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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

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No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Tooth survival · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

Cavity liners may make little or no difference to tooth survival (99.4% survival across groups; low certainty).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 5: open margin · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with open margin, surveyed dentists most often preferred replacement over repair (pooled RR 3.93; p < 0.001); ungraded.

1 finding from 1 review

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

Risk of fragility fractures · Females (all ages)

In females, fragility-fracture risk was U-shaped: lowest ~0.4 mg/L, rising above 0.9 mg/L (RR 0.84 at 0.34, 1.00 at 0.9, 1.13 at 1.1 mg/L vs null); ungraded.

3 findings 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: drinking-water fluoride 1.1 mg/L vs null
    RR 1.13 [0.93, 1.37]
    Studies not reported
    GRADE not reported
  • 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: drinking-water fluoride 0.34 mg/L vs null
    RR 0.84 [0.67, 1.07]
    Studies not reported
    GRADE not reported
  • 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: drinking-water fluoride 0.9 mg/L vs null
    RR 1.00 [0.79, 1.27]
    Studies not reported
    GRADE not reported

Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Femur fracture · European GWAS participants

The SVMR MR-Egger interval included the null.

3 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Osteoporosis with pathological fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on osteoporosis with pathological fracture (single-variable MR, OR 1.003).

2 findings from 1 review

Silver diamine fluoride (SDF) vs No biomimetic remineralization (control)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

Only one in vitro study assessed a Self-Etch adhesive with the biological ACAD protocol; it was insufficient for network meta-analysis, so no pooled effect estimate is available (ungraded).

1 finding from 1 review

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)

Oral health-related quality of life · school‐age children and adolescents

Theory-based interventions significantly improved oral health-related quality of life (SMD 7.38; low certainty), with very high heterogeneity.

1 finding from 1 review

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

Absence of secondary caries · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

Ion-releasing and composite restorations show no significant difference in absence of secondary caries in children (high certainty).

1 finding from 1 review

Biodentine vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Vital permanent teeth (mature or immature) with deep or extremely deep caries and asymptomatic pulp or reversible pulpitis, undergoing…

Biodentine and calcium hydroxide did not differ significantly in clinical and radiographic success (OR 3.14, 95% CI 0.91 to 10.86; ungraded subgroup analysis).

1 finding from 1 review

Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Lumbar spine and pelvis fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 2: loss of dental hard substance adjacent to the restoration · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with loss of dental hard substance adjacent to the restoration, surveyed dentists most often preferred replacement over repair (pooled RR 4.70; p < 0.001); ungraded.

1 finding from 1 review

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Postmenopausal osteoporosis with pathological fracture · Postmenopausal women (European ancestry)

In multivariable MR (adjusted for periodontitis), genetically predicted dental caries (DMFS) causally increased postmenopausal osteoporosis with pathological fracture (OR 1.422, moderate evidence).

2 findings from 1 review