Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,066 questions · 3,346 findings · 178 reviews · Dental caries

No studies found 48 · 1.4%GRADE not reported 2,789 · 83.4%Very low 208 · 6.2%Low 129 · 3.9%Moderate 136 · 4.1%High 36 · 1.1%

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

Dental caries in children · Children of mothers assessed for smoking status during pregnancy (early childhood dental caries)

In the USA study, maternal smoking during pregnancy was associated with increased odds of childhood dental caries (OR 1.85, 95% CI 1.38 to 2.49).

15 findings from 1 review
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Overweight/obesity (combined) vs Normal Weight or Non‐Obese

Dental caries prevalence · Brazilian children/adolescents in permanent dentition (BMI classified by CDC 2000 growth charts)

The evidence is very uncertain about the effect of overweight/obesity on caries odds in the permanent dentition (very 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

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Inter-examiner reliability · Children and adults with primary or permanent dentition

Inter-examiner kappa statistics ranged from 0.44 to 0.91 across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Age 8-10 years vs Age >10 years

Spontaneous space closure · Children and adolescents with maxillary permanent first molar extraction

In the maxilla, age 8-10 years was not associated with a statistically significant difference in space closure odds.

1 finding from 1 review

Nocturnal breastfeeding vs No nocturnal breastfeeding

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding one study, nocturnal breastfeeding was associated with higher ECC risk (RR 3.05, 95% CI 2.40 to 3.87; I²=33%).

2 findings 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

Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal

Pulp exposure rate · Patients with deep carious lesions in permanent (mainly posterior) teeth

Minimally invasive caries removal was associated with a lower mean pulp exposure rate than conventional removal (1.2% vs 8.1%), but the difference was not statistically significant (Wilcoxon, p = 0.068); certainty of evidence was not graded.

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Dental caries prevalence · Primary school children in Ethiopia

Among studies using systematic random sampling, the pooled prevalence of dental caries was 35% (ungraded; CI not reported).

4 findings from 1 review
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Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight)

Early childhood caries (ECC) · Children (approx. 4-18 years)

In the Region: Asian countries subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.70, 95% CI 1.25 to 2.32; ungraded).

17 findings from 1 review
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Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Intra-examiner reliability ranged from kappa 0.52 to 1.00 across 6 studies; certainty not graded.

1 finding from 1 review

Periodontitis vs No periodontitis (periodontal health or gingivitis)

Dental caries prevalence · adults

With a non-standard periodontitis definition, the association persisted (OR 1.38).

12 findings from 1 review
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Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children aged <6 years

No significant association between cesarean vs vaginal delivery and ECC among America/Canada/Brazil studies (OR 1.11, 95% CI 0.70-1.76).

17 findings from 1 review
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TT genotype vs TC+CC genotypes

Dental caries · Children (<18 years) with vs without dental caries

In the PCR-RFLP genotyping subgroup, TaqI(rs731236) recessive model: TT vs TC+CC showed no significant association with caries (OR 1.49); ungraded.

8 findings from 1 review
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Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (mean number of new lesions per subject) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

Patients developed on average about 2.29 new ICLs during fixed orthodontic treatment (95% CI 1.12-3.46; very low certainty; very high heterogeneity).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Prevalence of ICLs (mean number of lesions per subject) · Patients (permanent dentition) during or after fixed orthodontic treatment with fixed (multibracket) appliances

Patients had on average about 2.24 ICLs per subject during/after fixed orthodontic treatment (95% CI 1.79-2.70; very low certainty; very high heterogeneity).

1 finding from 1 review

Non-syndromic cleft lip and palate (CLP) status and its oral microbiota (exposure/grouping) vs Children and adolescents aged 0-18 years without CLP (controls)

Dental caries · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

Pooling 3 studies, children/adolescents with CLP were about 2.03 times more likely to have dental caries than non-CLP controls (p<0.005; low heterogeneity), though most included studies were at high risk of bias; the evidence is ungraded.

1 finding from 1 review