Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Breastfeeding vs No breastfeeding

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

After excluding five studies, breastfeeding was associated with lower ECC risk in cohort studies (RR 0.82, 95% CI 0.71 to 0.95; I²=0%).

3 findings from 1 review

Slum residence vs Non-slum urban setting

Dental caries · Adult residents of slums and non-slum urban settings of LMICs

Slum residents had non-significantly higher odds of caries than non-slum residents (OR 1.21, 95% CI 0.94-1.56; single study); ungraded.

1 finding from 1 review

Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional ceramic brackets

Enamel demineralization (DIAGNOdent score) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Adhesive precoated flash-free brackets showed no demineralization difference, with certainty not graded.

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 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

T allele vs G allele

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

TaqI/BglI(rs739837) allelic model: T vs G was not significantly associated with dental caries (OR 1.00); ungraded.

1 finding from 1 review

T allele vs C allele

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

In the Permanent dentition subgroup, TaqI(rs731236) allelic model: T vs C showed no significant association with caries (OR 0.90); ungraded.

8 findings from 1 review
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Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Regular toothbrushing usage (prevalence) · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

About 91% of children with IDD in India use a toothbrush regularly (pooled prevalence 0.91, 95% CI 0.80-0.96; high heterogeneity; ungraded).

1 finding from 1 review

Transbond XT with 1% chitosan and 1% TiO2 nanoparticles vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Chitosan and TiO2 adhesive reduced S. mutans counts, with certainty not graded.

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

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Demineralised lesion depth · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation significantly reduced demineralised lesion depth versus untreated control (SMD -0.55, 95% CI -0.97 to -0.12; 3 in vitro studies, I2=62%; ungraded).

1 finding from 1 review

Breastfeeding <12 months vs Breastfeeding for ≥12 months

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

Breastfeeding for <12 vs ≥12 months was associated with significantly fewer caries (RR 0.65, 95% CI 0.50-0.86), indicating breastfeeding beyond 12 months increases ECC risk (substantial heterogeneity; ungraded).

2 findings from 1 review

Significant salivary microbial (Lactobacillus) load vs No/low significant microbial load

Dental caries · Primary school children in Ethiopia

A significant salivary microbial (Lactobacillus) load was associated with higher odds of dental caries (OR 3.82, 95% CI 3.439-4.192; ungraded).

1 finding from 1 review

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

Positive predictive value for dental caries diagnosis · Children and adults with primary or permanent dentition

Positive predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Extraction at patient age 11-12 years vs Extraction at patient age 8-10 years

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, extraction at 11-12 vs 8-10 years showed no significant difference in one analysis (OR 0.82; not GRADE-rated).

2 findings from 1 review

Periodontitis vs Individuals without periodontal disease (by LOA)

Malignant transformation (oral cancer development) · Adults in case-control studies of oral cancer; people assessed for periodontitis

Periodontitis is associated with roughly a threefold higher odds of oral cancer (pooled OR 2.94, 95% CI 2.13-4.07; low certainty of evidence), though heterogeneity is moderate (I2=52.4%).

1 finding from 1 review

Second molar at Nolla developmental stage 6-7 at extraction vs Second molar at later Nolla stages at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

One study found mandibular Nolla stage 6-7 associated with better space closure (OR 55.1; single study; not GRADE-rated).

1 finding from 1 review