Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs7325099 (13:28104496; nearest gene(s) LNX2, POLR1D, RPL21) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs7325099 near LNX2, POLR1D, RPL21 showed suggestive (not genome-wide significant) association with ECC (Z = 4.485, p = 7.28e-6); genetic association, ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).

1 finding from 1 review

Baby-Led Introduction to SolidS (BLISS) vs Traditional complementary feeding (TCF)

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

In RCTs, BLISS did not significantly change overweight/obesity risk versus traditional feeding (RR 0.15, 95% CI 0.00 to 17.79; low certainty).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Chronic herpes simplex infection prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in chronic herpes simplex infection between ART regimens (very low certainty).

1 finding from 1 review

Prefabricated zirconia crowns (e.g., NuSmile, Zirkiz, Kinder Krown) vs Other crowns/restorations (stainless steel crowns, pre-veneered SSC, resin composite strip crowns, glass-fiber composite crowns)

Crown retention · Children with primary (deciduous) teeth requiring full-coverage crown restoration

Zirconia crowns showed no significant difference in crown retention versus other restorations at 6 months (RR 1.02, 95% CI 0.94 to 1.11; 3 studies; not GRADE-rated).

2 findings from 1 review

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

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

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

Overweight/obesity risk · Healthy children aged 6–24 months in Western industrialized countries

NRCF showed no significant association with overweight/obesity across the reported comparisons (very low certainty).

1 finding from 1 review

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

Oral hairy leukoplakia (WHO clinical stage 3) · Children or adolescents

No difference in oral hairy leukoplakia between groups (pooled OR 1.00, 95% CI 0.06 to 16.19); lesion essentially absent in both.

1 finding from 1 review

30% silver diamine fluoride vs Atraumatic restorative treatment (ART)

Patient discomfort during treatment (anxiety scale) · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

One study found no significant difference in patient discomfort between SDF and ART (p = 0.15; ungraded).

1 finding from 1 review

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

Angular cheilitis (WHO clinical stage 2) · Children or adolescents

No significant difference in angular cheilitis prevalence between CLWH and healthy controls (pooled OR 1.95, 95% CI 0.16 to 23.65).

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 LACC1 (chr13q14.11) · 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 LACC1 expression reached the TWAS threshold for ECC (p = 3.98e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with mineral trioxide aggregate (MTA)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure

Biodentine had a significantly higher pulpotomy success rate than MTA (indirect comparison; numeric estimate not available); ungraded.

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 NRAD1 (LINC00284) (chr13q14.11) · 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 NRAD1 (LINC00284) expression reached the TWAS threshold for ECC (p = 1.69e-6) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs Atraumatic restorative treatment (ART)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF was not significantly better than ART at arresting caries (pooled ES 0.05, 95% CI -0.42 to 0.51; ungraded).

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 TAS2R31 (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 TAS2R31 was suggestively associated with ECC in the TWAS (p = 1.04e-5); genetic association, ungraded.

1 finding from 1 review

Pulpotomy (full or partial) vs None (single-arm pooled success proportion)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis and open (immature) root apex due to carious pulp exposure

In open-apex teeth, pooled pulpotomy success was 95.8% (95% CI 81-99%); significantly higher than closed apex (z=2.33, p=0.02); ungraded.

1 finding from 1 review