Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,052 questions · 1,797 findings · 134 reviews

No studies found 10 · 0.6%GRADE not reported 1,630 · 90.7%Very low 95 · 5.3%Low 23 · 1.3%Moderate 22 · 1.2%High 17 · 0.9%

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 1.24, 95% CI 0.89-1.71).

1 finding from 1 review

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

Caries experience (mean DMFT) · Adult residents of slums and non-slum urban settings of LMICs

Mean DMFT ranges from 0.26 to 16.6 across LMIC urban/slum populations; ungraded.

1 finding from 1 review

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

Use of toothbrush and toothpaste for mouth cleaning · Adult residents of slums and non-slum urban settings of LMICs

Toothbrush/paste is the commonest cleaning method but is used less in slum/disadvantaged/rural groups than urban/non-slum groups; ungraded.

1 finding from 1 review

Absence of toothpaste use vs Toothpaste use

Dental caries · Primary school children in Ethiopia

Absence of toothpaste use was not significantly associated with dental caries (OR 1.42, 95% CI -1.278 to 4.109, p=0.3029; ungraded).

1 finding from 1 review

CO2 laser (carbon dioxide) vs No anticaries intervention (untreated enamel)

Enamel surface / cross-sectional microhardness · Human / bovine enamel specimens under cariogenic challenge (in situ / ex vivo)

CO2 laser irradiation changes enamel microhardness versus untreated enamel (MD 49.55, CI 37.74 to 61.37; ungraded, 3 ex-vivo studies, I2=48%); the forest plot shows higher microhardness in laser-treated enamel, although the review text states the opposite.

1 finding from 1 review

Grade level 1-4 (first cycle) vs Grade level 5 or above

Dental caries · Primary school children in Ethiopia

Being in grade levels 1-4 was associated with higher odds of dental caries (OR 2.46, 95% CI 1.523-3.397; ungraded).

1 finding from 1 review

High intake of sweets vs Lower/less intake of sweets

Dental caries · Primary school children in Ethiopia

A high intake of sweets was associated with higher odds of dental caries (OR 2.71, 95% CI 1.968-3.451; ungraded).

1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Enamel surface microhardness · Human tooth enamel specimens, sound/intact (in vitro)

In sound enamel, Er:YAG laser irradiation significantly increased surface microhardness after acid challenge versus untreated control (SMD 2.41, 95% CI 0.70 to 4.12; 3 in vitro studies; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the individual (patient) level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-arrestment proportion at the individual level, but the reported difference was not statistically significant.

1 finding from 1 review

Erbium:YAG laser vs Untreated / high-speed-handpiece control enamel

Enamel resistance to demineralization (microhardness / lesion depth) · Human enamel adjacent to restorations or in pits and fissures (in situ / ex vivo)

Er:YAG laser showed a mixed and limited effect on enamel resistance to demineralization: feasible for controlling progression around restorations but not preventing caries formation, and ineffective in pits and fissures (ungraded, 2 ex-vivo studies, no pooled estimate).

1 finding from 1 review

CO2 laser combined with fluoride vs Fluorides alone (monotherapy)

Enamel demineralization (QLF ΔF) · Human enamel specimens under cariogenic challenge (in situ / ex vivo)

Evidence on a synergistic effect of combining CO2 laser with fluoride versus fluoride alone is mixed: one ex-vivo study found combined treatment superior while another found no synergy (ungraded, 2 ex-vivo studies, no pooled estimate).

1 finding from 1 review

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

Pattern of dental service utilisation and barriers · Adult residents of slums and non-slum urban settings of LMICs

Dental service use is low, episodic and pain-driven, with widespread self-care and cost/funding barriers; ungraded.

1 finding from 1 review

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

Frequency of mouth cleaning · Adult residents of slums and non-slum urban settings of LMICs

Twice-daily cleaning (recommended) is uncommon; most clean once, in the morning; 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

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

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

Sociodemographic and behavioural factors (older age, lower education, lower income, poor oral hygiene/brushing, smoking, disadvantaged/slum residence, sex) vs Referent groups (younger, higher education/income, better oral hygiene, non-slum residence)

Determinants of oral diseases · Adult residents of slums and non-slum urban settings of LMICs

Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded.

1 finding from 1 review

Primary teeth / primary dentition (younger children) vs Permanent teeth / permanent dentition (older children)

Dental caries susceptibility · Institutionalized orphan children (roughly 3 to 18 years)

Primary teeth may carry a higher caries risk than permanent teeth in institutionalized children (RR 1.31), but the difference is not statistically significant (very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the tooth level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-free proportion at the tooth level, but the reported difference was not statistically significant.

1 finding from 1 review