Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

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%

Maternal education attainment vs Not applicable (single-group prevalence)

No formal maternal education prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 10% of children with caries in LMICs had mothers with no formal education (pooled prevalence 0.101, 95% CI 0.033 to 0.201; 3 studies; not GRADE-rated).

1 finding from 1 review

Ion-releasing restoration (glass ionomer-based and compomer/polyacid-modified composite) vs Resin composite restoration

Secondary caries (caries around restorations), load-bearing cavities · Patients with permanent dentition in need of restorations in load-bearing cavities (Class I/II posterior)

In load-bearing cavities, ion-releasing (GIC and compomer) and resin composite restorations show no significant difference in secondary caries (RD -0.00, 95% CI -0.01 to 0.01; not GRADE-rated).

1 finding from 1 review

Fluoride-free nano-hydroxyapatite (nHA) dentifrice/paste vs Sodium fluoride (control) toothpaste

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under demineralizing conditions, nHA allowed significantly more enamel demineralization than NaF (MD 1625, 95% CI 553 to 2697; very low certainty).

2 findings from 1 review

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

Linear gingival erythema prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in linear gingival erythema between ART regimens (very low certainty).

1 finding from 1 review

Resin-modified glass ionomer cement for bonding orthodontic brackets vs Compomer and composite resin

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; failure rates were tabulated by arm.

1 finding from 1 review

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

Persistent parotid enlargement (WHO clinical stage 2) · Children or adolescents

No significant difference in persistent parotid enlargement between groups (OR 10.36, 95% CI 0.53 to 201.45; single study, very imprecise).

1 finding from 1 review

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

Oral hairy leukoplakia prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in oral hairy leukoplakia between CLWH with and without ART (very low certainty).

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs7325099 (13:28104496; nearest gene(s) LNX2, POLR1D, RPL21) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs7325099 near LNX2, POLR1D, RPL21 showed suggestive (not genome-wide significant) association with ECC (Z = 4.485, p = 7.28e-6); genetic association, ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

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

SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).

1 finding from 1 review

Baby-Led Introduction to SolidS (BLISS) vs Traditional complementary feeding (TCF)

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

In RCTs, BLISS did not significantly change overweight/obesity risk versus traditional feeding (RR 0.15, 95% CI 0.00 to 17.79; low certainty).

1 finding from 1 review

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

Chronic herpes simplex infection prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in chronic herpes simplex infection between ART regimens (very low certainty).

1 finding from 1 review

Prefabricated zirconia crowns (e.g., NuSmile, Zirkiz, Kinder Krown) vs Other crowns/restorations (stainless steel crowns, pre-veneered SSC, resin composite strip crowns, glass-fiber composite crowns)

Crown retention · Children with primary (deciduous) teeth requiring full-coverage crown restoration

Zirconia crowns showed no significant difference in crown retention versus other restorations at 6 months (RR 1.02, 95% CI 0.94 to 1.11; 3 studies; not GRADE-rated).

2 findings from 1 review

Maternal education attainment vs Not applicable (single-group prevalence)

Primary maternal education prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 42% of children with caries in LMICs had mothers with primary education (pooled prevalence 0.425, 95% CI 0.280 to 0.576; 7 studies; not GRADE-rated).

1 finding from 1 review

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

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

Imaging (analog or digital radiographs) vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection of enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies)

Radiographic imaging had a summary specificity of 0.89 (95% CrI 0.83, 0.93) for detecting enamel caries; low certainty.

2 findings from 1 review

Compomer (C) vs Amalgam, RMGIC, HVGIC, composite resin, bulk-fill composite resin, another compomer, or alternative caries management

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Compomer had an annual failure rate of 0-14.7% (7 RCTs), comparable to amalgam/RMGIC/composite and better than high-viscosity GIC; low quality of evidence (ungraded).

1 finding from 1 review

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

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

NRCF showed no significant association with overweight/obesity across the reported comparisons (very low certainty).

1 finding from 1 review