Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

821 questions · 993 findings · 80 reviews · Dental caries

No studies found 60 · 6%GRADE not reported 749 · 75.4%Very low 109 · 11%Low 41 · 4.1%Moderate 34 · 3.4%High 0 · 0%

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Percentage of bleeding on probing (BOP) · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in bleeding on probing between SSc patients and controls (SMD 1.05, CI includes 0); certainty ungraded.

1 finding from 1 review

Dental plaque assessment (plaque score/index) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Plaque · Children in the United Arab Emirates (Ajman, Sharjah)

Dental plaque levels were high and associated with frequent snacking and less frequent tooth brushing, and higher plaque was linked to more caries (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Periodontitis (clinical attachment loss) · Adults (general and hospital populations assessed in case-control studies)

Attachment loss is significantly increased in systemic sclerosis patients (SMD 2.58) with very high heterogeneity; certainty ungraded.

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Patient outcomes: mean number of filled teeth per 0- to 15-year-old · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in number of filled teeth between SSc patients and controls (SMD -0.12, CI includes 0); certainty ungraded.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

S. mutans counts (5th-root transformed) · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in S. mutans counts between aligners and fixed appliances in adolescents at 1 month (MD -2.22, 95% CI -6.82 to 2.38; ungraded).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary Lactobacilli counts · Patients with drooling (sialorrhea) due to neurological disease

Salivary Lactobacilli counts were unchanged in two studies but significantly increased in one study one month after BoNT (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant Lactobacilli increase at 1 month; Wu 2011 and 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    No statistically significant changes in Lactobacilli CFU counts were reported by Wu et al. or by Tiigimae-Saar 2017. However, the 2018 study found that Lactobacilli CFU counts were significantly increased one month…
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary osmolality (hydration level) · Patients with drooling (sialorrhea) due to neurological disease

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary S. mutans level · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Development of >=1 new carious lesion (caries incidence) · Patients with drooling (sialorrhea) due to neurological disease

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

2 findings from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary buffering capacity · Patients with drooling (sialorrhea) due to neurological disease

Salivary buffering capacity did not decrease after BoNT; one of two quasi-experimental studies reported a significant increase (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant buffering increase at 1 month; 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The quasi-experimental studies of Tiigimae-Saar found different results concerning the changes in buffering capacity. For the analysis carried out in 2017, no statistically significant change was observed. By contrast,…
    2 studies
    GRADE not reported

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Temporomandibular disorders (TMD), TMJ arthritis/involvement and orofacial pain · Children and adolescents with juvenile idiopathic arthritis (JIA)

TMD and TMJ arthritis/involvement (and orofacial pain) were consistently reported more frequently in children/adolescents with JIA than in healthy peers, though several studies had small samples; no pooled estimate (ungraded).

1 finding from 1 review

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Developmental defects of enamel measured by any validated index · Children and adolescents with juvenile idiopathic arthritis (JIA)

A single small study suggested developmental enamel defects were more frequent in children with JIA, but the evidence is insufficient (1 study; ungraded).

1 finding from 1 review