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Evidence found and GRADE certainty

1,692 questions · 2,586 findings · 180 reviews · Dental caries

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No studies found 194 · 7.5%GRADE not reported 1,937 · 74.9%Very low 248 · 9.6%Low 136 · 5.3%Moderate 52 · 2%High 19 · 0.7%

38% silver diamine fluoride vs Glass ionomer cement (GIC) plus fluoride varnish

Caries prevention (preventive fraction, SDF vs GIC+5% fluoride varnish) · intellectually disabled individuals with caries in permanent posterior teeth

SDF had a 45% preventative fraction versus glass ionomer cement plus fluoride varnish; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Sodium fluoride (NaF) varnish, applied every 3 months, plus OHI vs inactive control

Root carious lesions prevention · Older adults with root caries (community-dwelling or residential elders)

In elders, sodium fluoride varnish gave a 64% prevented fraction for root caries vs water, lower than SDF (71%) (p<0.01; ungraded).

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Barriers and facilitators to implementation of the integration strategy (qualitative) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
    15 studies
    GRADE not reported

Periodontal disease (periodontitis; clinical attachment loss >=4 mm) vs Adults without periodontal disease (healthy periodontal status; CAL <=3 mm)

Root caries (presence of root caries) · Adults (mean age ~53 years)

Adults with periodontal disease had significantly higher odds of root caries than those without (pooled OR 1.38, 95% CI 1.25 to 1.53; 2 observational studies; low certainty).

1 finding from 1 review

38% SDF (one-time application) vs Information unavailable

New coronal carious lesions or fillings on permanent (first) molars (caries prevention) · Children with dental caries in permanent (first) molars

One-time 38% SDF gave a 57% prevented fraction for caries in children's permanent first molars (single study; ungraded).

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Dental caries prevalence and severity · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in dental caries/severity between ART regimens (very low certainty).

1 finding from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Linear gingival erythema prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in linear gingival erythema between CLWH with and without ART (very low certainty).

1 finding from 1 review

Food and nonalcoholic beverage marketing (exposure) vs No, less, or less powerful food marketing

Food preference · Children and adolescents (general population, aged under 20 years)

Food marketing was associated with increased food preference (pooled SMD, 0.30; combined evidence).

3 findings from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Acute necrotising ulcerative gingivitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Acute necrotising ulcerative gingivitis was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Parotid hypertrophy prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Parotid hypertrophy was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Angular cheilitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No eligible studies compared angular cheilitis between different ART regimens.

1 finding from 1 review

Primary dentition DMFT score 1-3 vs No caries in primary teeth (DMFT = 0)

Caries prevalence in permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

A primary-dentition DMFT of 1-3 is associated with 1.5 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between ART regimens (very low certainty).

1 finding from 1 review