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Evidence found and GRADE certainty

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

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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%

Food and nonalcoholic beverage marketing (exposure) vs No, less, or less powerful food marketing

Food preference · Children and adolescents (general population, aged under 20 years)

Food marketing was associated with increased food preference (pooled SMD, 0.30; combined evidence).

3 findings from 1 review

Caries experience measurement (mean D(M)FS, enamel lesions included) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries · European adolescents aged 12–19 years

Mean caries experience (DMFS) in subgroup 'Examination type: full-mouth' was 6.56 (95% CI 4.55 to 9.47; 12 studies).

11 findings from 1 review
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Nano-hydroxyapatite (nHA) dentifrice/paste (fluoride-free or fluoridated) vs nHA-free / fluoride-free (negative) control

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under remineralizing conditions, nHA produced significantly more remineralization than the negative control (MD 350, 95% CI 179 to 521; very low certainty).

2 findings from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to caries-affected dentin (in vitro)

SDF pretreatment without a rinsing step does not affect glass-ionomer cement bond strength to caries-affected dentin (MD 0.26 MPa, 95% CI -0.30 to 0.82; ungraded).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Mucosal (oral) hyperpigmentation · Children or adolescents

CLWH on ART had significantly higher prevalence of mucosal hyperpigmentation than healthy controls (pooled OR 20.35, 95% CI 3.86 to 107.39); the authors described the certainty as low.

1 finding from 1 review

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Oral-health-education-only interventions showed at most a marginal effect on tooth-level caries (dmft SMD -0.11, 95% CI -0.21 to -0.00; 2 studies; not GRADE-rated).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to sound dentin (in vitro)

Prior SDF without a rinsing step significantly reduces adhesive bond strength to sound dentin (MD 17.52 MPa favoring untreated dentin, 95% CI 5.81 to 29.22; ungraded).

1 finding from 1 review

Male sex (boys) vs Female sex

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

Gender is not associated with caries development in permanent teeth (OR 0.86, 95% CI 0.71 to 1.02; low certainty).

1 finding from 1 review

ART/HAART duration <3 years vs ART/HAART duration >=3 years

Other orofacial opportunistic infections (linear gingival erythema, hairy leukoplakia, angular cheilitis, oral ulcers) · Children and adolescents living with HIV on ART/HAART

ART/HAART duration had minimal influence on the prevalence of orofacial opportunistic infections other than candidiasis (no significant differences).

1 finding from 1 review
  • Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
    Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · ART/HAART duration <3 years vs >=3 years
    Except for candidiasis, no significant differences in the prevalence of opportunistic infection manifestations (linear gingival erythema, hairy leukoplakia, angular cheilitis, oral ulcers) between ART duration <3 years…
    2 studies
    GRADE not reported

Non-responsive complementary feeding (NRCF) vs Other models of complementary feeding

Overweight/obesity risk · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western industrialized countries

Non-responsive complementary feeding showed no significant association with overweight/obesity across observational studies (very low certainty).

1 finding from 1 review

Atraumatic restorative treatment vs placebo

Oral health-related quality of life · Children with dental caries

ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).

3 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Ulcerative stomatitis · Children or adolescents

One study found significantly higher ulcerative stomatitis among CLWH on ART (OR 28.59, 95% CI 1.67 to 490.32), though the estimate is very imprecise.

1 finding from 1 review

Consumption of xylitol chewing gum by women (mothers) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Xylitol sugar-free gum significantly reduced plaque quantity versus no-gum/control (SMD -0.743, 95% CI -1.148 to -0.338), with high heterogeneity (I2 = 86.0%; ungraded).

1 finding from 1 review

Ion-releasing restoration, glass ionomer-based (conventional GIC, HV-GIC, RMGIC, glass hybrid) vs Resin composite restoration

Secondary caries · Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions)

Pooled across follow-up periods, ion-releasing (GIC) and resin composite restorations show no significant difference in secondary caries (RD -0.00, 95% CI -0.01 to 0.00; not separately GRADE-rated).

6 findings from 1 review
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Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of TAS2R43 (chr12p13.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of TAS2R43 was significantly associated with ECC in the TWAS (p = 8.78e-8); genetic association, ungraded.

1 finding from 1 review

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Differential microbial abundance / taxa predictive of caries · Individuals providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples; 2016 samples from 19 studies (mixed children and…

A group of genera/species (notably Selenomonas, Aggregatibacter, Actinomyces, Treponema) was predictive of caries, whereas Streptococcus was not (ungraded).

1 finding from 1 review
  • Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. 2022 All outcomes
    Oral cavity microbiome (saliva and supragingival plaque samples); pooled across 19 international studies
    Mean-decrease-accuracy discriminating taxa: Capnocytophaga HMT-338, Lactobacillus panis, Treponema HMT-230, Bifidobacterium longum, Delftia acidovorans, Staphylococcus schleiferi; higher log2FC in caries: Selenomonas HMT-146, Aggregatibacter actinomycetemcomitans, Actinomyces HMT-896, Treponema HMT-257; Streptococcus not predictive
    19 studies · 2016 participants
    GRADE not reported