Gap finder
Search review questions
Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Every word you type has to appear somewhere in the question, and the closest matches are ranked first.
75,239 questions in 5,342 reviews
current versionsNo studies 15,213 · 20.2%Ungraded 10,323 · 13.7%Very low 17,528 · 23.3%Low 17,951 · 23.9%Moderate 11,190 · 14.9%High 3,034 · 4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight) Dental caries / early childhood caries (ECC) · Children (approx. 4-18 years) · Dental examinations of children; 15 countries across Europe, Asia, the Americas and Oceania, Study design: cohort Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… (2024) | OR 1.27 [1.07, 1.56] | 3 studies | Ungraded |
Overweight vs Normal weight (eutrophic) Untreated dental caries (d component), continuous · Brazilian children/adolescents (BMI classified by WHO 2007 Z-score) · Brazil Overweight/obesity and dental caries in Brazilian children and adolescents: a systematic review and… (2024) | MD 0.03 [-0.24, 0.30] | 2 studies · 515 participants | Low |
Superelastic NiTi arch wire vs Conventional (stabilised) NiTi arch wire Alignment rate · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch) · 5 to 10 weeks Initial arch wires used in orthodontic treatment with fixed appliances (2024) · Cochrane | Conventional NiTi vs superelastic NiTi (O'Brien 1990; Ong 2011); not pooled due to clinical heterogeneity; little or no difference in alignment rate | 2 studies · 124 participants | Low |
Advice about a healthy diet (including breastfeeding promotion and sugar avoidance) and feeding practices (e.g. relating to bottle-feeding and sleep) for infants and young children vs Standard care Child oral health behaviours · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes,… Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood… (2024) · Cochrane | Two trials (Feldens 2007; Watt 2009) reported infant/child oral health behaviours; not suitable for meta-analysis. Both observed some evidence of benefit favouring the intervention. | 2 studies | Ungraded |
Facemask with rapid maxillary expansion (RME) vs Mini maxillary protractor ANB · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion) · End of treatment Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children (2024) · Cochrane | MD -0.75 [-1.49, -0.01] | 1 study · 32 participants | Ungraded |
Not applicable (single-group prevalence) vs Not applicable (single-group prevalence) Early childhood caries (ECC) prevalence (%, dmft>0) · Children younger than 71 months (under 6 years) · Countries with highest life expectancy, Life expectancy: highest (>80 years) A systematic review and meta-analysis on early-childhood-caries global data. (2024) | Prevalence 28 | NR | Ungraded |
Advice about a healthy diet (including breastfeeding promotion and sugar avoidance) and feeding practices (e.g. relating to bottle-feeding and sleep) for infants and young children vs Standard care Adverse events for mother or child · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes,… Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood… (2024) · Cochrane | One trial only (Feldens 2007) provided information on adverse events and reported no events. | 1 study | Ungraded |
Occlusal splint vs Physical therapy (ultrasound, exercise, sensorimotor training, laser, TENS, manual therapy) Muscle pain at rest · People with temporomandibular disorders (TMD) · Short term (mean 4.4 weeks), Myofascial pain TMD Occlusal interventions for managing temporomandibular disorders (2024) · Cochrane | MD -0.19 [-1.25, 0.87] | 1 study · 72 participants | Very low |
Tongue depressor stretches (physiotherapy) vs Intralesional steroid plus hyaluronidase injections Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF) · Less than 3 months Interventions for managing oral submucous fibrosis (2024) · Cochrane | MD 5.38 [-2.24, 13.00] | 1 study · 20 participants | Very low |
