Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,066 questions · 3,346 findings · 178 reviews · Dental caries

No studies found 48 · 1.4%GRADE not reported 2,789 · 83.4%Very low 208 · 6.2%Low 129 · 3.9%Moderate 136 · 4.1%High 36 · 1.1%

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children with permanent dentition (>12 years)

In children with permanent dentition, vitamin D deficiency was associated with a 28% higher caries risk (RR 1.28; ungraded).

1 finding from 1 review

Calcium hydroxide (CH) vs Mineral trioxide aggregate (MTA)

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth of mixed/unspecified root maturation

In mixed-maturation teeth, the effect of MTA versus calcium hydroxide on success is very uncertain (OR 1.11, 95% CI 0.17-7.11; very low certainty).

1 finding from 1 review

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children with deciduous dentition (<6 years)

In children with deciduous dentition, vitamin D deficiency was associated with a 68% higher caries risk (RR 1.68; ungraded).

1 finding from 1 review

Biodentine vs Mineral trioxide aggregate (MTA)

Tooth discoloration · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy

More tooth discoloration was observed with MTA than with Biodentine, but odds ratios were implausibly large and not pooled (3 RCTs; ungraded).

1 finding from 1 review

Fluoride mouthwash vs Blank control

Gingival inflammation-related index · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Short-term fluoride mouthwash has uncertain effects on gingival inflammation-related indexes versus blank control (very low certainty).

1 finding from 1 review

Resin infiltration vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration was significantly better than CPP-ACP (SMD -0.77, 95% CI -1.31 to -0.23); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Periodontal disease assessed by Community Periodontal Index (CPI) vs Individuals without periodontal disease (by CPI)

Oral health-related quality of life · Indian adults and elderly (general, police, teachers, institutionalised)

Evidence on periodontal disease (CPI) and OHRQoL is inconsistent across studies (very low certainty).

3 findings from 1 review

Gingivitis (assessed by gingival index or WHO criteria) vs Individuals without gingivitis

Oral health-related quality of life · Indians

Continuous analyses (GOHAI, OHIP-14) of gingivitis and OHRQoL were inconsistent and mostly non-significant; ungraded.

2 findings from 1 review

Fluoride mouthwash vs Blank control

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Long-term fluoride mouthwash showed mixed plaque-index effects, with very low-certainty evidence.

2 findings from 1 review

Mineral trioxide aggregate (MTA) vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in immature permanent teeth

The effect of MTA versus CH in immature teeth is very uncertain (very low certainty).

1 finding from 1 review

Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)

Periapical pathosis · Vital teeth restored with indirect restorations

Periapical pathosis incidence among follow-up >5-10 years was 3.88% (subgroup analysis; not GRADE-rated).

6 findings from 1 review
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Resin infiltration vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration significantly improved remineralization versus control (SMD -0.94, 95% CI -1.46 to -0.43), ranking second of seven therapies by SUCRA (88.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Dental caries vs Caries-free controls

Oral health-related quality of life · Indian children aged 3-5 years

In children aged 3-5 years, early childhood caries was significantly associated with poorer OHRQoL (narrative; 3 studies); ungraded.

1 finding from 1 review

Fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish did not differ significantly from CPP-ACP (SMD -0.07, 95% CI -0.44 to 0.29); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs Caries-free status

CA VI concentration · Individuals assessed for dental caries (mainly children aged 2-9 years; one study in adults aged 18-24 years)

Salivary CA VI concentration is significantly lower in individuals with dental caries than in caries-free individuals (SMD -0.672, 95% CI -1.011 to -0.332; not GRADE-rated).

1 finding from 1 review

Fluoride mouthwash vs Blank control

Cariogenic bacteria (Lactobacilli colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Long-term (>=12 months) fluoride mouthwash may make little or no difference to Lactobacilli colony counts versus blank control (very low certainty).

1 finding from 1 review

Gum chewing (sugar-free) vs Within-subject before/after comparison of soft gum vs hard gum (no no-gum control)

Oral mucosal moisture · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

One small study found that chewing hard (but not soft) gum increased oral mucosal moisture.

1 finding from 1 review

Dental caries vs Caries-free status

CA VI activity · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

CA VI activity was higher in participants with caries (SMD 0.87, 95% CI 0.39 to 1.36; 7 studies, 411 participants); GRADE was not reported.

1 finding from 1 review

Prosthetic need vs Individuals without prosthetic need

Oral health-related quality of life · Indian elderly and general-population adults

Prosthetic need was significantly associated with poorer OHRQoL in both included studies (moderate certainty).

3 findings from 1 review