Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-8 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-8 levels are higher in children and young adults with active dental caries than in controls but the difference is not statistically significant (SMD 57.20 pg/mL, 95% CI -18.60 to 133.00; 7 studies); ungraded.

1 finding from 1 review

Farzanegan 2021 = Transbond XT + 1% chitosan + 1% TiO2 (co-intervention); Mollabashi 2022 = TiO2-only composite (1 wt%) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel demineralization / white spot lesion prevention (DIAGNOdent, enamel mineral content) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

Two small RCTs gave inconsistent results for TiO2-modified adhesives/composites on enamel demineralization (one favorable on DIAGNOdent, one no difference in mineral content); ungraded.

1 finding from 1 review

nCaF2 primer vs Control Transbond primer

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

A single small split-mouth RCT found the nCaF2-containing primer reduced demineralization (DIAGNOdent) but showed no significant clinical white spot lesion difference at debonding (ungraded).

1 finding from 1 review

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Mean DMFT (decayed, missing, filled permanent teeth) · Institutionalized orphan children (roughly 3 to 18 years)

Permanent-teeth caries experience (DMF) was marginally higher in institutionalized children but essentially similar to parented children (pooled MD 0.09, not significant; very low certainty).

1 finding from 1 review

AA+GG (homozygous) genotypes vs GA (heterozygous) genotype

Dental caries · Children (<18 years) with vs without dental caries

After removing Zhang 2006, the over-dominant model at BsmI(rs1544410) remained non-significant (OR 0.85); ungraded.

2 findings from 1 review

Obesity (Unclassified) vs Normal Weight or Non‐Obese

Dental caries prevalence · Brazilian children/adolescents in permanent dentition (BMI classified by CDC 2000 growth charts)

Normal-weight adolescents in the permanent dentition probably have greater odds of dental caries than obese peers (OR 2.53; moderate certainty).

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

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

Oral disease burden, slum vs non-slum urban comparison · Adult residents of slums and non-slum urban settings of LMICs

Where compared, oral disease burden is generally higher in slums than non-slum urban/national populations (5 studies; 1 found no difference); ungraded.

1 finding from 1 review

Genome-wide common variants (additive dosage; present-study GWAS) vs Genome-wide significance threshold (P<5E-8)

Dental caries - genome-wide-significant loci · Japanese adults (present-study cohort: 30,859 dental caries cases / 14,666 controls)

The present Japanese GWAS found no genome-wide-significant loci for dental caries (top suggestive rs140784657); ungraded.

1 finding from 1 review
  • Genome-wide association meta-analysis identifies two novel loci associated with dental caries. 2024 All outcomes
    Lifelong (germline genotype) · Population-based genetic association study (Japanese direct-to-consumer genetic testing cohort) · Present-study GWAS (Japanese)
    In the present Japanese GWAS, no loci reached genome-wide significance (P<5E-8) for dental caries; several loci reached the suggestive level (P<1E-5). Top-associated variant rs140784657 (intergenic). All 47 lead…
    1 study · 45525 participants
    GRADE not reported

Second molar mesially inclined at extraction vs Second molar upright at extraction

Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar)

In the mandible, mesial inclination of the second molar vs upright was not significantly associated with space closure (OR 0.68; not GRADE-rated).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish)

Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF probably results in a slight increase in tooth-level caries arrestment versus other methods (moderate certainty).

1 finding from 1 review

Breastfeeding for <4 months vs Breastfeeding for ≥4 months

Early childhood caries (ECC) · Preschool children (<6 years)

Breastfeeding for <4 vs ≥4 months was not significantly associated with early childhood caries (RR 0.95, 95% CI 0.80-1.13; ungraded).

1 finding from 1 review

nCaF2 primer vs Control Transbond primer

Photographic white spot lesion score · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

nCaF2 primer showed no clinical photographic WSL difference at debonding, with certainty not graded.

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children with average age ≤3 years

No significant association between cesarean vs vaginal delivery and ECC among children with average age ≤3 years (OR 0.86, 95% CI 0.67-1.10).

1 finding from 1 review

Obesity (Unclassified) vs Normal Weight or Non‐Obese

Caries experience (mean DMFT) · Brazilian children in primary dentition (BMI classified by CDC 2000 growth charts)

Obesity may make little or no difference to caries experience (dmft) in the primary dentition (very low certainty).

1 finding from 1 review

Experimental orthodontic adhesive containing amorphous fluorinated calcium phosphate nanoparticles (n-AFCP) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel remineralization extent and color change · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, an n-AFCP-containing orthodontic primer showed significant enamel remineralization and less color change versus control in a single study (ungraded).

1 finding from 1 review