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Evidence found and GRADE certainty

3,556 questions · 10,375 findings · 429 reviews · Oral Health

No studies found 1,344 · 13%GRADE not reported 6,832 · 65.9%Very low 1,228 · 11.8%Low 613 · 5.9%Moderate 290 · 2.8%High 68 · 0.7%

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P11-4 + fluoride varnish vs Self-assembling peptide P11-4

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish did not differ significantly from P11-4 alone (SMD -0.40, 95% CI -0.97 to 0.17; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Fluoride varnish vs Placebo varnish, resin sealant, or standard care (oral hygiene instructions)

White spot lesion clinical score (mean values), subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances

In a pooled analysis of two placebo-controlled trials, fluoride varnish also reduced white spot lesion clinical scores (pooled SMD -0.44, 95% CI -0.64 to -0.24); this secondary outcome was not separately GRADE-rated.

1 finding from 1 review

Amalgam (AAG) vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 2 or more years in permanent teeth, amalgam had a higher risk of secondary caries than GIC (RR 1.79, 95% CI 1.04-3.09; low certainty).

1 finding from 1 review

Low‐level laser therapy vs Conventional orthodontic appliance treatment

Orthodontically-induced inflammatory root resorption (OIIRR) during molar intrusion · Adolescents and adults with malocclusion undergoing fixed orthodontic appliance treatment
1 finding from 1 review

Silver diamine fluoride (SDF) vs Any (current minimally invasive techniques)

Not applicable (no eligible studies) · Adults with coronal (crown) dental caries in permanent teeth

No eligible studies assessed SDF for coronal caries in adults; this is an evidence gap identified by the review.

1 finding from 1 review

Probiotic mouthwash (e.g., Lactobacillus-based) vs Blank control

Cariogenic bacteria (Mutans streptococci) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Probiotic mouthwash has inconsistent effects on Mutans streptococci colony counts versus blank control; the evidence is very uncertain (very low certainty).

1 finding from 1 review

Treatment of traumatic dental injury vs Untreated dental trauma

Oral health-related quality of life · Adolescents (10-19 years)

Treating traumatic dental injuries reduces their negative impact on OHRQoL in adolescents (narrative synthesis; included review reports low certainty; no pooled estimate or GRADE rating by the umbrella review).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Treatment of TDI reduces the negative impact on OHRQoL in adolescents, based on parental perception [33]. Treatment of traumatic dental injuries reduces the impact on the OHRQoL with low evidence [46].
    Studies not reported
    GRADE not reported

Daily chewing gum for 2 weeks or longer vs No gum chewing or control

Salivary flow rate (unstimulated) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

codex

1 finding from 1 review

Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment

Orthodontic tooth movement (OTM) during alignment stage · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances

Light vibrational forces (LVF) showed no clear difference in orthodontic tooth movement (OTM) during alignment stage (reduction… compared with conventional orthodontic appliance treatment (placebo or no adjunct) (low certainty).

1 finding from 1 review

Pulp-status assessment method

Pulp necrosis · Vital teeth

The pooled incidence with radiographic assessment was 4.95%.

2 findings from 1 review

Fluoride varnish vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish (gold standard) did not differ significantly from control (SMD -0.25, 95% CI -0.51 to 0.02); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Light vibrational forces (LVF) vs Conventional orthodontic appliance treatment

Harms: non-serious adverse effects (headache, discomfort, loosening of temporary anchorage devices) · Adolescents and adults with malocclusion undergoing orthodontic treatment with fixed or removable appliances

Light vibrational forces (LVF) showed no clear difference in harms: non-serious adverse effects (headache, discomfort, loosening… compared with conventional orthodontic appliance treatment (placebo or no adjunct); GRADE not reported.

1 finding from 1 review

Chlorhexidine mouthwash vs Placebo mouthwash

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash probably reduces the Gingival Index versus placebo in the short term (WMD -0.45, 95% CI -0.70 to -0.20; low certainty).

1 finding from 1 review

0-19 remaining teeth vs Individuals without functional edentulism

Oral health-related quality of life · Indian elderly

Evidence on functional edentulism and OHRQoL is inconsistent across two studies (very low certainty).

2 findings from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Barriers and facilitators to implementation of the integration strategy (qualitative) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
    15 studies
    GRADE not reported