Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

232 questions · 289 findings · 30 reviews · All outcomes

No studies found 26 · 9%GRADE not reported 199 · 68.9%Very low 33 · 11.4%Low 17 · 5.9%Moderate 12 · 4.2%High 2 · 0.7%

Prenatal passive tobacco exposure (maternal smoking during pregnancy / in the womb) vs No passive tobacco exposure (non-exposed children)

Dental caries in permanent teeth · Children and adolescents with permanent dentition

No eligible studies examined prenatal tobacco exposure and caries in permanent dentition.

1 finding from 1 review

Prenatal passive tobacco exposure (maternal smoking during pregnancy / in the womb) vs No passive tobacco exposure (non-exposed children)

Caries presence in primary teeth · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

Prenatal (in-womb) tobacco exposure is associated with higher odds of caries in primary dentition (pooled OR 1.46, 95% CI 1.41 to 1.52; 4 studies; no heterogeneity); certainty not graded.

1 finding from 1 review

Passive tobacco exposure (prenatal maternal smoking or postnatal secondhand/household smoke) vs No passive tobacco exposure (non-exposed children)

Dental caries · Children and adolescents (general population, aged under 20 years)

In children and adolescents, passive tobacco exposure (prenatal or postnatal) is associated with higher odds of dental caries (pooled OR 1.53, 95% CI 1.39 to 1.68; 21 studies), though heterogeneity was high (I2=86.5%); certainty of evidence not graded.

1 finding from 1 review

Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Caries prevalence (early childhood caries) · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Preschool children exposed to secondary smoking have higher odds of caries prevalence (OR 1.77), but the cross-sectional evidence is very uncertain (very low certainty).

2 findings from 1 review

Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Early childhood caries (ECC) - incidence/risk · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Children exposed to secondary smoking from infancy have a higher incidence of early childhood caries by age 3 (RR 1.45; low certainty).

1 finding from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Caries in primary teeth: dmft (3 years) · Children and adolescents with epilepsy

In children/adolescents, the dmft (primary teeth) index does not differ significantly with epilepsy (SMD 0.132, 95% CI -0.220 to 0.484, P = .463; ungraded subgroup).

1 finding from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Mean DMFT (decayed, missing, filled permanent teeth) · Children and adolescents with epilepsy

In children/adolescents, the higher DMFT with epilepsy is not statistically significant (SMD 0.334, 95% CI -0.140 to 0.827, P = .164; ungraded subgroup).

1 finding from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Mean DMFT (decayed, missing, filled permanent teeth) · people with epilepsy

People with epilepsy have a significantly higher DMFT (permanent-teeth caries) index than controls (SMD 0.403, 95% CI 0.057 to 0.749; high certainty).

1 finding from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Mean DMFT (decayed, missing, filled permanent teeth) · Adults with epilepsy

In adults, epilepsy is associated with a significantly higher DMFT than controls (SMD 0.548, P < .001; ungraded subgroup analysis).

1 finding from 1 review

Epilepsy (as exposure/condition) vs Healthy participants without epilepsy (control group)

Caries in primary teeth: dmft (3 years) · people with epilepsy

The dmft (primary-teeth caries) index does not differ significantly between people with epilepsy and controls (SMD 0.132, 95% CI -0.22 to 0.484; high certainty).

1 finding from 1 review

Double primary (canine and first molar) tooth extraction vs Single primary (canine) tooth extraction

Number of participants referred for surgical exposure of the PDC · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)

It is very uncertain whether double primary (canine and first molar) tooth extraction changes number of participants referred for surgical exposure of the PDC compared with single primary (canine) tooth extraction (very low certainty).

1 finding from 1 review

Extraction of the primary (baby) canine (single primary tooth extraction) vs No extraction (non-intervention control)

Number of participants referred for surgical exposure of the PDC · Young people aged 9 to 14 years diagnosed with one or both palatally displaced permanent maxillary canines (PDC)

It is very uncertain whether extraction of the primary (baby) canine (single primary tooth… changes number of participants referred for surgical exposure of the PDC compared with no extraction (non-intervention control) (very low certainty).

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

Food marketing exposure or greater marketing power vs No, less, or less powerful food marketing

Food choice · Children and adolescents (general population, aged under 20 years)

In crossover studies with binary outcomes, food marketing had no clear association with food choice (OR 3.45, 95% CI 0.97 to 12.43; ungraded).

1 finding from 1 review

Food marketing exposure or greater marketing power vs No, less, or less powerful food marketing

Food purchasing · Children and adolescents (general population, aged under 20 years)

Across five studies, 40% showed any association of potential public health harm for food purchasing (very low certainty).

1 finding from 1 review

Food marketing exposure or greater marketing power vs No, less, or less powerful food marketing

Dental caries · Children and adolescents (general population, aged under 20 years)

Across two studies, 50% showed any association of potential public health harm for dental caries (very low certainty).

1 finding from 1 review

Food marketing exposure or greater marketing power vs No, less, or less powerful food marketing

Food preference · Children and adolescents (general population, aged under 20 years)

In crossover studies with binary outcomes, food marketing increased food preference (OR 3.49, 95% CI 2.03 to 6.22; ungraded).

1 finding from 1 review