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Evidence found and GRADE certainty

781 questions · 1,089 findings · 92 reviews · Dental caries

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No studies found 77 · 7.1%GRADE not reported 781 · 71.7%Very low 86 · 7.9%Low 97 · 8.9%Moderate 38 · 3.5%High 10 · 0.9%

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Dental erosion · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Dental erosion was more prevalent in anorexia nervosa patients than controls (low erosive-wear severity), but was not pooled or graded (ungraded).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Plaque · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa patients tended to have higher plaque accumulation than healthy controls (significant in 2 of 3 studies), but results were not pooled or graded (ungraded).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Caries experience · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

1 finding from 1 review

Ate or licked fluoride toothpaste vs Did not eat or lick fluoride toothpaste

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years
1 finding from 1 review
  • Topical fluoride as a cause of dental fluorosis in children 2024 · Cochrane All outcomes
    Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
    Nine studies investigated whether children ate or licked toothpaste; measurement subjective so not meta-analyzed (Table 1). Findings mixed: some studies found no significant difference; others (e.g. Celeste 2016 OR up…
    9 studies
    GRADE not reported

Brushed less than once per day vs Brushed once or more per day

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Brushed less than once per day may leads to lower fluorosis (percentage prevalence in permanent teeth) compared with brushed once or more per day (low certainty).

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Regular toothbrushing usage (prevalence) · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

About 91% of children with IDD in India use a toothbrush regularly (pooled prevalence 0.91, 95% CI 0.80-0.96; high heterogeneity; ungraded).

1 finding from 1 review

Used fluoride mouth rinse vs No fluoride mouth rinse

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Used fluoride mouth rinse showed no clear difference in fluorosis (percentage prevalence in permanent teeth) compared with no fluoride mouth rinse; GRADE not reported.

1 finding from 1 review

Used a pea-sized amount of fluoride toothpaste or less vs Used more than a pea-sized amount

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether used a pea-sized amount of fluoride toothpaste or less changes fluorosis (percentage prevalence in permanent teeth) compared with used more than a pea-sized amount (very low certainty).

1 finding from 1 review

Started toothbrushing with fluoride toothpaste at or before 12 months (earlier start) vs Started after 12 months (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste at or before 12… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 12 months (later start) (very low certainty).

2 findings from 1 review

Fluoride toothpaste less than 1000 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether fluoride toothpaste less than 1000 ppm (lower concentration) changes fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1000 ppm or more (higher concentration) (very low certainty).

2 findings from 1 review

Started toothbrushing with fluoride toothpaste before 24 months (earlier start) vs Started after 24 months (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste before 24 months… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 24 months (later start) (very low certainty).

1 finding from 1 review

Brushed less than twice per day vs Brushed twice or more per day

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether brushed less than twice per day changes fluorosis (percentage prevalence in permanent teeth) compared with brushed twice or more per day (very low certainty).

2 findings from 1 review

Started toothbrushing with fluoride toothpaste at or before 24 months (earlier start) vs Started after 24 months (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste at or before 24… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 24 months (later start) (very low certainty).

2 findings from 1 review

Started toothbrushing with fluoride toothpaste before 12 months (earlier start) vs Started after 12 months (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste before 12 months… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 12 months (later start) (very low certainty).

1 finding from 1 review

Fluoride toothpaste 440 ppm (lower concentration) vs 1450 to 1500 ppm F toothpaste

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Fluoride toothpaste 440 ppm (lower concentration) probably leads to lower fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1450 ppm (higher concentration) (moderate certainty).

1 finding from 1 review

Fluoride toothpaste 550 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Fluoride toothpaste 550 ppm (lower concentration) probably leads to lower fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1000 ppm (higher concentration) (moderate certainty).

1 finding from 1 review

Used less than half of the brush of fluoride toothpaste vs Used half or more of the brush

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether used less than half of the brush of fluoride toothpaste changes fluorosis (percentage prevalence in permanent teeth) compared with used half or more of the brush (very low certainty).

1 finding from 1 review

Early childhood caries / severe early childhood caries vs Caries-free controls

Change in height-for-age z score · Children aged ≤6 years (early childhood)

The association between baseline caries and declining height-for-age persisted after adjustment (coefficient -0.02); ungraded.

1 finding from 1 review

Early childhood caries / severe early childhood caries vs Caries-free controls

Stunting · Children aged ≤6 years (early childhood)

One Nepalese cross-sectional study found caries severity significantly correlated with chronic malnutrition/stunting (HAZ; p<0.0001), especially in rural children; ungraded, no effect size reported.

3 findings from 1 review

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

Kaposi's sarcoma (WHO clinical stage 4) · Children or adolescents

No eligible studies reported Kaposi's sarcoma.

1 finding from 1 review