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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%

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 rs76823412 (8:134690570; nearest gene(s) ST3GAL1) · 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 rs8091366 near CHST9, KCTD1 showed suggestive (not genome-wide significant) association with ECC (Z = 4.476, p = 7.60e-6); genetic association, ungraded.

2 findings from 1 review

Silver diamine fluoride (SDF) vs placebo

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

SDF did not significantly differ from placebo for oral health-related quality of life in children (MD 0.03, 95% CI -0.16 to 0.22; ungraded).

1 finding from 1 review

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

Dental caries · Children and adolescents (general population, aged under 20 years)

Evidence on food marketing and dental caries is very uncertain (very low certainty); 1 of 2 studies found an association.

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 at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Oral-health-education-only interventions did not show a statistically significant effect on surface-level caries (dmfs SMD -0.20, 95% CI -0.43 to 0.03; 2 studies; not GRADE-rated).

1 finding from 1 review

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

Angular cheilitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No eligible studies compared angular cheilitis between different ART regimens.

1 finding from 1 review

Caries in first and second primary molars vs Reference (other primary tooth locations / caries-free)

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

Caries in the first and second primary molars is the strongest tooth-specific predictor of caries in permanent teeth (RR 3.4; single study; not GRADE-rated).

1 finding from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

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

SDF pretreatment with a rinsing step does not affect glass-ionomer cement bond strength to sound dentin (MD -1.11 MPa, 95% CI -3.47 to 1.25; ungraded).

1 finding from 1 review

Atraumatic restorative treatment plus fluoride varnish vs Silver diamine fluoride plus fluoride varnish

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

The direct estimate found no statistically significant difference in oral health-related quality of life between atraumatic restorative treatment plus fluoride varnish and silver diamine fluoride plus fluoride varnish.

2 findings from 1 review

SDF applied biannually (every 6 months) vs Other non/minimally-invasive treatment (ART or 5% NaF varnish)

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

Biannual SDF application significantly arrested caries (pooled ES 0.39, 95% CI 0.19-0.60; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

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

SDF did not significantly differ from atraumatic restorative treatment for oral health-related quality of life (MD 0.02, 95% CI -0.32 to 0.36; ungraded).

1 finding from 1 review

Primary dentition DMFT score 1-3 vs No caries in primary teeth (DMFT = 0)

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

A primary-dentition DMFT of 1-3 is associated with 1.5 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

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

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between ART regimens (very low certainty).

1 finding from 1 review

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

Dental caries prevalence · Children or adolescents

In permanent dentition, CLWH on ART had higher caries prevalence than healthy controls (OR 2.49, 95% CI 1.86 to 3.32; single study).

3 findings from 1 review

Resin infiltration vs Baseline before resin infiltration

Color change · Patients with post-orthodontic white spot lesions and permanent dentition

Eckstein (2015) reported a statistically significant color-change effect.

4 findings from 1 review
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CD4+ T-cell count below 250 cells/mm3 vs CD4+ T-cell count >=250 cells/mm3

HIV-related oral lesions · Children and adolescents living with HIV on ART/HAART

Lower CD4+ counts (<250 cells/mm3) were associated with roughly twice the odds of HIV-related oral lesions in two studies (not pooled).

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) · CD4+ T-cell count <250 cells/mm3 vs higher
    CLWH with CD4+ <250 cells/mm3 were about twice as likely to have HIV-related oral lesions: Baghirath 2013 OR 1.916 (95% CI 0.613 to 2.513), p=0.001; Divakar 2015 OR 1.999 (95% CI 0.129 to 3.688), p=0.001. Not pooled.
    2 studies
    GRADE not reported

Responsive complementary feeding (RCF) / other caregivers' feeding practices vs Other models of complementary feeding (traditional/non-responsive CF)

Type 2 diabetes (later in life) · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western industrialized countries

No eligible studies examined the influence of complementary feeding practices on later type 2 diabetes; this is an evidence gap.

1 finding from 1 review