Extraction of the mandibular permanent first molar vs None (single-group prevalence) Rotation of the mandibular second permanent molar · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar) · Until eruption of the permanent second molar (median follow-up 4.0 years), University clinics and hospitals in 8 countries (children/adolescents <18 years), Mandible Spontaneous space closure after extraction of permanent first molars in children and adolescents: a… (2024) | Prevalence 76.9 [15.5, 98.4] | 2 studies · 108 participants | Ungraded |
Not applicable (single-group prevalence) vs Not applicable (single-group prevalence) Early childhood caries (ECC) prevalence (%, dmft>0) · Children younger than 71 months (under 6 years) · GNI $5000-$9999, GNI $5000-$9999 A systematic review and meta-analysis on early-childhood-caries global data. (2024) | Prevalence 53 [41, 65] | 14 studies | Ungraded |
Prophylaxis (teeth cleaning) and CHX or iodine-NaF solution application in the dentition of women (mothers) vs Placebo 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… · Children assessed at 2-3 yrs Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood… (2024) · Cochrane | RR 0.97 [0.80, 1.19] | 3 studies · 479 participants | Very low |
Platelet-rich fibrin (PRF) vs Calcium hydroxide (CH) Overall success (composite of clinical and radiographic success) · Mature permanent teeth with irreversible pulpitis and carious pulp exposure (treated with full pulpotomy) · >=12 months Efficacy of pulpotomy for permanent teeth with carious pulp exposure: A systematic review and meta-analysis… (2024) | OR 1.67 [0.59, 4.72] | 2 studies · 70 participants | Ungraded |
Silver diamine fluoride (SDF) vs Chlorhexidine varnish Aesthetics · Children and adults (with or without carious lesions) Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | No studies reported data for this outcome in this comparison | 0 studies | No studies |
Cesarean section delivery vs Vaginal delivery Early childhood caries (ECC) · Children aged <6 years · Community/population-based; multiple countries, Sample size: ≥300 RETRACTED: The association between mode of childbirth delivery and early childhood caries: A comprehensive… (2024) | OR 1.05 [0.86, 1.28] | 11 studies | Ungraded |
Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs Standard care dmft index score · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes,… · Children assessed at 6 yrs Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood… (2024) · Cochrane | MD -0.30 [-0.96, 0.36] | 1 study · 187 participants | Low |
Probiotics (any strain, dose, or presentation), minimum intake duration 0.2 months vs No treatment or placebo (control) Streptococcus mutans count (CFU/mL) · Children and/or adolescents (<18 years) without background systemic disease · follow-up: mean 4.4 months, Healthy children and/or adolescents (<18 years) without systemic disease; RCTs from multiple countries (India, Thailand, Spain, Australia, New Zealand, Sweden, Poland, Colombia, Saudi Arabia); mostly school/community and clinic settings, Overall (all presentations pooled) Efficacy of Probiotic Consumption on Oral Outcomes in Children and/or Adolescents: A Meta-Analysis. (2024) | MD -0.40 [-0.57, -0.24] | 11 studies · 1321 participants | Moderate |
Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride) Bacterial growth inhibition (MIC/MBC) · Streptococcus mutans (in vitro cultures and biofilms) · in vitro (laboratory) Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus… (2024) | GSE inhibited S. mutans growth across ~0.5-250 mg/mL (Abstract): inhibition at 250-500 mg/mL (Swadas), 4 mg/mL (Zhao), MIC 1000 ug/mL and MBC 4000 ug/mL (Furiga), MIC 0.5 mg/mL (Smullen), and MIC 19.07 mg/mL for… | 5 studies | Ungraded |
T allele vs C allele Dental caries · Children (<18 years) with vs without dental caries · Allelic model (T vs C), Children under 18 years; case-control and cross-sectional studies (China, Czech Republic, Turkey, Brazil, India), Primary dentition Association of vitamin D receptor gene polymorphisms with caries risk in children: a systematic review and… (2024) | OR 1.45 [0.96, 2.18] | NR | Ungraded |
