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Evidence found and GRADE certainty

410 questions · 836 findings · 55 reviews

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No studies found 1 · 0.1%GRADE not reported 794 · 95%Very low 16 · 1.9%Low 12 · 1.4%Moderate 6 · 0.7%High 7 · 0.8%

Low socioeconomic position and adverse behavioural factors vs Higher socioeconomic position and fewer adverse behaviours

Systemic inflammation (C-reactive protein) and periodontal disease progression · General-population adults (German cohort)

In one 5-year longitudinal study, accumulation of low socioeconomic and behavioural factors was associated with greater periodontal disease progression and higher C-reactive protein; not pooled (ungraded).

1 finding from 1 review

Growth stunting (linear growth retardation, low height-for-age) vs Children without growth stunting (normal height-for-age)

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

One Nigerian cross-sectional study reported a significant adjusted association between nutritional (stunting) status and ECC (APR 0.14, 95% CI 0.03-0.69); ungraded.

4 findings from 1 review
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Resin infiltration vs Pre-treatment baseline before infiltration (T0); pooled as a within-arm before/after change

Lightness/brightness change of white spot lesion (luminosity L*, T0 to T1) · Patients with post-orthodontic white spot lesions and permanent dentition

ICON resin infiltration showed no statistically significant change in lightness/brightness of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD -0.001, 95% CI -0.23 to 0.23; 3 studies, 330 teeth; I2=97%); not GRADE-rated.

1 finding from 1 review

Resin infiltration vs Pre-treatment baseline before infiltration (T0); pooled as a within-arm before/after change

Color change of white spot lesion (color difference, T0 to T1) · Patients with post-orthodontic white spot lesions and permanent dentition

ICON resin infiltration significantly improved the color of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD 1.36, 95% CI 1.14 to 1.59; 4 studies, 458 teeth), although heterogeneity was very high (I2=98%) with a heavy outlier (Kannan); not GRADE-rated.

1 finding from 1 review

Indirect bonding using flowable composite adhesive (Opal Bond MV) vs Direct bonding (conventional, Transbond XT)

White spot lesion formation (QLF: fluorescence loss, lesion area) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

A single RCT found indirect bonding with flowable composite reduced white spot lesion formation versus direct bonding (ungraded).

1 finding from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries in children · Children aged 6 to 8 years whose mothers' prenatal vitamin D status was assessed

In the single study of children aged 6-8 years, the association was not statistically significant (OR 1.07, 95% CI 0.84-1.30); ungraded.

1 finding from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries in children · Infants and children (aged about 2 to 8 years) whose mothers' vitamin D status was assessed during pregnancy

Prenatal vitamin D deficiency is associated with significantly higher odds of dental caries in children (pooled OR 1.35, 95% CI 1.22-1.47), but heterogeneity is high (I2=86.6%) and publication bias is present; the observational evidence is ungraded.

2 findings from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries in children · Children aged 4 to 6 years whose mothers' prenatal vitamin D status was assessed

Among children aged 4-6 years, prenatal vitamin D deficiency is associated with significantly higher odds of dental caries (OR 1.44, 95% CI 1.32-1.56); ungraded.

1 finding from 1 review

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

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: effect size (f) for microbial load (log10 CFU) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

The weighted effect size favoured hardness (f=2.62) over colour (f=0.46) for discriminating microbial load, supporting hardness as the more reliable examination (ungraded).

1 finding from 1 review

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: mean difference in log10 CFU (microbial load) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

For yellow-vs-other colour compared with soft-vs-harder hardness, hardness was significantly the more discriminant test (pooled WMD -3.87, 95% CI -4.46 to -2.87; ungraded).

6 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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Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs no intervention

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol significantly reduced Mutans streptococci in dental plaque compared with no treatment (SMD -0.73, 95% CI -1.09 to -0.37; 5 trials, I2=53%; not GRADE-rated).

1 finding from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Restoration longevity · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

Cavity liners may make little or no difference to restoration longevity (high success across groups; low certainty).

1 finding from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Treatment failure · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

The evidence is very uncertain about the effect of cavity liners on treatment failure; no significant difference between lined and unlined (or differently lined) restorations was found (very low certainty).

1 finding from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Postoperative hypersensitivity (POH), patient-reported (VAS score) · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

The evidence is very uncertain whether cavity liners reduce postoperative hypersensitivity; no significant difference was found overall (very low certainty).

1 finding from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Tooth survival · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

Cavity liners may make little or no difference to tooth survival (99.4% survival across groups; low certainty).

1 finding from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Oral health-related quality of life · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

No included study reported oral health-related quality of life (a planned outcome), so no evidence is available.

1 finding from 1 review