Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,066 questions · 3,346 findings · 178 reviews · Dental caries

No studies found 48 · 1.4%GRADE not reported 2,789 · 83.4%Very low 208 · 6.2%Low 129 · 3.9%Moderate 136 · 4.1%High 36 · 1.1%

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

The additional use of a sealant probably reduces the initiation of white spot lesions during fixed orthodontic treatment compared with no sealant (RR 0.70), but the certainty of evidence is very low.

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Maximal mouth opening (interincisal distance) · Adults (general and hospital populations assessed in case-control studies)

Systemic sclerosis patients have significantly reduced mouth opening compared with controls (SMD -1.06); certainty ungraded.

1 finding from 1 review

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

White spot lesions were also measured by laser fluorescence in 3 fluoride-vs-non-fluoride studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Frequent carbohydrate / sugary food intake vs Infrequent carbohydrate intake

Dental caries · Individuals in East Africa assessed for dental caries

Frequent carbohydrate intake was associated with significantly higher odds of dental caries (OR 1.575, 95% CI 1.13 to 3.051); certainty not graded.

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Number of teeth · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in number of teeth between SSc patients and controls (SMD -0.95, CI includes 0); certainty ungraded.

1 finding from 1 review

Intervention not reported

Dental caries prevalence · General population (children and adults) in East Africa

Caries prevalence in mixed dentition (6-12 years) was 41.3% (95% CI 33.5 to 49.2); certainty not graded.

1 finding from 1 review

Intervention not reported

Mean DMFT (decayed, missing, filled permanent teeth) · Individuals with permanent dentition in East Africa

The pooled mean DMFT (permanent dentition) in East Africa was 1.941 (95% CI 1.561 to 2.322); certainty not graded.

1 finding from 1 review

Edentulous (0 remaining teeth) vs 20-32 remaining teeth

All-cause mortality (ACM) · Adults (any age) with a known number of remaining teeth, followed prospectively in cohort studies

In prospective cohorts, edentulous adults (0 teeth) had a higher cumulative incidence of all-cause mortality than adults with 20-32 teeth (RR 2.27, 95% CI 1.82 to 2.83; 8 cohort studies, I2=94%); GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Mean number of missing teeth in OC cases vs controls · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in number of missing teeth between SSc patients and controls (SMD 0.55, CI includes 0); certainty ungraded.

1 finding from 1 review

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Lesion area (decalcification area, pixels) · Adults undergoing orthodontic treatment

A single study reported a larger decalcification lesion area with aligners versus fixed appliances in adults at 3 months (MD 80.50 pixels, 95% CI 60.52 to 100.48; ungraded).

1 finding from 1 review

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Fluoride-releasing coating materials do not appear to reduce WSL initiation more than non-fluoride coatings (RR 0.84, not significant); certainty of evidence is very low.

1 finding from 1 review