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%

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to caries-affected dentin (in vitro)

SDF pretreatment without a rinsing step does not affect glass-ionomer cement bond strength to caries-affected dentin (MD 0.26 MPa, 95% CI -0.30 to 0.82; ungraded).

1 finding from 1 review

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

Mucosal (oral) hyperpigmentation · Children or adolescents

CLWH on ART had significantly higher prevalence of mucosal hyperpigmentation than healthy controls (pooled OR 20.35, 95% CI 3.86 to 107.39); the authors described the certainty as low.

1 finding from 1 review

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Oral-health-education-only interventions showed at most a marginal effect on tooth-level caries (dmft SMD -0.11, 95% CI -0.21 to -0.00; 2 studies; not GRADE-rated).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Stepwise excavation reduced the reported risk of pulp exposure by 69% versus complete caries removal (RR 0.31; ungraded).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to sound dentin (in vitro)

Prior SDF without a rinsing step significantly reduces adhesive bond strength to sound dentin (MD 17.52 MPa favoring untreated dentin, 95% CI 5.81 to 29.22; ungraded).

1 finding from 1 review

Male sex (boys) vs Female sex

Caries development in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Gender is not associated with caries development in permanent teeth (OR 0.86, 95% CI 0.71 to 1.02; low certainty).

1 finding from 1 review

Compomer (C) vs Resin composite restoration

Treatment failure (annual failure rate) · Children with carious primary molars treated by pulpotomy (vital pulp therapy)

Compomer restorations had an annual failure rate of 8.9% in primary molars after pulpotomy, higher than composite resin in the same trial (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

Fluoride-containing dental care products (mainly fluoride toothpaste) vs Dietary fluoride sources (drinking water, beverages, food)

Contribution of dental care products to total daily fluoride intake (TDFI), by tap-water fluoride level · Children using fluoride-containing dental care products (majority of included studies)

In children in low-fluoridated tap water areas, dental care products contributed on average 39% of total fluoride exposure (ungraded).

5 findings from 1 review
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ART/HAART duration <3 years vs ART/HAART duration >=3 years

Other orofacial opportunistic infections (linear gingival erythema, hairy leukoplakia, angular cheilitis, oral ulcers) · Children and adolescents living with HIV on ART/HAART

ART/HAART duration had minimal influence on the prevalence of orofacial opportunistic infections other than candidiasis (no significant differences).

1 finding from 1 review
  • Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
    Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · ART/HAART duration <3 years vs >=3 years
    Except for candidiasis, no significant differences in the prevalence of opportunistic infection manifestations (linear gingival erythema, hairy leukoplakia, angular cheilitis, oral ulcers) between ART duration <3 years…
    2 studies
    GRADE not reported

Non-responsive complementary feeding (NRCF) vs Other models of complementary feeding

Overweight/obesity risk · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western industrialized countries

Non-responsive complementary feeding showed no significant association with overweight/obesity across observational studies (very low certainty).

1 finding from 1 review

Atraumatic restorative treatment vs placebo

Oral health-related quality of life · Children with dental caries

ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).

3 findings from 1 review

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

Ulcerative stomatitis · Children or adolescents

One study found significantly higher ulcerative stomatitis among CLWH on ART (OR 28.59, 95% CI 1.67 to 490.32), though the estimate is very imprecise.

1 finding from 1 review

Consumption of xylitol chewing gum by women (mothers) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Xylitol sugar-free gum significantly reduced plaque quantity versus no-gum/control (SMD -0.743, 95% CI -1.148 to -0.338), with high heterogeneity (I2 = 86.0%; ungraded).

1 finding from 1 review

Mixed breast- and bottle-feeding vs Bottle feeding

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between mixed breast-and-bottle-fed and bottle-fed-only children (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Ion-releasing restoration, glass ionomer-based (conventional GIC, HV-GIC, RMGIC, glass hybrid) vs Resin composite restoration

Secondary caries · Patients with permanent dentition in need of restorations (all cavity types: Black's Class I, II, V, and non-carious cervical lesions)

Pooled across follow-up periods, ion-releasing (GIC) and resin composite restorations show no significant difference in secondary caries (RD -0.00, 95% CI -0.01 to 0.00; not separately GRADE-rated).

6 findings from 1 review
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Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review