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Evidence found and GRADE certainty

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

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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%

Chlorhexidine mouthwash vs Placebo mouthwash

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

Chlorhexidine mouthwash probably reduces the Gingival Index versus placebo in the short term (WMD -0.45, 95% CI -0.70 to -0.20; low certainty).

1 finding from 1 review

0-19 remaining teeth vs Individuals without functional edentulism

Oral health-related quality of life · Indian elderly

Evidence on functional edentulism and OHRQoL is inconsistent across two studies (very low certainty).

2 findings from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Barriers and facilitators to implementation of the integration strategy (qualitative) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
    15 studies
    GRADE not reported

Dental caries vs Caries-free status

CA VI concentration · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

CA VI concentration was lower in participants with caries (SMD -0.66, 95% CI -1.00 to -0.32; 2 studies, 141 participants); GRADE was not reported.

1 finding from 1 review

Self-assembling peptide P11-4 vs Fluoride varnish

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…

Self-assembling peptide P11-4 did not differ significantly from fluoride varnish (SMD -0.31, 95% CI -0.71 to 0.09); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children (mixed dentition; baseline about 8 years)

In children with mixed dentition, vitamin D deficiency was associated with an 8% higher caries risk (RR 1.08; ungraded).

1 finding from 1 review

Self-assembling peptide P11-4 vs CPP-ACP

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…

Self-assembling peptide P11-4 did not differ significantly from CPP-ACP (SMD -0.38, 95% CI -0.87 to 0.11; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities)

Dental caries estimates · People receiving or providing primary care; all ages, ability types, and locations

Seven studies measured change in dental caries estimates.

1 finding from 1 review

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

MMP-9 location/depth · Human ex vivo carious dentin

No clear direction of MMP-9 expression by lesion depth/location was found; the evidence is very uncertain (very low certainty).

1 finding from 1 review

CPP-ACP 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…

CPP-ACP did not differ significantly from CPP-ACFP (SMD 0.25, 95% CI -0.24 to 0.73); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Toothache vs No dental pain

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

Toothache/dental pain is associated with worse 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
    Toothache, DMT and tooth loss have a high impact on OHRQoL in adolescentes [26]. There is low evidence that dental pain has a negative impact on OHRQoL [37].
    Studies not reported
    GRADE not reported

Periodontal disease (periodontitis; clinical attachment loss >=4 mm) vs Adults without periodontal disease (healthy periodontal status; CAL <=3 mm)

Root caries (presence of root caries) · Adults (mean age ~53 years)

Adults with periodontal disease had significantly higher odds of root caries than those without (pooled OR 1.38, 95% CI 1.25 to 1.53; 2 observational studies; low certainty).

1 finding from 1 review

38% SDF one-time application without brushing programme vs no treatment without brushing programme

new carious lesions or fillings · Children with dental caries in permanent (first) molars

The review reported no significant result for SDF; no effect estimate or GRADE rating was reported.

1 finding from 1 review

Access to dental care / health services vs No / limited access to dental care

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

Access to dental care 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
    having parents who can provide dental care and safe housing are positive predictors for OHRQoL. access to dental care and the performance of health promotion programs are directly proportional to OHRQoL in adolescents.
    Studies not reported
    GRADE not reported

Glass ionomer cement vs Resin composite restoration

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 2 or more years in permanent teeth, GIC probably reduces secondary caries versus resin composite (RR 0.50, 95% CI 0.28-0.91; moderate certainty).

2 findings from 1 review

Carious dentin before cavity sealing vs Carious dentin after cavity sealing

MMP-2 expression/activity · Human ex vivo carious dentin under sealed cavities

MMP-2 shows no difference before vs after cavity sealing; the evidence is very uncertain (very low certainty).

1 finding from 1 review