Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,127 questions · 1,590 findings · 132 reviews · All outcomes

No studies found 189 · 11.9%GRADE not reported 1,166 · 73.3%Very low 130 · 8.2%Low 69 · 4.3%Moderate 25 · 1.6%High 11 · 0.7%

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Dental caries: dmfs increment (primary teeth) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmfs increment ranged from -1.0 to 1.0 across 7 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free children (primary dentition, d3) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual decline in the percentage of caries-free children ranged from 3.8% to 12.2% across 6 studies (descriptive range, no pooled estimate; ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries incidence rate (first D3 lesion) per person-year at risk (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the pooled caries incidence rate was 0.11 per person-year at risk (95% CI 0.09 to 0.13; random-effects meta-analysis of 15 studies), i.e., about 11 of every 100 caries-free persons develop dentine caries each year (ungraded).

1 finding from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per person-year at risk · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    Incidence rate (per person-year at risk) 0.11 [0.09, 0.13]
    15 studies · 10768 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in dmft (primary dentition) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmft increment ranged from -0.3 to 0.3 across 4 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding 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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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

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

Repositioning of ankylosed teeth after osteotomy followed or not by distraction osteogenesis, or after luxation vs Conventional orthodontic treatment or follow-up with no specific treatment for ankylosis

Outcome not reported · Any patient with ankylosis and displacement of permanent front teeth diagnosed by clinical and radiographic assessment, with or without…

The review found no eligible studies for this question.

1 finding from 1 review

Sociodemographic / socioeconomic factors (single-parent family, low parental education, family income, socioeconomic status) vs Absence of the factor / reference socioeconomic category

Caries increment in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Evidence on the association between sociodemographic/socioeconomic factors and permanent-teeth caries is weak and inconsistent (3 studies; could not be pooled; not GRADE-rated).

1 finding from 1 review

Unfavourable oral hygiene and dietary habits (frequent sweet/sugar consumption; low toothbrushing frequency in early childhood) vs Favourable oral hygiene and dietary habits

Caries development in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Early-childhood oral hygiene and dietary habits show inconsistent associations with permanent-teeth caries, often losing significance after adjustment for past caries (2 studies; not pooled; not GRADE-rated).

1 finding from 1 review

Chlorhexidine varnish (10%) vs placebo or no treatment

Elevated mutans streptococci levels (>=4 with caries screen; high vs low) · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

It is very uncertain whether chlorhexidine varnish (10%) changes elevated mutans streptococci levels (>=4 with caries screen; high vs… compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Removable appliance with palatal crib associated with high-pull chincup vs no treatment

Expansion of the upper and lower jaw · Children and adolescents (over 80% aged 16 years or younger at treatment start) with anterior open bite (lack of vertical overlap or…
1 finding from 1 review
  • Orthodontic and orthopaedic treatment for anterior open bite in children 2014 · Cochrane All outcomes
    End of treatment (12 months)
    Listed among the outcome measures evaluated by Almeida 2005. No separate width/expansion estimate is reported in the text; the review concluded the interventions produced no significant change in the skeletal maxillary…
    1 study
    GRADE not reported

Frankel's function regulator-4 (FR-4) with lip-seal training vs no treatment

Signs and symptoms of atypical swallowing and speech production disturbances · Children and adolescents (over 80% aged 16 years or younger at treatment start) with anterior open bite (lack of vertical overlap or…

The review found no eligible studies for this question.

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 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

Low birth weight (<2500 g) vs Normal birth weight (2500 g or more)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

Adjusted analyses also showed no association between low birth weight and early childhood caries (adjusted OR 1.05, 95% CI 0.71 to 1.57); certainty not graded.

3 findings from 1 review

Slow-release fluoride devices vs Alternative fluoride therapy (topical fluoride: toothpaste, mouthrinse, gel, or varnish)

Outcome not reported · Children or adults

The review found no eligible studies for this question.

1 finding from 1 review

Slow-release fluoride device (fluoride glass beads) vs placebo or usual care

Caries increment, surface index D(M)FS · Children with high risk of dental decay

It is very uncertain whether slow-release fluoride device (fluoride glass beads) changes increase in DMFS at 2 years compared with baseline compared with placebo or usual care (control) (very low certainty).

1 finding from 1 review

Slow-release fluoride device (fluoride glass beads) vs placebo or usual care

Caries increment, tooth index D(M)FT · Children with high risk of dental decay

It is very uncertain whether slow-release fluoride device (fluoride glass beads) changes increase in DMFT at 2 years compared with baseline compared with placebo or usual care (control) (very low certainty).

1 finding from 1 review