Second molar at Demirjian stage E at extraction vs Second molar at Demirjian stage F-H at extraction Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar) · Until eruption of the permanent second molar (median follow-up 4.0 years), University clinics and hospitals in 8 countries (children/adolescents <18 years), Mandible Spontaneous space closure after extraction of permanent first molars in children and adolescents: a… (2024) | OR 3.81 [1.85, 7.83] | 3 studies · 94 participants | Low |
Adjunctive antimicrobial photodynamic therapy (aPDT) applied after submucosal instrumentation (SI) vs Submucosal instrumentation (SI) alone, or SI plus placebo/sham aPDT Pocket closure · Adults (> 18 years) with peri-implant mucositis, receiving active treatment Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | Only one study reported evidence for adjunctive aPDT in people with peri-implant disease (Al Rifaiy 2022). Data were only available for two outcomes (PPD and BOP), both reported only at three months. No studies… | NR | No studies |
rs10974056 effect allele A (intron variant in GLIS3, chr9:3,889,264) vs Non-effect allele C Dental caries (meta of mixed phenotypes: present-study self-report + GLIDE clinical DMFS + UKB self-report/dentures) · Adults from Japanese and European cohorts (present-study Japanese direct-to-consumer cohort + GLIDE consortium and UK… · Lifelong (germline genotype), Population-based genetic association study (Japanese direct-to-consumer cohort + European GLIDE/UKB cohorts), Meta-analysis: present study + GLIDE + UKB Genome-wide association meta-analysis identifies two novel loci associated with dental caries. (2024) | Z-score (meta) -5.494 | 3 studies · 533348 participants | Ungraded |
Presence of oral Candida albicans vs Absence of oral Candida albicans Early childhood caries (ECC) · Children aged ≤6 years (early childhood) · Exposure and outcome assessed concurrently (observational); children aged ≤6 years, Children aged ≤6 years; multiple countries (Asia, Europe, Americas); dental/clinical and community settings, Study design: cross-sectional RETRACTED: Investigating the association between Candida albicans and early childhood dental caries: A… (2024) | OR 4.30 [2.92, 6.33] | 20 studies · 2593 participants | Ungraded |
Adjunctive antimicrobial photodynamic therapy (aPDT) applied after subgingival instrumentation (SI) vs Subgingival instrumentation (SI) alone (hand or power-driven, or both), or SI plus placebo/sham aPDT Change in probing pocket depth (PPD) · Adults (> 18 years) with recurrent periodontitis, receiving supportive (maintenance) periodontal care · 6 months (change from baseline) Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | MD -0.04 [-0.19, 0.10] | 3 studies · 125 participants | Very low |
Adjunctive antimicrobial photodynamic therapy (aPDT) applied after subgingival instrumentation (SI) vs Subgingival instrumentation (SI) alone (hand or power-driven, or both), or SI plus placebo/sham aPDT Patient satisfaction · Adults (> 18 years) with recurrent periodontitis, receiving supportive (maintenance) periodontal care Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | No studies reported data for this outcome. | NR | No studies |
Occlusal splint vs Acupuncture Severity of joint noise · People with temporomandibular disorders (TMD) Occlusal interventions for managing temporomandibular disorders (2024) · Cochrane | Listed in Summary of findings 5 as 'Not reported'; this outcome was not reported by any included study for this comparison. | 0 studies | No studies |
Dental crowding present vs Dental spacing present Spontaneous space closure · Children and adolescents (<18 years) after extraction of a permanent first molar before eruption of the permanent… · Until eruption of the permanent second molar (median follow-up 4.0 years), University clinics and hospitals in 8 countries (children/adolescents <18 years), Overall Spontaneous space closure after extraction of permanent first molars in children and adolescents: a… (2024) | OR 5.9 [1.3, 27.7] | 1 study | Ungraded |
T allele vs C allele Dental caries · Children (<18 years) with vs without dental caries · Allelic model (T vs C), Children under 18 years; case-control and cross-sectional studies (China, Czech Republic, Turkey, Brazil, India), Real-time quantitative PCR genotyping Association of vitamin D receptor gene polymorphisms with caries risk in children: a systematic review and… (2024) | OR 1.24 [0.96, 1.60] | NR | Ungraded |
