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What do systematic reviews say?

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Evidence found and GRADE certainty

4,534 questions · 5,247 findings · 456 reviews

No studies found 1,142 · 21.8%GRADE not reported 1,503 · 28.6%Very low 1,040 · 19.8%Low 869 · 16.6%Moderate 554 · 10.6%High 139 · 2.6%

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Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Proper surface staining · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in surface staining (moderate certainty; downgraded for inconsistency).

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs Partial pulpotomy with calcium hydroxide

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Tri-calcium silicate use was associated with a 37% increase in partial-pulpotomy success in meta-regression.

1 finding from 1 review

Country-level dental caries prevalence (Global Burden of Disease) vs Low vs high dental caries prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

Lower country-level dental caries prevalence was associated with better OHRQoL (low-prevalence pooled mean 81.5, 95% CI 76.5 to 86.6, higher than high-prevalence countries); statistically significant (ungraded).

1 finding from 1 review

Caries experience vs Adolescents without dental caries

Negative oral-health impact on daily performance (OIDP or Child-OIDP) · Adolescents (10-19 years)

For experience (history) of dental caries, adolescents had a significantly worse oral-health impact: PR 1.72 (95% CI 1.23 to 2.43) from 6 studies (I2=97%); ungraded, and not statistically different from the presence subgroup (p=0.19).

1 finding from 1 review
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Caries-definition subgroup: experience of dental caries
    PR 1.72 [1.23, 2.43]
    6 studies
    GRADE not reported

High dental-caries prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

The review reported higher OHRQoL in the low than high dental-caries-prevalence category.

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Adequate periodontal tissue · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

Uncertain whether IRR and CR differ in periodontal tissue outcomes (low certainty; downgraded for very serious inconsistency).

1 finding from 1 review

Prenatal vitamin D level ≤50 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a lower odds ratio at maternal prenatal vitamin D ≤50 nmol/L than at ≤35 nmol/L, without a numeric value in the available sources.

1 finding from 1 review

Dietary advice on how to achieve a healthy diet for infants (tailored advice focused on a diet low in saturated fat and cholesterol intake) vs usual care

Dental caries · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

The review found no eligible studies for this question.

2 findings from 1 review

Nocturnal breastfeeding vs No nocturnal breastfeeding

Early childhood caries (ECC) · Preschool children (<6 years)

After excluding one study, nocturnal breastfeeding was associated with higher ECC risk (RR 3.05, 95% CI 2.40 to 3.87; I²=33%).

1 finding from 1 review

Facemask (RME) or modified facemask vs Other non-surgical orthodontic treatments (mini maxillary protractor, Pushing Splints, modified tandem, Reverse Forsus, reverse Twin Block, reverse chin cup, tongue appliance, Frankel III)

Perceived need for surgery in adulthood · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

The review found no eligible studies for this question.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Mother microbiological presence (high-level mutans streptococci / lactobacilli) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

Oral health education/promotion (oral hygiene advice plus diet and… showed no clear difference in mother microbiological presence (high-level mutans streptococci /… compared with standard care; GRADE not reported.

1 finding from 1 review

Consumption of xylitol chewing gum by women (mothers) vs Consumption of CHX/xylitol gum by women, or CHX varnish applied to women's dentition

Caries presence in primary teeth · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

It is very uncertain whether consumption of xylitol chewing gum by women (mothers) changes caries presence in primary teeth compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to… (very low certainty).

1 finding from 1 review

Bone-anchored intermaxillary traction (BAIMT) vs Removable mandibular retractor (RMR)

Overjet · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Bone-anchored intermaxillary traction (BAIMT) led to higher overjet compared with removable mandibular retractor (RMR); GRADE not reported.

1 finding from 1 review

Cesarean section delivery vs Vaginal delivery

Early childhood caries (ECC) · Children aged <6 years

No significant association between cesarean vs vaginal delivery and ECC among America/Canada/Brazil studies (OR 1.11, 95% CI 0.70-1.76).

17 findings from 1 review
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Orthodontic removable traction appliance (ORTA) vs no intervention

Wits appraisal · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Orthodontic removable traction appliance (ORTA) led to higher wits appraisal compared with untreated control (no treatment); GRADE not reported.

1 finding from 1 review

Prophylaxis (teeth cleaning) and CHX or iodine-NaF solution application in the dentition of women (mothers) vs placebo

Mother microbiological presence · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age
1 finding from 1 review

Facemask (with frame internal fixation) vs Frankel III functional appliance

Wits appraisal · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion)

Facemask (with frame internal fixation) showed no clear difference in wits appraisal compared with frankel III functional appliance; GRADE not reported.

1 finding from 1 review