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%

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Angular cheilitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in angular cheilitis between CLWH with and without ART (very low certainty).

1 finding from 1 review

Fluoride-free nano-/micro-hydroxyapatite (nHA) dentifrice vs Control (regular fluoride) dentifrice

Caries lesion initiation/progression (ICDAS score, laser fluorescence/DIAGNOdent, photographic pixels, enamel acid resistance) · Patients (children and adults, age 3-40 years) with initial enamel caries lesions (non-orthodontic and orthodontic)

No meta-analysis was possible for the 5 in vivo RCTs (high heterogeneity); narratively nHA showed generally no significant difference versus fluoridated dentifrice, and the evidence was not graded (ungraded).

1 finding from 1 review
  • Efficacy of nano-hydroxyapatite on caries prevention-a systematic review and meta-analysis. 2022 All outcomes
    Median follow-up 6 months (range 6-12 months) · In vivo (clinical); non-orthodontic and orthodontic patients
    No meta-analysis was performed for the in vivo studies owing to high heterogeneity (population, control group, outcomes, follow-up periods, risk of bias) and differing statistical designs (e.g., non-inferiority);…
    5 studies · 420 participants
    GRADE not reported

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Ulcerative stomatitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Ulcerative stomatitis was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

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

Acute necrotizing ulcerative gingivitis/periodontitis (WHO clinical stage 3) · Children or adolescents

No eligible studies reported acute necrotizing ulcerative gingivitis/periodontitis.

1 finding from 1 review

Baby-led weaning (BLW) vs Other models of complementary feeding

Overweight/obesity risk · Healthy children aged 6–24 months in Western industrialized countries

BLW was associated with lower overweight/obesity risk in observational studies, but the certainty was very low.

1 finding from 1 review

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

Chronic herpes simplex infection (WHO clinical stage 4) · Children or adolescents

No eligible studies reported chronic herpes simplex infection.

1 finding from 1 review

Isolated cleft palate (CP) or other specific cleft type vs Cleft lip and palate (CLP) or other cleft type

Caries experience by cleft type · Children in the primary dentition with cleft lip and/or palate (CL/P)

Whether cleft type is associated with caries experience could not be determined; the planned CP-versus-CL/P subgroup analysis was not possible owing to sparse isolated-CP data (5 studies described narratively; ungraded).

1 finding from 1 review
  • Caries in children with and without orofacial clefting: A systematic review and meta-analysis. 2022 All outcomes
    Children with CL/P and comparable non-CL/P children across 12 countries (India, Brazil, China, Sweden, UK, USA, Germany, Greece, Ireland, Netherlands, Jordan, Thailand); studies published 1989-2021
    Five studies investigated caries experience by cleft type (Howe 2017; Kirchberg 2014; Mutarai 2008; Sunderji 2017; Zhu 2010). A subgroup analysis comparing CP and CL/P as different entities was not possible due to the…
    5 studies
    GRADE not reported

Primary dentition DMFT score over 13 vs No caries in primary teeth (DMFT = 0)

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

A primary-dentition DMFT over 13 is associated with about 15 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

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

Poor (inadequate) oral hygiene (prevalence) · Children or adolescents

No significant difference in oral hygiene between CLWH on ART and healthy controls (OR 1.23, 95% CI 0.73 to 2.07; single study).

1 finding from 1 review

Single-surface ART restoration using high-viscosity glass ionomer vs Multi-surface ART with high-viscosity GIC

Restoration survival · Children with decayed primary molar teeth

Single-surface ART/HVGIC restorations had high reported survival (86% at 3 years), significantly higher than multi-surface restorations (ungraded).

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms compared with one another / against the reference caries diagnosis

Diagnostic accuracy for root caries detection · Dental radiographic/intraoral images of human teeth (X-ray and photographic)

One study reported machine-learning accuracy for root caries detection (97.1%, support vector machine); not pooled and not graded.

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Acute necrotising ulcerative periodontitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in acute necrotising ulcerative periodontitis between ART regimens (very low certainty).

1 finding from 1 review

Bio-active restorative materials vs Any conventional restorative material

Treatment failure (planned; no eligible studies) · Children with carious primary teeth after vital or non-vital pulp therapy

No eligible studies were found evaluating bio-active restorative materials for restoring carious primary teeth after pulp therapy.

1 finding from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

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

A rinsing step after SDF eliminates the negative effect on adhesive bond strength to sound dentin (MD 7.11 MPa, 95% CI -0.57 to 14.79, non-significant; ungraded).

1 finding from 1 review

38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review