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Evidence found and GRADE certainty

96 questions · 190 findings · 27 reviews

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No studies found 5 · 2.6%GRADE not reported 176 · 92.6%Very low 8 · 4.2%Low 1 · 0.5%Moderate 0 · 0%High 0 · 0%

Older adults (population mean age >33.4 years) vs Younger adults (population mean age <=33.4 years)

Caries experience (mean DMFT) · Adults aged 19-60 years

Studies of older adults (mean age >33.4 years) had higher pooled DMFT than younger adults, but the age to DMFT meta-regression was not statistically significant; ungraded observational evidence.

5 findings from 1 review
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Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with low socioeconomic status (>=22.4% of the population with low SES) vs Populations with higher socioeconomic status (<22.4% of the population with low SES)

Caries experience (mean DMFT) · Adults aged 19-60 years

Populations with a higher proportion of people with low socioeconomic status had higher caries experience (pooled DMFT 15.99 vs 5.50), and meta-regression associated low SES with higher DMFT (about 10.35 more DMFT per unit; p=0.050); ungraded observational evidence.

5 findings from 1 review
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Populations with a lower proportion of university-educated people (<33.78% with university level) vs Populations with a higher proportion of university-educated people (>=33.78% with university level)

Caries experience (mean DMFT) · Adults aged 19-60 years

The proportion of university-educated people was not associated with caries experience (DMFT); pooled DMFT was similar across subgroups and the meta-regression was non-significant; ungraded observational evidence.

5 findings from 1 review
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HDI (quantitative) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Populations with a low level of schooling (>=33.60% of the population with low schooling) vs Populations with a higher level of schooling (<33.60% of the population with low schooling)

Caries experience (mean DMFT) · Adults aged 19-60 years

Population level of schooling was not significantly associated with caries experience (DMFT) in subgroup meta-analysis or meta-regression; ungraded observational evidence with very high heterogeneity.

5 findings from 1 review
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Down syndrome vs Individuals without Down syndrome (healthy controls: siblings, schoolchildren or others)

Mean DMFT (decayed, missing, filled permanent teeth) · Individuals of all ages

Individuals with Down syndrome had a lower mean DMFT in permanent teeth than controls (pooled SMD -0.18, 95% CI -0.35 to -0.02; 6 studies; I2=20%); certainty of evidence not graded.

1 finding from 1 review

Dental caries vs Adolescents without dental caries

Negative oral-health impact on daily performance (OIDP or Child-OIDP) · Adolescents (10-19 years)

In the Child-OIDP subgroup, dental caries is associated with a worse oral-health impact: PR 1.66 (95% CI 1.19 to 2.31) from 6 studies (I2=96%); ungraded, and not statistically different from the OIDP subgroup (p=0.96).

4 findings from 1 review
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Instrument subgroup: Child-OIDP
    PR 1.66 [1.19, 2.31]
    6 studies
    GRADE not reported
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Instrument subgroup: OIDP (all 3 studies)
    PR 1.68 [0.89, 3.17]
    3 studies
    GRADE not reported
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Instrument subgroup: OIDP, sensitivity analysis excluding Krisdapong et al.
    PR 1.21 [1.15, 1.28]
    2 studies
    GRADE not reported
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  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Overall (all meta-analyzed studies pooled; both instruments and both caries definitions)
    PR 1.52 [1.15, 2.01]
    9 studies
    GRADE not reported

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Caries experience · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Caries experience (mean DMFT) · Adult residents of slums and non-slum urban settings of LMICs

Mean DMFT ranges from 0.26 to 16.6 across LMIC urban/slum populations; ungraded.

1 finding from 1 review

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Oral-health-education-only interventions showed at most a marginal effect on tooth-level caries (dmft SMD -0.11, 95% CI -0.21 to -0.00; 2 studies; not GRADE-rated).

1 finding from 1 review

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Oral-health-education-only interventions did not show a statistically significant effect on surface-level caries (dmfs SMD -0.20, 95% CI -0.43 to 0.03; 2 studies; not GRADE-rated).

1 finding from 1 review

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a small, statistically significant reduction in surface-level caries (dmfs SMD -0.14, 95% CI -0.26 to -0.02; 10 studies; not GRADE-rated).

1 finding from 1 review

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small, statistically significant reduction in caries experience at the surface level (dmfs SMD -0.15, 95% CI -0.25 to -0.04; 12 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a statistically significant reduction in tooth-level caries (dmft SMD -0.47, 95% CI -0.84 to -0.10; 4 studies; not GRADE-rated), though heterogeneity was very high.

1 finding from 1 review

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small-to-moderate, statistically significant reduction in caries experience at the tooth level (dmft SMD -0.34, 95% CI -0.54 to -0.13; 6 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

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

Caries experience · Children and adolescents (<18 years) living with HIV (CLWH)

ART was not associated with a significant difference in dental caries experience among CLWH (very low certainty).

1 finding from 1 review

High maternal allostatic load (chronic stress) and low socioeconomic status vs Lower maternal allostatic load

Dental caries in children · Mother-child pairs

In one cross-sectional study, higher maternal allostatic load was associated with child dental caries experience and with health-related maternal care-taking behaviours; not pooled (ungraded).

1 finding from 1 review

Caries experience vs Adolescents without dental caries

Negative oral-health impact on daily performance (OIDP or Child-OIDP) · Adolescents (10-19 years)

For experience (history) of dental caries, adolescents had a significantly worse oral-health impact: PR 1.72 (95% CI 1.23 to 2.43) from 6 studies (I2=97%); ungraded, and not statistically different from the presence subgroup (p=0.19).

1 finding from 1 review
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Caries-definition subgroup: experience of dental caries
    PR 1.72 [1.23, 2.43]
    6 studies
    GRADE not reported

Caries severity measurement (mean dmft for primary dentition; mean DMFT for permanent dentition) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Caries experience · Healthy children and adolescents (primary and permanent dentition) in the United Arab Emirates

Caries severity was substantial, with mean dmft 0.75-10.9 (primary dentition) and mean DMFT 1.48-3.19 (permanent dentition), and higher indices in Emirati than non-Emirati children (narrative synthesis; not GRADE-rated).

1 finding from 1 review