Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

439 questions · 686 findings · 68 reviews

No studies found 4 · 0.6%GRADE not reported 617 · 89.9%Very low 26 · 3.8%Low 20 · 2.9%Moderate 11 · 1.6%High 8 · 1.2%

Low periodontal-disease prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by periodontal-disease prevalence.

1 finding from 1 review

Dental caries vs Caries-free status

Prevalence (detection frequency) of S. mutans in plaque · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

S. mutans prevalence in plaque is significantly higher in caries-active than caries-free individuals (pooled OR 2.58, 95% CI 1.65 to 4.02; I2=16%); ungraded.

1 finding from 1 review

Postbiotic toothpaste vs Fluoride toothpaste alone

Increased salivary pH · children aged 6‐12 years

Postbiotic toothpaste raises salivary pH in one pediatric RCT (ungraded).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    4 weeks · Clinical; salivary/plaque sampling
    Postbiotic toothpaste significantly increased salivary pH versus fluoride toothpaste in children (Basir 2022); postbiotics are also proposed to buffer acidic pH; no pooled estimate.
    1 study
    GRADE not reported

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Probing pocket depth · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a greater probing pocket depth than healthy controls (MD 0.88, 95% CI 0.82 to 0.95; 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

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

No significant difference between IRR and CR in restoration retention (high certainty).

1 finding from 1 review

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

Proper surface texture or luster · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in surface texture or luster (high certainty).

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Lumbar spine bone mineral density (BMD) · Females aged over 50 years

In females over 50, spine BMD showed an inverted U-shaped curve with a downward trend beginning at lower fluoride concentrations than in the overall analysis; no numeric MD reported in text; ungraded.

1 finding from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females >50, spine BMD dose-response
    Inverted U-shaped curve with a downward trend starting at lower fluoride concentrations than the overall analysis (no numeric MD reported in text)
    Studies not reported
    GRADE not reported

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

Postbiotic products (postbiotic toothpaste; heat-killed/postbiotic oral lozenges; inactivated-bacteria tablets) vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Streptococcus mutans count · Humans at risk of dental caries (children aged 6-12 years; adults with dental caries)

Postbiotic products reduce salivary S. mutans counts in human trials, though not always significantly (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Daily for 14 days to 4 weeks · Clinical; salivary/plaque sampling
    Three RCTs reported reduced salivary S. mutans counts after postbiotic intervention; the reduction was statistically significant in Lin 2022 but non-significant in Basir 2022; no pooled estimate.
    3 studies
    GRADE not reported

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of Veillonella spp. · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

Evidence on whether Veillonella spp. relative abundance is higher or lower in children with dental caries than caries-free controls is inconsistent across 7 small observational studies; no pooled estimate was produced and the evidence is ungraded.

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Plaque · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; 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

Proper surface staining · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in surface staining (moderate certainty; downgraded for inconsistency).

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs Partial pulpotomy with calcium hydroxide

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Tri-calcium silicate use was associated with a 37% increase in partial-pulpotomy success in meta-regression.

1 finding from 1 review

Country-level dental caries prevalence (Global Burden of Disease) vs Low vs high dental caries prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

Lower country-level dental caries prevalence was associated with better OHRQoL (low-prevalence pooled mean 81.5, 95% CI 76.5 to 86.6, higher than high-prevalence countries); statistically significant (ungraded).

1 finding from 1 review

Caries experience vs Adolescents without dental caries

Negative oral-health impact on daily performance (OIDP or Child-OIDP) · Adolescents (10-19 years)

For experience (history) of dental caries, adolescents had a significantly worse oral-health impact: PR 1.72 (95% CI 1.23 to 2.43) from 6 studies (I2=97%); ungraded, and not statistically different from the presence subgroup (p=0.19).

1 finding from 1 review
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Caries-definition subgroup: experience of dental caries
    PR 1.72 [1.23, 2.43]
    6 studies
    GRADE not reported

High dental-caries prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

The review reported higher OHRQoL in the low than high dental-caries-prevalence category.

1 finding from 1 review