Antioxidants (lycopene, curcumin, Oxitard) vs Placebo or no active treatment Difficulty in mouth opening (participant-reported proxy) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF) Interventions for managing oral submucous fibrosis (2024) · Cochrane | OR 0.00 [0.00, 0.02] | 1 study · 100 participants | Ungraded |
Silver diamine fluoride (SDF) vs Chlorhexidine varnish Dental pain or sensitivity · Children and adults (with or without carious lesions) Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | No studies reported data for this outcome in this comparison | 0 studies | No studies |
Started toothbrushing with fluoride toothpaste before 12 months (earlier start) vs Started after 12 months (later start) Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years) Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane | OR 1.22 [0.98, 1.52] | 7 studies · 4329 participants | Very low |
Children with severe early childhood caries (S-ECC) vs Caries-free children Serum 25-hydroxyvitamin D level · Preschool children ≤6 years The Association Between Vitamin D and Early Childhood Caries: A Systematic Review and Meta-Analysis. (2024) | MD -18.64 [-20.06, -17.22] | 7 studies · 1658 participants | Ungraded |
Institutionalization (living in an orphanage/institution) vs Parented children living with their families Dental caries prevalence (DMF/dmf score > 0) · Institutionalized orphan children (roughly 3 to 18 years) · Orphanages/childcare institutions in low- and middle-income countries (India, Iran, China, Yemen, Egypt, Lithuania, Malaysia), Overall (pooled) Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis. (2024) | RR 1.19 [0.89, 1.59] | 4 studies · 1420 participants | Very low |
Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material Caries arrest · Children and adults (with or without carious lesions) · Permanent dentition Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | No studies reported this outcome in this dentition type | 0 studies | No studies |
Probiotics (any strain, dose, or presentation), minimum intake duration 0.2 months vs No treatment or placebo (control) Gingival bleeding index · Children and/or adolescents (<18 years) without background systemic disease · 1.5 months, Healthy children and/or adolescents (<18 years) without systemic disease; RCTs from multiple countries (India, Thailand, Spain, Australia, New Zealand, Sweden, Poland, Colombia, Saudi Arabia); mostly school/community and clinic settings, Single study (Borrell 2021); not pooled Efficacy of Probiotic Consumption on Oral Outcomes in Children and/or Adolescents: A Meta-Analysis. (2024) | MD 0.10 [0.02, 0.18] | 1 study · 27 participants | Ungraded |
Occlusal splint vs Acupuncture Frequency of joint noise · People with temporomandibular disorders (TMD) Occlusal interventions for managing temporomandibular disorders (2024) · Cochrane | Listed in Summary of findings 5 as 'Not reported'; this outcome was not reported by any included study for this comparison. | 0 studies | No studies |
Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control) Salivary TNF-α level (pg/mL) · Children and young adults (3-25 years) · Observational studies in children and young adults across nine countries (saliva-based cytokine comparison) Activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults with dental caries: a… (2024) | SMD 14.81 [4.76, 24.86] | 7 studies · 348 participants | Ungraded |
Occlusal splint vs Physical therapy (ultrasound, exercise, sensorimotor training, laser, TENS, manual therapy) Discomfort · People with temporomandibular disorders (TMD) Occlusal interventions for managing temporomandibular disorders (2024) · Cochrane | Listed in Summary of findings 3 as 'Not reported'; this outcome was not reported by any included study for this comparison. | 0 studies | No studies |
Serum 25(OH)D 50–75 nmol/l vs Serum 25(OH)D ≥ 75 nmol/l Early childhood caries (ECC) · Preschool children ≤6 years, North America · North America The Association Between Vitamin D and Early Childhood Caries: A Systematic Review and Meta-Analysis. (2024) | OR 2.09 [1.55, 2.82] | 3 studies · 750 participants | Ungraded |
