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Evidence found and GRADE certainty

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

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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%

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

Dental caries prevalence · Adult residents of slums and non-slum urban settings of LMICs

Dental caries prevalence in LMIC urban/slum populations ranges widely (13%-76%); not GRADE-rated (narrative synthesis).

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Probiotics vs placebo or control

Salivary pH · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to salivary pH versus control (MD -0.12 pH units, 95%CI -0.72 to 0.48; very low certainty).

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Sensitivity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs incidence · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

ICLs incidence increased with longer orthodontic treatment duration (meta-regression P<.01; ungraded).

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the number of dental caries versus control (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo control

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

Pooling two trials, SDF markedly increased individual-level caries arrestment versus placebo (OR 18.10; ungraded subgroup).

1 finding from 1 review

Breastfeeding for <6 months vs Breastfeeding for ≥6 months

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

In cohort studies, breastfeeding for <6 vs ≥6 months was not significantly associated with early childhood caries (RR 0.97, 95% CI 0.88-1.06; ungraded).

2 findings from 1 review

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

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Poor (inadequate) oral hygiene (prevalence) · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

Poor oral hygiene affects about 38% of children with IDD in India (pooled prevalence 0.38, 95% CI 0.21-0.59; high heterogeneity; ungraded).

1 finding from 1 review

Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal

Treatment success (caries lesion arrest or restoration survival) · Patients with deep carious lesions in permanent (mainly posterior) teeth

Minimally invasive caries removal showed a marginally higher mean restoration success rate than conventional removal (83.6% vs 75.4%), but the difference was not statistically significant (Mann-Whitney U, p > 0.05); certainty of evidence was not graded.

1 finding from 1 review

Orthodontic adhesives containing bioactive glass (BAG) particles/nanoparticles (including fluoride- or Ga-doped BAG) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Ion release (fluoride, calcium, phosphate) · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, among the 5 BAG ion-release studies only Ga-doped BAG (GaMBN, Song [31]) reported a significant increase (phosphate, up to 14 days); a general significant fluoride/calcium/phosphate increase across all 5 is not supported (ungraded).

1 finding from 1 review

nCaF2 primer vs Control Transbond primer

Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

nCaF2 primer differed in S. mutans count only at T1, with certainty not graded.

1 finding from 1 review

Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride)

Biofilm formation (reduction) · Streptococcus mutans (in vitro cultures and biofilms)

Grape seed extract reduces S. mutans biofilm formation in vitro (5 studies; ungraded).

1 finding from 1 review

Cranberry extract or cranberry flavonoid fractions vs No extract or vehicle control; other antimicrobial agents

Biofilm formation · Streptococcus mutans (in vitro cultures and biofilms)

No meta-analysis was conducted; ten included studies reported reduced or inhibited Streptococcus mutans biofilm formation with cranberry extract or fractions.

1 finding from 1 review

High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Dental caries in permanent teeth · Nigerian individuals with permanent dentition (approximately 12 years and older)

In permanent dentition, high-frequency sugar consumption was associated with non-significant 15% higher odds of caries (OR 1.15, 95% CI 0.88 to 1.52), with no heterogeneity (I2=0%; ungraded).

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Proportion of teeth with non-carious cervical lesions (NCCLs) in ancient skulls · Ancient/prehistoric human skulls (excavated/archaeological skeletal remains)

Non-carious cervical lesions affected a pooled proportion of about 0.4% of teeth in ancient skulls (4 studies; ungraded, very high heterogeneity I2=97.6%).

1 finding from 1 review