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Evidence found and GRADE certainty

3,556 questions · 10,375 findings · 429 reviews · Oral Health

No studies found 1,344 · 13%GRADE not reported 6,832 · 65.9%Very low 1,228 · 11.8%Low 613 · 5.9%Moderate 290 · 2.8%High 68 · 0.7%

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Upper fixed (bonded) retainer vs No retention

Stability: Little's Irregularity Index (upper arch) · People who had received fixed appliance orthodontic treatment

Upper fixed (bonded) retainer led to lower stability: Little's Irregularity Index (upper arch) compared with no retention; GRADE not reported.

1 finding from 1 review

Fluoride varnish vs Placebo varnish, resin sealant, or standard care (oral hygiene instructions)

Prevalence of white spot lesions (WSL) at debonding, subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances

Fluoride varnish applied regularly during fixed orthodontic treatment may reduce the prevalence of white spot lesions at debonding (pooled RR 0.64, 95% CI 0.42 to 0.98), but the certainty of evidence is very low.

1 finding from 1 review

Higher family income / socioeconomic status vs Lower income / worse socioeconomic status

Oral health-related quality of life · Adolescents (10-19 years)

Higher family income / better socioeconomic status is associated with better OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Adolescents from families with higher incomes and higher levels of maternal education have better OHRQoL scores [34]. Worse oral health status, older age, female sex and worse socioeconomic status were significantly…
    Studies not reported
    GRADE not reported

Low‐level laser therapy vs Conventional orthodontic appliance treatment

Overall treatment time wearing orthodontic appliances · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment

The review found no eligible studies for this question.

1 finding from 1 review

Completed orthodontic treatment vs Untreated / never received orthodontic treatment

Oral health-related quality of life · Adolescents (10-19 years)

Completing orthodontic treatment is associated with improved OHRQoL in adolescents (narrative synthesis; included reviews report low-to-moderate certainty; no pooled estimate or GRADE rating by the umbrella review).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Adolescents who had never received orthodontic treatment had a greater impact on quality of life compared to patients who had already completed treatment [34, 40, 44-46]. Orthodontic treatment during childhood or…
    Studies not reported
    GRADE not reported

Prosthetic need vs Individuals without prosthetic need

Oral health-related quality of life · Indian elderly and general-population adults

Prosthetic need was significantly associated with poorer OHRQoL in both included studies (moderate certainty).

3 findings from 1 review

Missing teeth / tooth loss vs No tooth loss

Oral health-related quality of life · Adolescents (10-19 years)

Tooth loss/edentulism is associated with worse OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).

1 finding from 1 review

Fluoride-containing amalgam (FAAG) vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 2 or more years in permanent teeth, secondary caries did not differ significantly between fluoride-containing amalgam and GIC (RR 0.95, 95% CI 0.45-2.00; low certainty).

1 finding from 1 review

Bruxism vs No bruxism

Oral health-related quality of life · Adolescents (10-19 years)

Bruxism was not shown to impact OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

2 findings from 1 review

Dental erosion vs No dental erosion

Oral health-related quality of life · Adolescents (10-19 years)

The umbrella review reported that dental erosion has not been shown to affect oral health-related quality of life.

2 findings from 1 review

Caries-associated bacterial biofilm vs Sound/control tissue (sound dentin, sound root, or enamel caries)

Bacterial collagenolytic protease gene expression · Human ex vivo carious lesions / caries-associated biofilm

Genes encoding bacterial collagenolytic proteases were detected/overexpressed in coronal and root caries (ungraded; GRADE not feasible).

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs Caries-free status

CA VI activity · Children (age about 2-9 years) across the 7 meta-analyzed activity samples; excludes Kivela 1999 adults (18-24 years), qualitative only…

Salivary/biofilm CA VI activity is significantly higher in individuals with dental caries than in caries-free individuals (SMD 0.894, 95% CI 0.386 to 1.392; not GRADE-rated).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Adverse events (participants with >=1 adverse event) · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin showed a borderline, non-significant increase in adverse events versus placebo (RD 0.10, 95% CI 0.00 to 0.21; ungraded subgroup).

3 findings from 1 review

38% silver diamine fluoride vs Atraumatic restorative treatment (ART)

restoration and caries status · children with caries in permanent molars

The review reported SDF was beneficial for arresting caries; no effect estimate or GRADE rating was reported.

1 finding from 1 review

Dental fluorosis (assessed by TFI or WHO criteria) vs Individuals without dental fluorosis

Oral health-related quality of life · Indian children and young adults

Two studies found dental fluorosis significantly associated with poorer OHRQoL; narrative, ungraded.

1 finding from 1 review

Composite resin vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

Over 2 or more years in deciduous teeth, secondary caries did not differ significantly between resin composite and RMGIC (RR 1.60, 95% CI 0.85-3.00; low certainty).

1 finding from 1 review

CPP-ACP enamel pre-treatment for remineralization of white spot lesions before bonding metallic orthodontic brackets vs No enamel pre-treatment before bonding, or treatment with another material

Shear bond strength (SBS) of metallic orthodontic brackets · Demineralized enamel of extracted permanent human teeth

When used to remineralize white spot lesions on demineralized enamel, CPP-ACP pre-treatment did not significantly affect shear bond strength (MD 1.501, 95% CI -0.630 to 3.632; ungraded).

1 finding from 1 review