Breastfeeding <12 months vs Breastfeeding ≥12 months Dental caries (ECC) · Preschool children under 6 years of age · First dental examination before age 6 years, Clinical, field, or unclear dental examination settings, Cohort studies; sensitivity analysis excluding studies 35, 42, and 48 Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta-Analysis. (2024) | RR 0.70 [0.62, 0.80] | 5 studies | Ungraded |
Mineral trioxide aggregate (MTA) vs Calcium-enriched mixture (CEM) Overall success (composite of clinical and radiographic success) · Permanent teeth with carious pulp exposure · >=12 months Efficacy of pulpotomy for permanent teeth with carious pulp exposure: A systematic review and meta-analysis… (2024) | OR 0.78 [0.46, 1.34] | 4 studies · 611 participants | Ungraded |
Cranberry extract or cranberry flavonoid fractions vs No extract or vehicle control; other antimicrobial agents Bacterial adhesion or initial colonization · Streptococcus mutans cultures and biofilms · In vitro laboratory studies Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus… (2024) | no estimate extracted | 3 studies | Ungraded |
Obesity vs Normal weight (eutrophic) Dental caries experience (DMFT), continuous · Brazilian children/adolescents in permanent dentition (BMI classified by CDC 2000 growth charts) · Brazil Overweight/obesity and dental caries in Brazilian children and adolescents: a systematic review and… (2024) | MD 0.61 [0.08, 1.15] | 2 studies · 659 participants | Very low |
Antioxidants (lycopene, curcumin, Oxitard) vs Placebo or no active treatment Difficulty in swallowing (participant-reported proxy) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF) Interventions for managing oral submucous fibrosis (2024) · Cochrane | OR 0.24 [0.10, 0.60] | 2 studies · 220 participants | Ungraded |
Occlusal splint vs No treatment or placebo (non-occlusal or transparent-foil placebo splint) Self-reported joint pain when chewing · People with temporomandibular disorders (TMD) · Short term (10 weeks), Mixed TMD Occlusal interventions for managing temporomandibular disorders (2024) · Cochrane | RR 1.88 [0.94, 3.75] | 1 study · 60 participants | Very low |
Superelastic NiTi arch wire vs Titanium-niobium-tantalum-zirconium (TiNbTaZr) arch wire Alignment rate · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch) · 8 to 12 weeks Initial arch wires used in orthodontic treatment with fixed appliances (2024) · Cochrane | Superelastic NiTi (Sentalloy) vs TiNbTaZr (Gummetal) (Nordstrom 2018); LII change over 8 to 12 weeks; no clear difference (ANOVA P=0.6938) | 1 study · 28 participants | Ungraded |
Cranberry extract / juice and proanthocyanidin (flavonoid) fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride) Bacterial adhesion (inhibition) · Streptococcus mutans (in vitro cultures and biofilms) · in vitro (laboratory) Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus… (2024) | Cranberry formulations adhered to and prevented biofilm on saliva-coated hydroxyapatite (Greene); reduced adhesion via inhibited glucan synthesis (Feng); reduced initial S. mutans colonization 40-60% through reduced… | 3 studies | Ungraded |
Periodontitis vs No periodontitis High salivary S. mutans (over 10^4 CFU/ml) · Adults · Salivary/plaque microbiology samples from case-control studies, Overall Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 0.82 [0.44, 1.51] | 2 studies | Ungraded |
Chin cup vs Untreated control (no treatment) Wits appraisal · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion) · End of treatment Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children (2024) · Cochrane | MD 4.87 [4.53, 5.20] | 1 study · 50 participants | Ungraded |
Nanda facemask vs Conventional facemask ANB · Children and adolescents (aged 16 years or younger) with prominent lower front teeth (Class III malocclusion) · End of treatment Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children (2024) · Cochrane | MD 1.29 [0.16, 2.42] | 1 study · 20 participants | Ungraded |