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%

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children younger than 6 years (healthy except for dental caries)

In children younger than 6 years, OHPPs were associated with lower odds of DMFT/S (OR 0.14, 95% CI 0.05 to 0.39; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Oral candidiasis prevalence · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users may have a higher prevalence of oral Candida colonization than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Oral microbiota composition (dysbiosis; increased periodontal/opportunistic pathogens) · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette use is associated with oral microbiota dysbiosis and increased pathogenic bacteria compared with non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Plaque index (PI) / oral hygiene · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users tend to have a higher plaque index (more biofilm accumulation) than non-smokers (narrative synthesis of systematic reviews; ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Oral microbiota composition · Individuals assessed for oral microbiota (mainly children and adolescents)

Oral microbiota composition differs between persons with orofacial cleft and healthy controls, synthesized qualitatively across 8 studies but not meta-analyzed (ungraded).

1 finding from 1 review

Periodontitis vs Individuals without periodontal disease (by LOA)

Malignant transformation (oral cancer development) · Adults in case-control studies of oral cancer; people assessed for periodontitis

Periodontitis is associated with roughly a threefold higher odds of oral cancer (pooled OR 2.94, 95% CI 2.13-4.07; low certainty of evidence), though heterogeneity is moderate (I2=52.4%).

1 finding from 1 review

Higher number of lost teeth (per one additional lost tooth) vs One fewer missing tooth

Malignant transformation (oral cancer development) · Adults in case-control studies (oral cancer patients vs healthy controls)

The number of missing teeth (per tooth) was not significantly associated with oral cancer (OR 0.96, 95% CI 0.92-1.01); ungraded.

1 finding from 1 review

Missing teeth / tooth loss vs Fewer or no missing teeth

Malignant transformation (oral cancer development) · Adults in case-control studies (oral cancer patients vs healthy controls)

Pooling across all missing-teeth measures, the overall association with oral cancer was not statistically significant (OR 1.20, 95% CI 0.97-1.48; high heterogeneity, I2=82.8%); ungraded.

1 finding from 1 review

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

Detection rate of oral pre-malignant and malignant lesions after referral (COE+vital rinsing vs COE alone) · Oral cavity cancer or potentially malignant disorder symptom-free individuals with tobacco habits

COE with vital rinsing (toluidine blue/tolonium chloride) showed no clear difference in detection rate of oral pre-malignant and malignant lesions after… compared with conventional oral examination (COE) alone (moderate certainty).

1 finding from 1 review

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

Resin-modified glass ionomer fissure sealant plus oral health education vs Fluoride varnish plus oral health education

Change in DMF increment on occlusal surfaces of first permanent molars · Children and adolescents (general population, aged under 20 years)

Resin-modified glass ionomer fissure sealant plus oral health… showed no clear difference in change in DMF increment on occlusal surfaces of first permanent molars compared with fluoride varnish plus oral health education; GRADE not reported.

2 findings from 1 review

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Adverse events · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…
1 finding from 1 review
  • Ozone therapy for the treatment of dental caries 2004 · Cochrane All outcomes
    To 6 months
    Baysan 2003 stated that no adverse events were reported to 6 months; no information was provided by Abu-Naba'a 2003 or Abu-Naba'a 2003pilot.
    1 study
    GRADE not reported

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Patient satisfaction · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…
1 finding from 1 review
  • Abu-Naba'a 2003 reported participants' state of anxiety, comparing ozone treatment with traditional dental interventions (injection, drilling, filling); because no participant was randomised between ozone and drilling…
    1 study
    GRADE not reported