Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Outer carious dentin (by lesion depth/location) vs Inner carious dentin

MMP-20 location/depth (outer vs inner) · Human ex vivo carious dentin

MMP-20 probably decreases in outer compared with inner carious dentin (moderate certainty).

1 finding from 1 review

Temporomandibular disorder vs No temporomandibular disorder

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

Temporomandibular disorder is associated with worse OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

2 findings from 1 review

Herbal mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Herbal mouthwash probably reduces the Gingival Index versus blank control in the short term (WMD -0.20, 95% CI -0.32 to -0.09; moderate certainty).

1 finding from 1 review

Chlorhexidine mouthwash vs placebo

Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.

1 finding from 1 review

Carious dentin before cavity sealing vs Carious dentin after cavity sealing

MMP-9 expression/activity · Human ex vivo carious dentin under sealed cavities

MMP-9 shows no difference before vs after cavity sealing; the evidence is very uncertain (very low certainty).

1 finding from 1 review

38% SDF (every 6 months) vs no treatment

Inactive (arrested) carious lesions on permanent first molars · Children with dental caries in permanent (first) molars

Six-monthly SDF produced significantly more inactive (arrested) lesions than no treatment in children's permanent molars (0.3 vs 0.1; p<0.05; ungraded).

1 finding from 1 review

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

Calcium hydroxide (CH) vs Mineral trioxide aggregate (MTA)

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy

MTA achieved higher clinical and radiographic success than calcium hydroxide overall (OR 2.94, 95% CI 1.96-4.49; low certainty), but this unadjusted estimate pools clinically heterogeneous DPC and pulpotomy studies.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded).

1 finding from 1 review

P11-4 + fluoride varnish vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish did not differ significantly from CPP-ACFP (SMD -0.54, 95% CI -1.15 to 0.08; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

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

Light-cured resin-modified glass ionomer cement vs Resin composite restoration

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

In deciduous teeth at 1 year, a single small trial found no difference in secondary caries between RMGIC and resin composite (RR 1.03, 95% CI 0.07-15.81; ungraded).

1 finding from 1 review

Root carious dentin vs Coronal carious dentin

MMP-13 presence/activity · Human ex vivo carious dentin

MMP-13 may be increased in root compared with coronal carious dentin, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline

Future caries experience (dmft/dmfs) · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Children with mutans streptococci at baseline had a greater future caries experience (SMD 0.85, a large effect; ungraded).

1 finding from 1 review