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Evidence found and GRADE certainty

1,338 questions · 2,104 findings · 136 reviews · Dental caries

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No studies found 159 · 7.6%GRADE not reported 1,657 · 78.8%Very low 138 · 6.6%Low 111 · 5.3%Moderate 36 · 1.7%High 3 · 0.1%

Electronic cigarette use vs Non-smokers

Tumour necrosis factor-alpha (TNF-α) · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Meta-analysis suggests no significant effect of e-cigarette use on the salivary level of Tumour necrosis factor-alpha (TNF-α) (7 studies), though heterogeneity was high (I2=95%) and the pooled estimate appears only in Figure 3E (unavailable); GCF data were limited (2 study(ies)) (ungraded).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Bone mineral density in forearm · European-ancestry adults

Genetically predicted periodontitis had no causal effect on forearm BMD.

1 finding from 1 review

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Proposed inhibition of S. mutans adhesion to tooth surface (mechanism; direct adherence endpoint confirmed only in Ahn 2018) · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

Postbiotics inhibit S. mutans adhesion to tooth surfaces in vitro (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    Postbiotics (mainly biosurfactants and lipoteichoic acid) interfered with S. mutans adhesion to tooth/hydroxyapatite surfaces in 5 in vitro studies; no pooled estimate.
    5 studies
    GRADE not reported

Electronic cigarette use vs Non-smokers

Combined salivary IL-1β, IL-6, IL-8, and TNF-α levels · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Combining all four salivary cytokines, the meta-analysis found no effect of e-cigarette use on salivary proinflammatory marker levels (low between-marker heterogeneity, I2=31%); the pooled estimate appears only in Figure 3F (unavailable) and is ungraded.

1 finding from 1 review

Postbiotic toothpaste vs Fluoride toothpaste alone

Increased salivary IgA · children aged 6‐12 years

Postbiotics increase salivary IgA (immune modulation) in human trials (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Daily for 14 days to 4 weeks · Clinical; salivary/plaque sampling
    Postbiotic toothpaste significantly increased salivary IgA versus fluoride toothpaste (Basir 2022); the review also cites Lin 2022 for postbiotic immune modulation/IgA; no pooled estimate.
    1 study
    GRADE not reported

Lactobacillus-derived postbiotics vs Not specified

Streptococcus mutans growth and biofilm formation · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

No meta-analysis was conducted; the narrative synthesis reported inhibition of Streptococcus mutans growth and biofilm formation.

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Interleukin-1 beta (IL-1β) · Humans who use e-cigarettes (mostly adults, often with periodontal disease) assessed for oral proinflammatory markers

Meta-analysis suggests no significant effect of e-cigarette use on the salivary level of Interleukin-1 beta (IL-1β) (11 studies), though heterogeneity was high (I2=97%) and the pooled estimate appears only in Figure 3B (unavailable); GCF data were limited (2 study(ies)) (ungraded).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Forearm fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on fracture of forearm (multivariable MR, OR 0.995).

2 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Femur fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Postmenopausal osteoporosis with pathological fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review