Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

319 questions · 654 findings · 45 reviews · Dental caries

No studies found 17 · 2.6%GRADE not reported 601 · 91.9%Very low 11 · 1.7%Low 11 · 1.7%Moderate 7 · 1.1%High 7 · 1.1%

Country-level unemployment rate vs Higher vs lower unemployment-rate categories

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

OHRQoL did not differ significantly across country-level unemployment-rate categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Health expenditure per capita vs Higher vs lower per-capita health expenditure categories

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

OHRQoL did not differ significantly across per-capita health-expenditure categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

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

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

OHRQoL did not differ significantly by country-level edentulism prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Out-of-pocket health expenditure vs Lower vs higher out-of-pocket expenditure categories

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

Lower out-of-pocket health expenditure was associated with better OHRQoL (83.9, 95% CI 75.2 to 92.6 vs 67.5, 95% CI 58.5 to 76.5); the difference was statistically significant (ungraded).

2 findings 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

Fluoride toothpaste less than 1000 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether fluoride toothpaste less than 1000 ppm (lower concentration) changes fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1000 ppm or more (higher concentration) (very low certainty).

2 findings from 1 review

Erbium:YAG laser vs Untreated / high-speed-handpiece control enamel

Enamel resistance to demineralization (microhardness / lesion depth) · Human enamel adjacent to restorations or in pits and fissures (in situ / ex vivo)

Er:YAG laser showed a mixed and limited effect on enamel resistance to demineralization: feasible for controlling progression around restorations but not preventing caries formation, and ineffective in pits and fissures (ungraded, 2 ex-vivo studies, no pooled estimate).

1 finding from 1 review

Sociodemographic and behavioural factors (older age, lower education, lower income, poor oral hygiene/brushing, smoking, disadvantaged/slum residence, sex) vs Referent groups (younger, higher education/income, better oral hygiene, non-slum residence)

Determinants of oral diseases · Adult residents of slums and non-slum urban settings of LMICs

Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded.

1 finding from 1 review

Fluoride toothpaste 440 ppm (lower concentration) vs 1450 to 1500 ppm F toothpaste

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Fluoride toothpaste 440 ppm (lower concentration) probably leads to lower fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1450 ppm (higher concentration) (moderate certainty).

1 finding from 1 review

Fluoride toothpaste 550 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Fluoride toothpaste 550 ppm (lower concentration) probably leads to lower fluorosis (percentage prevalence in permanent teeth) compared with fluoride toothpaste 1000 ppm (higher concentration) (moderate certainty).

1 finding from 1 review

Low-power CO2 laser irradiation (LLLT, 0.5 to 2 W) vs Placebo (placebo laser or placebo agent) or no treatment

White spot lesion incidence · High caries-risk patients: fixed-orthodontic-appliance patients and children with partially erupted permanent molars

Low-power CO2 laser (LLLT) is associated with a lower incidence of new white spot lesions than placebo (OR 0.21, CI 0.15 to 0.30; ungraded, 3 RCTs, considerable heterogeneity I2=71%).

1 finding from 1 review

Higher parental education (tertiary) vs Parental high school (secondary) education

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

Parental tertiary education (vs high-school education) was associated with about 1.8 times higher odds of early childhood caries in South Africa (OR 1.77, 95% CI 1.22-2.57; 2 studies; not GRADE-rated).

1 finding from 1 review

Composite resin vs High-viscosity GIC and bulk-fill composite resins

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; tabulated failure rates ranged from 0% to 2.9%.

1 finding from 1 review

Low parental socioeconomic status (SES) vs High parental socioeconomic status (SES)

Early childhood caries (ECC) · Healthy children under 6 years in South Africa

No significant difference in caries odds was found between children of low- versus high-SES parents (meta-analysis reported no difference; pooled estimate in an unavailable supplementary figure; not GRADE-rated).

1 finding from 1 review

Lower parental (maternal/paternal) education vs Higher parental education

Dental caries · Healthy children and adolescents in the United Arab Emirates

The association between parental education and caries was inconsistent; father's (but not consistently mother's) education was inversely associated with caries in some studies (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Lower family socioeconomic status / income vs Higher socioeconomic position

Dental caries · Healthy children and adolescents in the United Arab Emirates

Evidence on socioeconomic status/income and caries was inconsistent: some studies linked lower income to higher caries while others found no association (narrative synthesis; not GRADE-rated).

1 finding from 1 review