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%

Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)

Lactobacillus spp. mean levels/counts · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

No significant difference in Lactobacillus spp. presence was reported; GRADE was not reported.

1 finding from 1 review

Probiotics vs placebo or control

Lactobacillus count (CFU/mL) · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to Lactobacillus count versus control (MD -0.78 CFU/mL, 95%CI -1.65 to 0.09; very low certainty).

1 finding from 1 review

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

Pattern of dental service utilisation and barriers · Adult residents of slums and non-slum urban settings of LMICs

Dental service use is low, episodic and pain-driven, with widespread self-care and cost/funding barriers; ungraded.

1 finding from 1 review

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

Frequency of mouth cleaning · Adult residents of slums and non-slum urban settings of LMICs

Twice-daily cleaning (recommended) is uncommon; most clean once, in the morning; ungraded.

1 finding from 1 review

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

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

Dental caries prevalence in LMIC urban/slum populations ranges widely (13%-76%); not GRADE-rated (narrative synthesis).

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

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Probiotics vs placebo or control

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

Probiotics may make little to no difference to salivary pH versus control (MD -0.12 pH units, 95%CI -0.72 to 0.48; very 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

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

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

Probiotics vs placebo or control

Dental caries in children · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the number of dental caries versus control (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; 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

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

Inter-examiner reliability ranged from kappa 0.44 to 0.91 across 13 studies (moderate to almost perfect agreement); certainty not graded.

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

Negative predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Negative predictive value was reported in 10 studies and ranged widely across studies (about 31% to 99.5%); no pooled estimate and certainty not graded.

1 finding from 1 review

Probiotics vs placebo or control

Streptococcus mutans count · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably reduce Streptococcus mutans count versus control (MD -0.40 CFU/mL, 95%CI -0.57 to -0.24; moderate certainty).

1 finding from 1 review

Probiotics vs placebo or control

Gingival bleeding (various bleeding indices) · Children and/or adolescents (<18 years) without background systemic disease

Only one trial (Borrell 2021) reported the bleeding index, showing slightly more bleeding with probiotics (MD 0.10, 95%CI 0.02 to 0.18); not pooled or GRADE-rated.

1 finding from 1 review

Disability (developmental, intellectual, or sensory) vs Not applicable (single-group prevalence)

Moderate gingival inflammation / gingival health · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or multiple disabilities)…

Gingival inflammation is common among persons with disabilities in Saudi Arabia (moderate-to-severe up to about 60%), reported narratively without a pooled comparative estimate (ungraded).

1 finding from 1 review

Probiotics vs placebo or control

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

Probiotics may make little to no difference to the bacterial plaque index versus control (MD 0.21, 95%CI -0.55 to 0.96; very low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Streptococcus viridans count (CFU/mL) · Children and/or adolescents (<18 years) without background systemic disease

Only one trial (Mishra 2014) reported S. viridans count, showing a higher count with probiotics (MD 0.40 CFU/mL, 95%CI 0.33 to 0.47); not pooled or GRADE-rated.

1 finding from 1 review

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

Use of alternative/indigenous mouth-cleaning implements · Adult residents of slums and non-slum urban settings of LMICs

Indigenous/alternative cleaning tools and home remedies are widely used, more so in rural/slum groups; ungraded.

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)

Streptococcus mutans count · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP)

No difference in mean Streptococcus mutans presence was reported; GRADE was not reported.

1 finding from 1 review