Incidence of initial caries around brackets, aesthetic-zone teeth only · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
When only aesthetic-zone teeth (incisors and canines) were considered, two studies reported a significant reduction in initial caries incidence favoring fluoride mouthrinse (ungraded, narrative; no pooled estimate).
1 finding from 1 review
Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).
1 finding from 1 review
Incidence of initial enamel caries / white spot lesions adjacent to bracket base (subject level, dichotomized) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
Adding a fluoride mouthrinse to daily fluoride toothpaste produced a small reduction in the incidence of initial caries/white spot lesions adjacent to brackets (pooled risk difference -0.07, 95% CI -0.14 to -0.01; 5 studies, 491 subjects), but the authors judged the overall evidence inconclusive (ungraded).
1 finding from 1 review
Side effects or other adverse events · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
No adverse effects were reported in any of the seven included studies (ungraded).
1 finding from 1 review
Cell death / cytotoxicity · Streptococcus mutans (in vitro cultures and biofilms)
One study reported minimal cytotoxicity (<1% cell damage) with grape seed extract (ungraded).
1 finding from 1 review
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 years of age
It is very uncertain whether consumption of xylitol chewing gum by women (mothers) changes caries presence in primary teeth compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to… (very low certainty).
1 finding from 1 review
Bacterial growth inhibition · Streptococcus mutans (in vitro cultures and biofilms)
Cranberry extract inhibits S. mutans growth in vitro (MIC ~0.5-60 mg/mL across 7 studies; ungraded).
1 finding from 1 review
Cranberry extract inhibited S. mutans growth across ~0.5-25 mg/mL (Abstract): MIC 12.5 mg/dL and MBC 25 mg/dL (Singhal), MIC 60 mg/mL (Sumathi), MIC 0.5-0.75 mg/mL (Prince); 2 mg/mL PAC enhanced photo-irradiated H2O2…
7 studies
GRADE not reported
Secondary prevention of caries · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Child microbiological presence (any mutans streptococci colonisation) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age
Consumption of xylitol chewing gum by women (mothers) led to lower child microbiological presence (any mutans streptococci colonisation) compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to…; GRADE not reported.
1 finding from 1 review
RR 0.60 [0.45, 0.81]
2 studies
GRADE not reported
Caries arrest · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Bacterial adhesion (inhibition) · Streptococcus mutans (in vitro cultures and biofilms)
Grape seed extract inhibits S. mutans adhesion to hydroxyapatite in vitro (2 studies; ungraded).
1 finding from 1 review
Mother microbiological presence (mutans streptococci colonisation level, CFU/mL) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age
Consumption of xylitol chewing gum by women (mothers) led to higher mother microbiological presence (mutans streptococci colonisation… compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to…; GRADE not reported.
1 finding from 1 review
defs index score · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age
It is very uncertain whether consumption of xylitol chewing gum by women (mothers) changes defs index score (categories) compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to… (very low certainty).
2 findings from 1 review
Thorild 2003 defs score categories (very low-certainty): 1-3 defs RR 0.48 (95% CI 0.15 to 1.54); 3-4 defs RR 0.85 (95% CI 0.18 to 3.98); >=5 defs RR 0.28 (95% CI 0.01 to 6.78); 96 participants.
1 study · 96 participants
Very low
MD -0.28 [-0.83, 0.27]
1 study · 96 participants
Very low
Biofilm formation (reduction) · Streptococcus mutans (in vitro cultures and biofilms)
Cranberry extract reduces S. mutans biofilm formation in vitro (10 studies; ungraded).
1 finding from 1 review
Cranberry extract/PAC reduced S. mutans biofilm formation: 51% at 500 ug/mL (Philip 2019), 95.2% at 50 mg/mL (Sumathi), 50-70% of preformed biofilm at 16.67-20.83 mg/dL (Singhal), 32%/29%/14% at 500/250/125 ug/mL…
10 studies
GRADE not reported
pH drop / acidogenicity buffering · Streptococcus mutans (in vitro cultures and biofilms)
Cranberry extract reduces S. mutans acidogenicity / glycolytic pH drop in vitro (5 studies; ungraded).
1 finding from 1 review
Cranberry PAC buffered acidogenesis: final pH 5.6 vs 5.2 control (Koo), lactic acid reduced 44% (Philip 2019) and 46% at 500 ug/mL (Philip 2019 EJOS), final pH 4.7-4.9 vs 3.7 control (Duarte), and disrupted glycolytic…
5 studies
GRADE not reported
Gtf activity · Streptococcus mutans (in vitro cultures and biofilms)
One study reported grape seed extract inhibits S. mutans Gtf activity (ungraded).
1 finding from 1 review
Antioxidant capacity · Streptococcus mutans (in vitro cultures and biofilms)
One study reported high antioxidant capacity of grape seed extract (ungraded).
1 finding from 1 review
Biofilm morphological changes · Streptococcus mutans (in vitro cultures and biofilms)
Cranberry extract alters S. mutans biofilm morphology/architecture (4 studies; ungraded).
1 finding from 1 review
Cranberry treatment disrupted biofilm integrity with agglutination/cell degradation at higher concentrations (Singhal), reduced polymicrobial biomass 38% at 96 h (Philip 2019), produced defective accumulation and…
4 studies
GRADE not reported
Primary caries prevention · Children and adults (with or without carious lesions)
It is very uncertain whether silver diamine fluoride (SDF) changes primary caries prevention compared with chlorhexidine varnish (very low certainty).
1 finding from 1 review
Biofilm morphological changes · Streptococcus mutans (in vitro cultures and biofilms)
Grape seed extract alters S. mutans biofilm morphology (2 studies; ungraded).
1 finding from 1 review