Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

219 questions · 351 findings · 32 reviews

No studies found 17 · 4.8%GRADE not reported 270 · 76.9%Very low 20 · 5.7%Low 37 · 10.5%Moderate 5 · 1.4%High 2 · 0.6%

Low birth weight (<2500 g) vs Normal birth weight (2500 g or more)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

Adjusted analyses also showed no association between low birth weight and early childhood caries (adjusted OR 1.05, 95% CI 0.71 to 1.57); certainty not graded.

3 findings from 1 review

Preterm birth (<37 weeks gestation) vs Full-term birth (37 weeks or more gestation)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

In children aged 3 years or younger, preterm birth was not associated with early childhood caries (OR 0.90, 95% CI 0.59 to 1.37); certainty not graded.

2 findings from 1 review

Early childhood caries / severe early childhood caries vs Caries-free controls

Change in height-for-age z score · Children aged ≤6 years (early childhood)

The association between baseline caries and declining height-for-age persisted after adjustment (coefficient -0.02); ungraded.

1 finding from 1 review

Early childhood caries / severe early childhood caries vs Caries-free controls

Stunting · Children aged ≤6 years (early childhood)

One Nepalese cross-sectional study found caries severity significantly correlated with chronic malnutrition/stunting (HAZ; p<0.0001), especially in rural children; ungraded, no effect size reported.

3 findings from 1 review

Early childhood caries / severe early childhood caries vs Caries-free controls

Risk of malnutrition (younger children, 6 months to 6 years) · Children aged ≤6 years (early childhood)

One Nepalese cross-sectional study found no significant association between severe ECC and malnutrition risk in children under 6 (mean difference 0.13, p=0.609); ungraded.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free primary dentition

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

Early childhood caries increases the likelihood of caries in permanent teeth roughly three-fold, but the certainty of evidence is very low (OR 3.22, 95% CI 2.80 to 3.71).

1 finding from 1 review

Breastfeeding for more than 24 months vs Not breastfed at the same age or breastfed for a shorter duration

Early childhood caries (ECC) - incidence/risk · Children with exclusively primary dentition (age ≤71 months)

Breastfeeding beyond 24 months is associated with an increased risk (incidence) of early childhood caries versus not breastfeeding at the same age (RR 2.44, 95% CI 1.97 to 3.02; low certainty).

1 finding from 1 review

Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight)

Early childhood caries (ECC) · Children (approx. 4-18 years)

In the Region: Asian countries subgroup, the BMI (highest vs lowest)-childhood caries association was significant (OR 1.70, 95% CI 1.25 to 2.32; ungraded).

17 findings from 1 review
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Presence of oral Candida albicans vs Absence of oral Candida albicans

Early childhood caries (ECC) · Children aged ≤6 years (early childhood)

RETRACTED. Among studies before 2017, oral C. albicans presence was associated with higher odds of ECC (OR 4.89, 95% CI 2.79-8.58); ungraded subgroup from a retracted review.

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

Early childhood caries (ECC) · Children younger than 71 months (under 6 years)

Pooled ECC prevalence in Europe was 36% (95% CI 25-47).

16 findings from 1 review
Show 13 more findings

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of S. mutans in saliva · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

A few small studies report Streptococcus mutans relative abundance in caries versus caries-free children without pooling; the evidence is ungraded and not meta-analyzed.

1 finding from 1 review

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of Veillonella spp. · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

Evidence on whether Veillonella spp. relative abundance is higher or lower in children with dental caries than caries-free controls is inconsistent across 7 small observational studies; no pooled estimate was produced and the evidence is ungraded.

1 finding from 1 review

Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded.

2 findings from 1 review

Secondary (passive/secondhand) smoking exposure during childhood vs No secondary smoking exposure

Caries prevalence (early childhood caries) · Preschool children aged <=71 months (caries outcome assessed at 3-6 years)

Preschool children exposed to secondary smoking have higher odds of caries prevalence (OR 1.77), but the cross-sectional evidence is very uncertain (very low certainty).

2 findings from 1 review

Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded.

2 findings from 1 review