterogeneity was very high (I2=98%); not GRADE-rated.

1 finding from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs Sorbitol (low-intensity sweetener)

Change in Mutans streptococci (MS) count in saliva · healthy people

Xylitol and sorbitol did not differ significantly for Mutans streptococci in saliva (SMD -0.16, 95% CI -0.44 to 0.12; 2 trials, P=.25); not GRADE-rated.

1 finding from 1 review

Periodontitis vs Individuals without periodontal disease (by LOA)

Malignant transformation (oral cancer development) · Adults in case-control studies of oral cancer; people assessed for periodontitis

Periodontitis is associated with roughly a threefold higher odds of oral cancer (pooled OR 2.94, 95% CI 2.13-4.07; low certainty of evidence), though heterogeneity is moderate (I2=52.4%).

1 finding from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs no intervention

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol significantly reduced Mutans streptococci in dental plaque compared with no treatment (SMD -0.73, 95% CI -1.09 to -0.37; 5 trials, I2=53%; not GRADE-rated).

1 finding from 1 review

High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Dental caries in permanent teeth · Nigerian individuals with permanent dentition (approximately 12 years and older)

In permanent dentition, high-frequency sugar consumption was associated with non-significant 15% higher odds of caries (OR 1.15, 95% CI 0.88 to 1.52), with no heterogeneity (I2=0%; ungraded).

1 finding from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs Sorbitol (low-intensity sweetener)

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol reduced Mutans streptococci in dental plaque more than sorbitol (SMD -0.45, 95% CI -0.69 to -0.21; 4 trials, I2=7%); not GRADE-rated.

1 finding from 1 review

High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Dental caries prevalence · Nigerian individuals, including children and adults, with primary or permanent dentition

High-frequency sugar consumption was associated with 18% higher but non-significant odds of dental caries in Nigeria (OR 1.18, 95% CI 0.87 to 1.59; I2=36%; ungraded).

1 finding from 1 review

Original development of CAMBRA (Caries Management by Risk Assessment) or CAT (Caries-risk Assessment Tool) multivariable models vs Not applicable

Model development with reported performance measures (per CHARMS) · Individuals of any age at risk of caries increment

No original CAMBRA or CAT model-development studies reporting performance measures according to CHARMS were found (evidence gap); these tools appeared only as validated models within other studies.

1 finding from 1 review

Multivariable caries prediction model vs Additional prediction model(s)

Coronal caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

168 findings from 1 review
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Edentulism (complete or partial missing teeth) vs Individuals without edentulism

Oral health-related quality of life · Indian elderly

One study found edentulism did not affect OHRQoL (dichotomous); ungraded.

3 findings from 1 review

Malocclusion vs No malocclusion

Oral health-related quality of life · Indian children, adolescents and adults

One GOHAI study found no significant difference in OHRQoL by malocclusion status; ungraded.

3 findings from 1 review

Bruxism vs No bruxism

Oral health-related quality of life · Indian children and adults

Two studies found bruxers have poorer OHRQoL than non-bruxers; narrative, ungraded.

1 finding from 1 review

Dental caries vs Caries-free controls

Oral health-related quality of life · Indians

In adolescents (10-19 years), dental caries was associated with poorer OHRQoL (pooled OR 3.92; 5 studies); ungraded.

5 findings from 1 review
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Multivariable caries prediction model vs Additional prediction model(s)

Root caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

22 findings from 1 review
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Multivariable caries prediction model vs Additional prediction model(s)

Coronal and/or root caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

2 findings from 1 review

Periodontal disease assessed by loss of attachment (LOA / clinical attachment loss) vs Individuals without periodontal disease (by LOA)

Oral health-related quality of life · Indian adults and elderly (general, police, teachers, institutionalised)

No difference in OHRQoL was seen between groups for periodontal disease by LOA on OHIP-14/OIDP (pooled SMD -0.04, CI includes 0); ungraded.

3 findings from 1 review

Periodontal disease assessed by Community Periodontal Index (CPI) vs Individuals without periodontal disease (by CPI)

Oral health-related quality of life · Indian adults and elderly (general, police, teachers, institutionalised)

Evidence on periodontal disease (CPI) and OHRQoL is inconsistent across studies (very low certainty).

3 findings from 1 review