Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

319 questions · 654 findings · 45 reviews · Dental caries

No studies found 17 · 2.6%GRADE not reported 601 · 91.9%Very low 11 · 1.7%Low 11 · 1.7%Moderate 7 · 1.1%High 7 · 1.1%

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Prevalence and severity of oral and TMJ diseases/conditions (periodontal status and dental caries) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

1 finding from 1 review

Restorative materials placed by atraumatic restorative treatment (ART); mostly high-viscosity/conventional GIC, also RMGIC, glass carbomer, compomer, composite resin vs Different ART materials or application techniques (e.g., bilayer vs single-step, with vs without cavity conditioner/disinfectant), or composite resin

Treatment failure (annual failure rate) · Children with carious primary teeth treated by atraumatic restorative treatment (hand-instrument caries removal), no pulp therapy

ART restorations (mainly GIC) had a wide annual failure rate (1.2-37.1%) across 10 RCTs, with technique affecting survival; low to unclear quality of evidence (ungraded).

1 finding from 1 review

Western/Northern Europe (UN M49 region) vs Eastern/Southern Europe (UN M49 geographical categorization)

Odds of higher caries (DMFT) category · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

In the adjusted ordinal model geographical location was not independently significant for DMFT category (OR 0.57, 95% CI 0.24 to 1.35); not GRADE-rated.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Mother microbiological presence (high-level mutans streptococci / lactobacilli) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

Oral health education/promotion (oral hygiene advice plus diet and… showed no clear difference in mother microbiological presence (high-level mutans streptococci /… compared with standard care; GRADE not reported.

1 finding from 1 review

Periodontal therapy (scaling and root planing), post-treatment vs Pre-treatment (baseline, same group)

High salivary S. mutans (over 10^4 CFU/ml) · Periodontitis patients

High-level S. mutans did not change significantly after periodontal therapy (OR 1.54).

1 finding from 1 review

Socioeconomic status category vs Children without dental caries

Dental caries · Children (deciduous and/or permanent dentition) in low- and middle-income countries

High SES showed no significant association with dental caries (OR 1.03, 95% CI 0.81 to 1.31; 5 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Children without dental caries

Dental caries (association with secondary/higher maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Secondary/higher maternal education showed no significant association with dental caries (OR 0.96, 95% CI 0.64 to 1.44; 7 studies; not GRADE-rated).

1 finding from 1 review

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

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

About 45% of children with caries in LMICs had mothers with secondary or higher education (pooled prevalence 0.450, 95% CI 0.330 to 0.572; 7 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Not applicable (single-group prevalence)

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

About 25% of children with caries in LMICs were of high SES (pooled prevalence 0.245, 95% CI 0.162 to 0.339; 5 studies; not GRADE-rated).

1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: High dentine-caries prevalence (>=35%) (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)

Episodes of pain (moderate or high pain; six-face rating scale) · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years)

Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) may leads to lower episodes of pain (moderate or high pain; six-face rating scale) compared with conventional mechanical caries removal (standard drill; handpiece… (low certainty).

1 finding from 1 review

Vitamin D vs placebo or control

High density lipoprotein · Adults (general population)

Meta-analysis of randomised trials of vitamin D supplementation for High density lipoprotein: WMD -0.14 (95% CI -0.99 to 0.71), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.

1 finding from 1 review

Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded.

2 findings from 1 review

Lower unemployment rate vs Higher unemployment rate (low <=5% / medium >5-10% / high >10%)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT tended to increase with unemployment rate (low 1.23, medium 2.08, high 2.38; ANOVA p<.05); descriptive country-level means only, not meta-analyzed or GRADE-rated.

3 findings from 1 review

Country-level periodontal disease prevalence (Global Burden of Disease) vs Low vs high periodontal disease prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly by country-level periodontal disease prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Country-level income (World Bank income classification) vs Higher- vs lower-income country categories

Oral health-related quality of life · people aged 60 years and older living in the community

Community-dwelling older adults in higher-income countries had better OHRQoL than those in lower-income countries (77.9, 95% CI 70.2 to 85.6 vs 66.9, 95% CI 56.7 to 77.0); the difference by income was statistically significant (ungraded).

2 findings from 1 review

Country-level income inequality (Gini index) vs Lower vs higher income inequality categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in countries with relative income equality (low Gini index) had markedly higher OHRQoL (91.3, 95% CI 90.0 to 92.6) than those in less equal countries; the difference by Gini index was statistically significant (ungraded).

4 findings from 1 review
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Human Development Index (HDI) vs Higher vs lower HDI categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in higher-HDI countries had better OHRQoL (high 79.9, 95% CI 74.4 to 85.5; very high 78.4, 95% CI 71.1 to 85.8) than those in medium-HDI countries (63.5, 95% CI 54.3 to 72.7); the difference by HDI was statistically significant (ungraded).

3 findings from 1 review