Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,227 questions · 2,562 findings · 156 reviews · All outcomes

No studies found 297 · 11.6%GRADE not reported 1,616 · 63.1%Very low 405 · 15.8%Low 144 · 5.6%Moderate 81 · 3.2%High 19 · 0.7%

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Intra-examiner reliability ranged from kappa 0.52 to 1.00 across 6 studies; certainty not graded.

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Dental caries prevalence · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

Dental caries affects about 64% of children with IDD in India (pooled prevalence 0.64, 95% CI 0.45-0.79; high heterogeneity; ungraded).

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Periodontal disease prevalence · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

In the single study reporting it, periodontal disease prevalence was 54.2% (single study; ungraded).

1 finding from 1 review

Milk-based probiotic vs placebo or control

Plaque index (PI) / oral hygiene · Children and/or adolescents (<18 years) without background systemic disease

In a subgroup analysis, milk-based probiotics reduced the bacterial plaque index more than other presentations (MD -0.10, 95%CI -0.20 to -0.00; p-interaction=0.01); not GRADE-rated.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Dental service utilisation within the past year · Adult residents of slums and non-slum urban settings of LMICs

Past-year dental service use varies widely (4%-72%); ungraded.

1 finding from 1 review

Slum residence vs Non-slum urban setting

Dental caries · Adult residents of slums and non-slum urban settings of LMICs

Slum residents had non-significantly higher odds of caries than non-slum residents (OR 1.21, 95% CI 0.94-1.56; single study); ungraded.

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Regular toothbrushing usage (prevalence) · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

About 91% of children with IDD in India use a toothbrush regularly (pooled prevalence 0.91, 95% CI 0.80-0.96; high heterogeneity; ungraded).

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Adolescents (12-18 years) without background systemic disease

In a subgroup analysis, probiotics reduced the number of caries in adolescents (MD -0.60, 95%CI -0.92 to -0.28; p-interaction=0.02); not GRADE-rated.

1 finding from 1 review

Slum residence vs Non-slum urban setting

Periodontal pocket (odds), slum vs non-slum residence · Adult residents of slums and non-slum urban settings of LMICs

Slum residents had significantly higher odds of periodontal pocketing than non-slum residents (OR 1.50, 95% CI 1.13-1.98; single study); ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Caries experience (mean DMFT) · Adult residents of slums and non-slum urban settings of LMICs

Mean DMFT ranges from 0.26 to 16.6 across LMIC urban/slum populations; ungraded.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Dental trauma prevalence · Adult residents of slums and non-slum urban settings of LMICs

Dental trauma appears more common in urban and disadvantaged settings; ungraded, few studies.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Use of toothbrush and toothpaste for mouth cleaning · Adult residents of slums and non-slum urban settings of LMICs

Toothbrush/paste is the commonest cleaning method but is used less in slum/disadvantaged/rural groups than urban/non-slum groups; ungraded.

1 finding from 1 review

Probiotics vs placebo or control

Gingival index (GI) · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the gingival index versus control (MD 0.04, 95%CI -0.18 to 0.27; low certainty).

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Overall diagnostic accuracy (agreement) · Children and adults with primary or permanent dentition undergoing dental caries assessment

Where reported (about 5 studies, Table 2), overall diagnostic accuracy was high (about 93% to 97.6%); no pooled estimate and certainty not graded.

1 finding from 1 review

Mouth-rinse probiotic vs placebo or control

Salivary pH · Children and/or adolescents (<18 years) without background systemic disease

In a subgroup analysis, mouth-rinse probiotics reduced salivary pH (MD -0.40, 95%CI -0.54 to -0.26; p-interaction<0.01); not GRADE-rated.

1 finding from 1 review
  • Efficacy of Probiotic Consumption on Oral Outcomes in Children and/or Adolescents: A Meta-Analysis. 2024 All outcomes
    Healthy children and/or adolescents (<18 years) without systemic disease; RCTs from multiple countries (India, Thailand, Spain, Australia, New Zealand, Sweden, Poland, Colombia, Saudi Arabia); mostly school/community and clinic settings · Probiotic presentation: mouth rinse (vs other presentations; p-interaction<0.01)
    MD -0.40 [-0.54, -0.26]
    Studies not reported
    GRADE not reported

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

Dental caries prevalence and severity · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or multiple disabilities)…

Dental caries prevalence and severity are high among persons with disabilities in Saudi Arabia (60% to over 80%), and the one comparative autism study reported significantly higher caries than controls; synthesized narratively (ungraded).

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Specificity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the specificity of teledentistry caries diagnosis ranged from 83% to 100%; no pooled estimate and certainty not graded.

1 finding from 1 review