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Evidence found and GRADE certainty

3,971 questions · 9,849 findings · 853 reviews

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No studies found 1,150 · 11.7%GRADE not reported 3,387 · 34.4%Very low 1,963 · 19.9%Low 1,809 · 18.4%Moderate 1,207 · 12.3%High 333 · 3.4%

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Hall technique vs Partial caries removal (PCR)

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, the Hall technique had significantly higher treatment success than partial caries removal (OR 13.49; moderate certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Caries experience · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Adequate periodontal tissue · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

Uncertain whether IRR and CR differ in periodontal tissue outcomes (low certainty; downgraded for very serious inconsistency).

1 finding from 1 review

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

Microinvasive techniques probably reduce radiographic progression of non-cavitated proximal caries lesions compared with non-invasive measures (moderate certainty).

1 finding from 1 review

Prenatal vitamin D level ≤50 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a lower odds ratio at maternal prenatal vitamin D ≤50 nmol/L than at ≤35 nmol/L, without a numeric value in the available sources.

1 finding from 1 review

ADGRL2 gene (aggregate gene-based signal, MAGMA) vs Genome-wide gene background (FDR threshold)

Dental caries (self-reported history) · Japanese adults (present-study direct-to-consumer genetic testing cohort); self-reported disease cases vs controls

Gene-based analysis found ADGRL2 significantly associated with dental caries (FDR q<0.05); ungraded.

1 finding from 1 review
  • Genome-wide association meta-analysis identifies two novel loci associated with dental caries. 2024 All outcomes
    Lifelong (germline genotype) · Population-based genetic association study (Japanese direct-to-consumer genetic testing cohort) · MAGMA gene-based test (present study)
    Gene-based association analysis (MAGMA): ADGRL2 was the only gene associated with dental caries at false-discovery-rate q<0.05 (no effect size reported).
    1 study · 45525 participants
    GRADE not reported

Acidic bacillary pH on teeth vs Non-acidic bacillary pH

Dental caries · Primary school children in Ethiopia

Acidic bacillary pH on the teeth was associated with higher odds of dental caries (OR 2.42, 95% CI 1.494-3.335; ungraded).

1 finding from 1 review

Stevia (high-intensity/non-nutritive sweetener) in a daily snack vs Baseline (within-group change); white sugar snack is a parallel arm with no between-group effect size reported

Change in Mutans streptococci (MS) and Lactobacilli in saliva · Schoolchildren (6-9 years), high caries risk

The single stevia trial (Cocco 2019) reported a significant reduction in salivary Mutans streptococci and lactobacilli, but gave no effect size and was not GRADE-rated.

1 finding from 1 review
  • Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. 2024 All outcomes
    42 days · Schoolchildren in Italy, high caries risk; sweetener delivered as a daily snack · Single study (Cocco 2019); not pooled
    Cocco 2019 (the only high-intensity sweetener trial): the stevia snack showed a significant decrease in MS (P < .01) and in lactobacilli (P = .03) versus baseline, whereas the white-sugar snack showed no significant…
    1 study · 271 participants
    GRADE not reported

Disability (developmental, intellectual, or sensory) vs Persons without disabilities

Oral health-related quality of life · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or multiple disabilities)…

Persons with disabilities in Saudi Arabia report poorer overall oral health-related quality of life and greater oral-health impact than those without disabilities, synthesized narratively without a pooled estimate (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, SDF greatly increased individual-level caries arrestment versus ART/glass ionomer cement (OR 18.03); this subgroup was not separately GRADE-rated.

1 finding from 1 review

Poor / no tooth brushing habit vs Good tooth brushing habit

Dental caries · Primary school children in Ethiopia

A poor tooth-cleaning habit was associated with higher odds of dental caries (OR 3.90, 95% CI 2.761-5.045; ungraded).

1 finding from 1 review

Child has a disability (special needs) vs Parents/caregivers of children without disabilities

Parental concern / caregiver stress indices (parental perception and parenting stress about the child's oral health) · Parents/caregivers of children with disabilities (special needs; autism spectrum disorder or unspecified disability) in Saudi Arabia

Parents of children with disabilities in Saudi Arabia report significantly greater concern/stress about their child's oral health than parents of children without disabilities (pooled SMD 0.43, 95% CI 0.23 to 0.63; I2=0%; 3 studies); not GRADE-rated.

1 finding from 1 review

Dental caries vs Caries-free controls

Periodontitis (prevalence) · adults

Using adjusted ORs, caries remained associated with higher periodontitis odds (OR 1.57).

3 findings from 1 review

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

Dental caries in children · Children of mothers assessed for smoking status during pregnancy (early childhood dental caries)

In the USA study, maternal smoking during pregnancy was associated with increased odds of childhood dental caries (OR 1.85, 95% CI 1.38 to 2.49).

15 findings from 1 review
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Overweight/obesity (combined) vs Normal Weight or Non‐Obese

Dental caries prevalence · Brazilian children/adolescents in permanent dentition (BMI classified by CDC 2000 growth charts)

The evidence is very uncertain about the effect of overweight/obesity on caries odds in the permanent dentition (very low certainty).

1 finding from 1 review

High-intensity sweeteners other than stevia (aspartame, sucralose, saccharin) in food products vs Any comparator (dietary sugar, no treatment, or other sweetener)

Effects of non-stevia high-intensity sweeteners (aspartame, sucralose, saccharin) on cariogenic bacteria in dental plaque or saliva · healthy people

No eligible studies evaluated high-intensity sweeteners such as aspartame, sucralose, or saccharin for their effect on cariogenic bacteria.

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Inter-examiner reliability · Children and adults with primary or permanent dentition

Inter-examiner kappa statistics ranged from 0.44 to 0.91 across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

Age 8-10 years vs Age >10 years

Spontaneous space closure · Children and adolescents with maxillary permanent first molar extraction

In the maxilla, age 8-10 years was not associated with a statistically significant difference in space closure odds.

1 finding from 1 review