Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

624 questions · 782 findings · 62 reviews

No studies found 13 · 1.7%GRADE not reported 657 · 84%Very low 76 · 9.7%Low 23 · 2.9%Moderate 13 · 1.7%High 0 · 0%

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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38% SDF plus oral health education vs oral health instruction plus water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF plus oral health education had a 33% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% SDF plus oral health education vs oral health instruction plus tonic water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF had a 62% preventative fraction; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

1.23% APF gel + oral health education vs Oral health education

Arrest or reversal of noncavitated facial/lingual carious lesions · Children and adults with noncavitated carious lesions on facial/lingual surfaces (primary and permanent teeth)

1.23% APF gel + oral health education was probably more effective than Oral health education for arrest or reversal of facial/lingual carious lesions (RR 2.47, 95% CI 1.95 to 3.13; moderate certainty).

1 finding from 1 review

38% SDF varnish plus oral health instruction vs oral health instruction plus water

new root-surface carious lesions or restorations · Older adults with root caries in permanent (mature) teeth (mean age 75 years)

SDF had a 71% preventative fraction at 36 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline

Development of any (cavitated or non-cavitated) carious lesion · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Preschool children with mutans streptococci at baseline probably have about four times higher odds of developing early childhood caries (OR 4.13; moderate certainty).

10 findings from 1 review
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Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline

Future caries experience (dmft/dmfs) · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Children with mutans streptococci at baseline had a greater future caries experience (SMD 0.85, a large effect; ungraded).

1 finding from 1 review

38% SDF plus potassium iodide and oral health instruction vs oral health instruction plus tonic water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF plus potassium iodide had a 52% preventative fraction; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Unfavourable oral hygiene and dietary habits (frequent sweet/sugar consumption; low toothbrushing frequency in early childhood) vs Favourable oral hygiene and dietary habits

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 oral hygiene and dietary habits show inconsistent associations with permanent-teeth caries, often losing significance after adjustment for past caries (2 studies; not pooled; not GRADE-rated).

1 finding from 1 review

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

Most in vitro studies indicate e-cigarette aerosol/e-liquid (especially flavored/high-concentration) disrupts normal oral flora and favors cariogenic S. mutans growth and biofilm, plausibly increasing caries risk; not pooled (ungraded, narrative).

1 finding from 1 review

Preterm birth (oral health / enamel defects) vs Full-term children

Caries (DMFT) and enamel defects · Preterm children (about 8 years old) in the United Arab Emirates (Dubai)

One study found preterm children had higher DMFT and a fourfold higher prevalence of enamel defects than full-term children (narrative synthesis; not GRADE-rated).

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)

Dental caries estimates · People receiving or providing primary care; all ages, ability types, and locations

Seven studies measured change in dental caries estimates.

1 finding from 1 review

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children

High-intensity community education was associated with a 33% reduction in BBTD prevalence, without a GRADE rating.

3 findings from 1 review

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

Baby bottle tooth decay prevalence · Alaska Native Head Start children

The Alaska Native site had a 20% increase in BBTD prevalence, without a GRADE rating.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Inter-examiner reliability · Children and adults with primary or permanent dentition

Inter-examiner kappa statistics ranged from 0.44 to 0.91 across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Positive predictive value for dental caries diagnosis · Children and adults with primary or permanent dentition

Positive predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Negative predictive value for dental caries diagnosis · Children and adults with primary or permanent dentition

Negative predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition

Intra-examiner kappa statistics ranged from 0.52 to 1.00 across 6 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Sensitivity for dental caries diagnosis · Children and adults with primary or permanent dentition

Sensitivity ranged from 48% to 98.3% across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

d/D dft/DFT or dmft/DMFT score differences · Children and adults with primary or permanent dentition

Eight studies calculated caries-score differences; six reported no significant difference, one underestimation, and one overestimation with teledentistry.

1 finding from 1 review