Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · All outcomes

No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Fluoride-releasing compomer bonding agent did not show a statistically significant reduction in new white spot lesions versus non-fluoride compomer bonding agent (very low certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

S. mutans presence · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in S. mutans presence between aligners and fixed appliances in adolescents at 1 month (RR 0.86, 95% CI 0.64 to 1.14; ungraded).

1 finding from 1 review

Gum chewing (sugar-free) vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.

2 findings from 1 review

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Habit of tooth cleaning vs No habit of tooth cleaning

Dental caries · Individuals in Ethiopia assessed for dental caries

The habit of tooth cleaning was not significantly associated with dental caries (OR 0.71, 95% CI 0.17 to 2.96); certainty not graded.

1 finding from 1 review

Sweet food consumption (frequent) vs No/less frequent sweet food consumption

Dental caries · Individuals in Ethiopia assessed for dental caries

Sweet food consumption was associated with significantly higher odds of dental caries (OR 2.4, 95% CI 1.91 to 3.01); certainty not graded.

1 finding from 1 review

External control of fluoride concentration vs Not applicable

Water samples with fluoride concentration above the acceptable range · Brazilian cities in the Northeast region with artificially fluoridated public water supplies

In the Northeast region, 0.2% of samples were above the acceptable range.

1 finding from 1 review

1-19 remaining teeth vs 20-32 remaining teeth

Atherosclerotic cardiovascular disease (ACVD)-related events (morbidity and mortality) · Adults (any age) with a known number of remaining teeth, followed prospectively in cohort studies

In prospective cohorts, adults with 1-19 teeth had a higher cumulative incidence of ACVD-related events than adults with 20-32 teeth (RR 1.69, 95% CI 1.13 to 2.53; 2 cohort studies, I2=60%); GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

1 finding from 1 review

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Fluoride-releasing resin-based sealant vs Non-fluoride resin-based sealant

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For resin-based sealants, fluoride release did not significantly change WSL initiation (RR 0.71, wide CI); subgroup not separately GRADE-rated.

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

DMFT/DMFS index (dental caries experience) · Adults (general and hospital populations assessed in case-control studies)

No statistically significant difference in DMFT index between SSc patients and controls (SMD -0.03, CI includes 0); certainty ungraded.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Iron deficiency (as defined by trialists) · Preschool children (<6 years)

In a sensitivity analysis excluding one outlier study, ECC remained associated with higher odds of iron deficiency (OR 2.76, 95% CI 2.42 to 3.13); ungraded.

2 findings from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Full-mouth bleeding score (FMBS) · Adolescents/teenagers undergoing orthodontic treatment

A single study reported a lower full-mouth bleeding score with aligners versus fixed appliances in adolescents at 12 months (MD -20.44, 95% CI -22.98 to -17.90; ungraded).

1 finding from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

The additional use of a sealant probably reduces the initiation of white spot lesions during fixed orthodontic treatment compared with no sealant (RR 0.70), but the certainty of evidence is very low.

1 finding from 1 review

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Maximal mouth opening (interincisal distance) · Adults (general and hospital populations assessed in case-control studies)

Systemic sclerosis patients have significantly reduced mouth opening compared with controls (SMD -1.06); certainty ungraded.

1 finding from 1 review