Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

161 questions · 245 findings · 27 reviews · Dental caries

No studies found 0 · 0%GRADE not reported 219 · 89.4%Very low 5 · 2%Low 7 · 2.9%Moderate 7 · 2.9%High 7 · 2.9%

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

Higher BMI (continuous / per-unit increment) vs Lower BMI (continuous reference / per 1 kg/m2 decrement)

Dental caries in children · Children (approx. 4-18 years)

Pooling studies that used BMI as a continuous variable showed no significant association between per-unit BMI and childhood dental caries (OR 1.01, 95% CI 0.99 to 1.03; I2=3.5%); ungraded.

3 findings from 1 review

Higher waist circumference vs Lower waist circumference

Dental caries in children · Children (approx. 4-18 years)

Waist circumference was not significantly associated with childhood dental caries (pooled OR 1.08, 95% CI 0.90 to 1.30; I2=47.7%); ungraded.

1 finding from 1 review

Dental caries vs Absence/lower severity of dental caries

Oral health-related quality of life · Adolescents (10-19 years)

Dental caries is associated with worse OHRQoL in adolescents, with greater severity linked to greater impact (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    The impact of dental caries on OHRQoL was addressed in five systematic reviews [9, 26, 34, 36, 37]. Three articles report that the greater the severity of the carious lesion, the worse the impact on OHRQoL in…
    5 studies
    GRADE not reported

Higher family income / socioeconomic status vs Lower income / worse socioeconomic status

Oral health-related quality of life · Adolescents (10-19 years)

Higher family income / better socioeconomic status is associated with better OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Adolescents from families with higher incomes and higher levels of maternal education have better OHRQoL scores [34]. Worse oral health status, older age, female sex and worse socioeconomic status were significantly…
    Studies not reported
    GRADE not reported

Higher parental / maternal education vs Lower parental education (reference)

Oral health-related quality of life · Adolescents (10-19 years)

Higher parental education is associated with better OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Adolescents from families with higher incomes and higher levels of maternal education have better OHRQoL scores [34]. Children from families with high income, parental education and family economy had better OHRQoL [42].
    Studies not reported
    GRADE not reported

Malocclusion vs Absence/lower severity of malocclusion

Oral health-related quality of life · Adolescents (10-19 years)

Malocclusion is associated with worse oral health-related quality of life in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review

High Streptococcus mutans colonization in primary dentition (age 2-3 years) vs Lower Streptococcus mutans load

Caries (DMFT/DMFS) in mixed/permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Higher early Streptococcus mutans colonization is associated with more caries in the mixed/permanent dentition (2 studies; not pooled; not GRADE-rated).

1 finding from 1 review

Higher consumption of snacks / sugar / soft drinks vs Lower consumption

Dental caries · Healthy children and adolescents in the United Arab Emirates

Higher snacking and soft-drink/sugar consumption were associated with more caries in most studies, though one study found no association with sweet-consumption frequency (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Prevalence and severity of oral and TMJ diseases/conditions (periodontal status and dental caries) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

1 finding from 1 review

Fluoride toothpaste vs Placebo (non-fluoride) toothpaste or fluoride toothpaste of a different concentration

Adverse effects of toothpaste · Children and adolescents with immature permanent dentition (aged 5 to 16 years at study start)
1 finding from 1 review

Job-related or family-related stress and pessimistic attitude to life vs Lower stress and no pessimistic attitude

Periodontal disease and serum IL-1β IL-6 and cortisol · Patients with aggressive or chronic periodontitis at a university periodontology department

No correlation was reported between immunological markers cortisol and registered stress values; untreated aggressive periodontitis was accompanied by pessimistic attitude and elevated serum IL-6.

1 finding from 1 review

Perceived psychosocial stress vs No or lower perceived stress

GCF elastase activity and non-surgical periodontal treatment outcome (salivary cortisol, ICTP measured; no effect reported) · Adults with periodontitis needing non-surgical periodontal treatment

In one 6-month longitudinal study, patients under psychosocial stress had higher gingival crevicular fluid elastase and poorer outcomes after non-surgical periodontal therapy; not pooled (ungraded).

1 finding from 1 review

Depression and social isolation (psychosocial strain) vs No depression or lower psychosocial strain

Antibody titres to periodontal pathogens · Adults with periodontitis

In one case-control study, depression as a marker of social isolation was associated with elevated antibody titres to periodontal pathogens at baseline and 1-year follow-up; not pooled (ungraded).

1 finding from 1 review

High maternal allostatic load (chronic stress) and low socioeconomic status vs Lower maternal allostatic load

Dental caries in children · Mother-child pairs

In one cross-sectional study, higher maternal allostatic load was associated with child dental caries experience and with health-related maternal care-taking behaviours; not pooled (ungraded).

1 finding from 1 review

Low socioeconomic status and family financial stress vs Higher socioeconomic status and lower stress

Salivary cortisol, cariogenic bacterial load and dental caries · Kindergarten-age children

In one cross-sectional study of children, low socioeconomic status, higher basal salivary cortisol and higher cariogenic bacterial counts were each independently associated with higher dental caries risk; not pooled (ungraded).

1 finding from 1 review