Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

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%

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

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

No significant difference in chronic herpes simplex infection between CLWH with and without ART (very low certainty).

1 finding from 1 review

Glass carbomer restoration (placed after drilling) vs Composite resin or RMGIC

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

Glass carbomer had very high failure rates (up to 46.2%) in a single RCT, far worse than composite resin or RMGIC; low quality of evidence (ungraded).

1 finding from 1 review

SDF applied once (single application, no re-application) vs Other non/minimally-invasive treatment (ART or silver-fluoride varnish)

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

A single (one-time) SDF application did not significantly arrest caries (pooled ES -0.09, 95% CI -0.48 to 0.29; ungraded).

1 finding from 1 review

Resin-based fissure sealant vs Fluoride varnish

Caries incidence of first permanent molars (FPMs) · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars

Pit and fissure sealant and fluoride varnish showed no statistically significant difference in caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of LINC02905 (C8orf49) (chr8p23.1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted LINC02905 (C8orf49) expression reached the TWAS threshold for ECC (p = 1.82e-8) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small-to-moderate, statistically significant reduction in caries experience at the tooth level (dmft SMD -0.34, 95% CI -0.54 to -0.13; 6 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

Access to dental care / health services vs Not applicable (single-group prevalence)

Access to/visited dental services prevalence · Children (deciduous and/or permanent dentition) in low- and middle-income countries

About 44% of children in LMICs had access to or had visited dental services (pooled prevalence 0.444, 95% CI 0.277 to 0.618; 5 studies; not GRADE-rated).

1 finding from 1 review

Silver diamine fluoride (SDF >=30%, i.e. 30% or 38%), applied annually or biannually 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

The pooled caries arrest rate with SDF (>=30%, applied annually/biannually) was 51.62% (622/1205 lesions arrested) at >=12 months follow-up.

1 finding from 1 review

GIC with cavity conditioner vs GIC without cavity conditioner

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; the review states cavity conditioner did not improve success.

1 finding from 1 review

Electrical conductance or impedance 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)

Electrical conductance or impedance had a summary specificity of 0.72 (95% CrI 0.44, 0.89) for detecting enamel caries; low certainty.

1 finding from 1 review

High Streptococcus mutans colonization in primary dentition (age 2-3 years) vs Lower Streptococcus mutans load

Caries (DMFT/DMFS) in mixed/permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Higher early Streptococcus mutans colonization is associated with more caries in the mixed/permanent dentition (2 studies; not pooled; not GRADE-rated).

1 finding from 1 review

38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

Twice-yearly 38% SDF was reported to arrest more caries than once-yearly application (24-month rates 91% vs 79%; ungraded).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to caries-affected dentin (in vitro)

Only one study assessed SDF without a rinsing step on adhesive bonding to caries-affected dentin (Kucukyilmaz 2016, which reported impaired bond strength); no meta-analysis was possible, so no pooled estimate is available.

1 finding from 1 review

Fluoride-containing dental care products (mainly fluoride toothpaste) vs Dietary fluoride sources (drinking water, beverages, food)

Contribution of dental care products to total fluoride exposure · Pregnant and lactating women

No study has explored the contribution of dental care products to total fluoride exposure in pregnant and lactating women.

1 finding from 1 review

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

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

About 35% of children with caries in LMICs were of middle SES (pooled prevalence 0.353, 95% CI 0.180 to 0.550; 7 studies; not GRADE-rated).

1 finding from 1 review