Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Mean DMFT (decayed, missing, filled permanent teeth) · Institutionalized orphan children (roughly 3 to 18 years)

Permanent-teeth caries experience (DMF) was marginally higher in institutionalized children but essentially similar to parented children (pooled MD 0.09, not significant; very low certainty).

1 finding from 1 review

AA+GG (homozygous) genotypes vs GA (heterozygous) genotype

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

After removing Zhang 2006, the over-dominant model at BsmI(rs1544410) remained non-significant (OR 0.85); ungraded.

2 findings from 1 review

Obesity (Unclassified) vs Normal Weight or Non‐Obese

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

Normal-weight adolescents in the permanent dentition probably have greater odds of dental caries than obese peers (OR 2.53; moderate certainty).

1 finding from 1 review

Missing teeth / tooth loss vs Fewer or no missing teeth

Malignant transformation (oral cancer development) · Adults in case-control studies (oral cancer patients vs healthy controls)

Pooling across all missing-teeth measures, the overall association with oral cancer was not statistically significant (OR 1.20, 95% CI 0.97-1.48; high heterogeneity, I2=82.8%); ungraded.

1 finding from 1 review

Genome-wide common variants (additive dosage; present-study GWAS) vs Genome-wide significance threshold (P<5E-8)

Dental caries - genome-wide-significant loci · Japanese adults (present-study cohort: 30,859 dental caries cases / 14,666 controls)

The present Japanese GWAS found no genome-wide-significant loci for dental caries (top suggestive rs140784657); ungraded.

1 finding from 1 review
  • Genome-wide association meta-analysis identifies two novel loci associated with dental caries. 2024 All outcomes
    Lifelong (germline genotype) · Population-based genetic association study (Japanese direct-to-consumer genetic testing cohort) · Present-study GWAS (Japanese)
    In the present Japanese GWAS, no loci reached genome-wide significance (P<5E-8) for dental caries; several loci reached the suggestive level (P<1E-5). Top-associated variant rs140784657 (intergenic). All 47 lead…
    1 study · 45525 participants
    GRADE not reported

Second molar mesially inclined at extraction vs Second molar upright at extraction

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

In the mandible, mesial inclination of the second molar vs upright was not significantly associated with space closure (OR 0.68; not GRADE-rated).

1 finding from 1 review

Breastfeeding for <4 months vs Breastfeeding for ≥4 months

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

Breastfeeding for <4 vs ≥4 months was not significantly associated with early childhood caries (RR 0.95, 95% CI 0.80-1.13; ungraded).

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children with average age ≤3 years

No significant association between cesarean vs vaginal delivery and ECC among children with average age ≤3 years (OR 0.86, 95% CI 0.67-1.10).

1 finding from 1 review

Obesity (Unclassified) vs Normal Weight or Non‐Obese

Caries experience (mean DMFT) · Brazilian children in primary dentition (BMI classified by CDC 2000 growth charts)

Obesity may make little or no difference to caries experience (dmft) in the primary dentition (very low certainty).

1 finding from 1 review

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

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Probiotics vs placebo or control

Salivary pH · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to salivary pH versus control (MD -0.12 pH units, 95%CI -0.72 to 0.48; very low certainty).

1 finding from 1 review

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

Sensitivity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

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

Association between orthodontic treatment duration and ICLs incidence · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

ICLs incidence increased with longer orthodontic treatment duration (meta-regression P<.01; ungraded).

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the number of dental caries versus control (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo control

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF markedly increased individual-level caries arrestment versus placebo (OR 18.10; ungraded subgroup).

1 finding from 1 review

Breastfeeding for <6 months vs Breastfeeding for ≥6 months

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

In cohort studies, breastfeeding for <6 vs ≥6 months was not significantly associated with early childhood caries (RR 0.97, 95% CI 0.88-1.06; ungraded).

2 findings from 1 review