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Evidence found and GRADE certainty

122 questions · 185 findings · 7 reviews · Oral and maxillofacial surgery

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No studies found 0 · 0%GRADE not reported 175 · 94.6%Very low 0 · 0%Low 10 · 5.4%Moderate 0 · 0%High 0 · 0%

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Osteoporosis · European-ancestry adults

Genetically predicted periodontitis had no causal effect on osteoporosis (multivariable MR, OR 1.000).

2 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Bone mineral density in forearm · European-ancestry adults

Genetically predicted periodontitis had no causal effect on forearm BMD.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · Females (all ages)

In females (low-to-moderate risk-of-bias studies), hip BMD rose monotonically above ~0.9 mg/L: MD 0.04 g/cm2 (95% CI -0.03-0.12) up to ~2.3 mg/L and 0.09 (-0.09-0.27) at 4.0 mg/L vs null; ungraded.

2 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-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, low-to-moderate risk-of-bias studies: up to ~2.3 mg/L vs null
    MD 0.04 [-0.03, 0.12]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-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, low-to-moderate risk-of-bias studies: 4.0 mg/L vs null
    MD 0.09 [-0.09, 0.27]
    Studies not reported
    GRADE not reported

Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Osteoporosis · European GWAS participants

The SVMR Weighted Median interval excluded the null.

3 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Forearm fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on fracture of forearm (multivariable MR, OR 0.995).

2 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Femur fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Postmenopausal osteoporosis with pathological fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Wrist fractures · general population

Wrist-fracture risk declined nearly linearly with increasing fluoride: RR 1.00 at 0.01 mg/L to 0.84 at 1.5 mg/L drinking-water fluoride vs null; ungraded.

2 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-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 · Drinking-water fluoride 1.5 mg/L vs null
    RR 0.84 [0.43, 1.65]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-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 · Drinking-water fluoride 0.01 mg/L vs null
    RR 1.00 [0.99, 1.01]
    Studies not reported
    GRADE not reported

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

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

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Oral microbiota composition · Individuals assessed for oral microbiota (mainly children and adolescents)

Oral microbiota composition differs between persons with orofacial cleft and healthy controls, synthesized qualitatively across 8 studies but not meta-analyzed (ungraded).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Postmenopausal osteoporosis with pathological fracture · Postmenopausal women (European ancestry)

Genetically predicted periodontitis had no causal effect on postmenopausal osteoporosis with pathological fracture (single-variable MR, OR 1.014).

2 findings from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip Fracture · general population

Overall hip-fracture risk showed little association with drinking-water fluoride and a nearly flat dose-response curve (narrow CI); no numeric RR reported in text; ungraded.

1 finding from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-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 · Overall dose-response (0 to highest exposure)
    Curve indicated little association and was nearly flat, with a comparatively narrow 95% confidence band (no numeric RR reported in text)
    Studies not reported
    GRADE not reported

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Femur fracture · European-ancestry adults

Genetically predicted dental caries (DMFS) had no significant causal effect on fracture of femur (multivariable MR, OR 1.069).

2 findings from 1 review

Unilateral cleft lip and palate (UCLP) vs Bilateral cleft lip and palate (BCLP)

Plaque · Patients with cleft lip and palate (CLP)

Plaque index does not differ significantly between unilateral and bilateral cleft lip and palate (MD -0.13, 95% CI -0.38 to 0.12; ungraded).

1 finding from 1 review