What do systematic reviews say?

Intervention not reported

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
  3 of 3 studies reported favourable outcomes
  3 studies
  GRADE not reported

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Adverse events: 22 surgical complications in the PET-CT group vs 83 in the planned-surgery group (Mehanna 2017).
  1 study · 564 participants
  Very low

Light-emitting diode (LED) photobiomodulation vs Conventional orthodontic appliance treatment

It is very uncertain whether light-emitting diode (LED) photobiomodulation changes duration of orthodontic treatment: alignment stage (mandibular arch) compared with conventional orthodontic appliance treatment (very low certainty).

• Non‐surgical adjunctive interventions for accelerating tooth movement in patients undergoing orthodontic treatment 2023 · Cochrane All outcomes

  Alignment stage
  MD -24.5 [-42.45, -6.55]
  1 study · 34 participants
  Very low

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Disease-free survival: outcome not reported in a usable way (Mehanna 2017: disease-specific and other-cause mortality did not differ, P=0.80 and 0.41).
  1 study
  GRADE not reported

Herbal mouthwash vs Blank control

Herbal mouthwash showed mixed effects on Mutans streptococci, with very low-certainty evidence.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to baseline [48]; another study found an insignificant reduction compared to baseline [51].
  2 studies
  Very low

Mutans streptococci detected in plaque or saliva at baseline vs No mutans streptococci detected in plaque or saliva at baseline

Across the sample-based sensitivity analysis, mutans streptococci at baseline were associated with higher odds of developing caries.

• Is Mutans Streptococci count a risk predictor of Early Childhood Caries? A systematic review and meta-analysis. 2023 All outcomes

  6 months to 3.5 years · Japan; Finland; USA; Sweden; Singapore · Overall sample sensitivity analysis
  OR 4.04 [3.33, 4.90]
  12 studies · 3313 participants
  GRADE not reported

Elective radical (comprehensive) neck dissection vs Elective selective neck dissection

It is very uncertain whether elective radical (comprehensive) neck dissection changes disease-free survival (new disease, progression, and mortality) compared with elective selective neck dissection (very low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  5 years
  HR 0.57 [0.29, 1.11]
  1 study · 104 participants
  Very low

Outer carious dentin (by lesion depth/location) vs Inner carious dentin

MMP-20 probably reduces in outer compared with inner carious dentin (moderate certainty).

• Presence of host and bacterial-derived collagenolytic proteases in carious dentin: a systematic review of ex vivo… 2023 All outcomes
  no estimate extracted
  1 study · 5 participants
  Moderate

Severe traumatic dental injury with pulp exposure or tooth darkening vs No traumatic dental injury

The umbrella review reported a greater negative oral health-related quality-of-life impact for traumatic injuries involving pulp exposure or tooth darkening.

• Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
  no estimate extracted
  Studies not reported
  GRADE not reported

Full-time clear plastic (removable) retainer vs Any type of fixed (bonded) retainer

It is very uncertain whether full-time clear plastic (removable) retainer changes adverse effects on oral health: caries (lower arch) compared with any type of fixed (bonded) retainer (very low certainty).

• Retention procedures for stabilising tooth position after treatment with orthodontic braces 2023 · Cochrane All outcomes

  12 months · lower arch
  RD 0.00 [-0.05, 0.05]
  1 study · 84 participants
  Very low

Skin color / ethnicity vs Reference skin color / ethnicity

There is no concrete evidence on the impact of skin color/ethnicity on OHRQoL in adolescents (evidence gap; narrative synthesis; no pooled estimate or GRADE rating).

• 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
  Biological data such as skin color and age have no concrete evidence about this impact in the OHRQoL. Important aspects like gender and skin color did not have their level of impact clarified.
  Studies not reported
  GRADE not reported

Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)

The pooled incidence with ≤ 5 years of follow-up was 3.53%.

• Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a… 2023 All outcomes

  ≤ 5 years · ≤ 5 years
  Proportion 3.53 [2.10, 5.31]
  5532 participants
  Low

Zinc oxide and eugenol (ZOE) vs Alvogyl (old formulation)

The review found no eligible studies for this question.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
  No studies reported this outcome
  0 studies
  No studies found

Fluoride toothpaste vs Not applicable (single-group prevalence)

About 39% of children with caries in LMICs used fluoride toothpaste (pooled prevalence 0.391, 95% CI 0.166 to 0.644; 2 studies; not GRADE-rated).

• Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries. 2022 All outcomes

  Low- and middle-income countries (Brazil, Nigeria, Cambodia, Tanzania, Mexico, Ethiopia)
  Prevalence 0.391 [0.1658, 0.644]
  2 studies
  GRADE not reported

Resin infiltration vs Baseline before resin infiltration

Knosel (2019) reported a statistically significant lightness-change effect.

• Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… 2022 All outcomes

  6 months · Permanent teeth
  Cohen's d 0.71 [0.32, 1.09]
  1 study
  GRADE not reported
• Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… 2022 All outcomes

  6 months · Permanent teeth
  Cohen's d -1.76 [-2.22, -1.30]
  1 study
  GRADE not reported
• Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the… 2022 All outcomes

  6 months · Permanent teeth
  Cohen's d 0.40 [0.11, 0.65]
  1 study
  GRADE not reported

CBT vs alternative treatment

The review found no eligible studies for this question.

• Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
  This outcome was not measured (not synthesised for this comparison; review-wide only one study reported quality of life).
  Studies not reported
  No studies found

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

Evidence on salivary IgA in CLWH on versus off ART was divergent and inconclusive (very low certainty).

• Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and Meta-Analysis. 2022 All outcomes

  Hospitals and AIDS outpatient centres in India, Brazil, and several Asian countries
  Two studies gave divergent results: Subramaniam (2015) reported higher SIgA in children on ART for more than 3 years than pre-ART (8.6 (SD 2.9) vs 6.2 (SD 1.7) mg/dL; p < 0.001), whereas Pomarico (2009) found lower…
  2 studies
  Very low

CBT vs alternative treatment

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

• Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes

  Treatment completion
  SMD 0.03 [-0.21, 0.28]
  5 studies · 509 participants
  Low
• Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes

  Follow-up (6-12 months)
  SMD -0.29 [-0.50, -0.08]
  5 studies · 475 participants
  Low

Selective caries removal (SCR) + composite resin vs Complete caries removal (CCR) + composite resin

In one RCT, selective caries removal had a 3.44 higher probability of failure than complete caries removal.

• Clinical effectiveness of restorative materials for the restoration of carious lesions in pulp treated primary teeth:… 2022 All outcomes

  2 to 3 years · University, Brazil
  Relative probability of failure 3.44
  1 study · 48 participants
  GRADE not reported

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histology, excavation, or enhanced visual examination)

In the fully within-person analysis, visual classification had a summary sensitivity of 0.82 (95% CrI 0.73, 0.89); ungraded.

• Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. 2022 All outcomes

  General dental practice; in vitro (extracted teeth) and in vivo (clinical) studies · Analysis 1: fully within-person comparison (studies evaluating >=3 index tests)
  Sensitivity 0.82 [0.73, 0.89]
  19 studies · 2849 participants
  GRADE not reported
• Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. 2022 All outcomes

  General dental practice; in vitro (extracted teeth) and in vivo (clinical) studies · Analysis 2: network meta-analysis (all studies evaluating >=2 index tests)
  Sensitivity 0.83 [0.77, 0.87]
  64 studies · 24567 participants
  Low