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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · All outcomes

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No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

All European countries pooled (overall) vs None (overall pooled prevalence)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Across European countries the overall pooled mean DMFT in 12-year-olds was 2.10 (95% CI 1.63 to 2.57), with very high between-country heterogeneity (I2=100%); not GRADE-rated.

1 finding from 1 review

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

Hip/femoral bone mineral density (BMD) · general population

Hip BMD increased with fluoride in both sexes (linearly in males, non-linearly above ~1.2 mg/L in females); no numeric MD reported in text for the main analysis; 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 · Both sexes, main dose-response
    Hip BMD increased in both sexes, linearly in males and non-linearly (starting above 1.2 mg/L) in females (no numeric MD reported in text for main analysis)
    Studies not reported
    GRADE not reported

Older child age (months) vs Younger age (reference)

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

Age 48-59 months was associated with higher odds of ECC (OR 2.602).

2 findings from 1 review

Timing of first dental visit vs Reference visit timing

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

An early first dental visit was associated with much lower odds of ECC (OR 0.042).

2 findings from 1 review

Flavonoids (e.g., quercetin, proanthocyanidin) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Etch-and-Rinse adhesive + biological ACAD protocol network, Flavonoids showed 12.771 MPa lower 24 h bond strength than Calcium Phosphate (MD -12.771, 95% CI -20.538 to -5.003; Moderate certainty).

2 findings 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

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Proper anatomic form · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in anatomic form (high certainty).

1 finding from 1 review

Pulp and periapical diseases vs Without pulp and periapical diseases

Lacunar stroke · adults

No eligible studies were found for the association between pulp and periapical diseases and lacunar stroke in the meta-analysis.

1 finding from 1 review

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

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

Stimulated salivary flow rate was significantly lower in anorexia nervosa patients than controls, but only unstimulated flow was meta-analyzed; this outcome is ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Specificity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled specificity (0.90) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%).

1 finding from 1 review