Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,227 questions · 2,562 findings · 156 reviews · Oral Health

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%

Referral to a specific dental treatment facility vs Generic advice letter to see a dentist

Dental attendance · School children, primary school in Saudi Arabia

It is very uncertain whether referral to a specific dental treatment facility changes dental attendance (number of dental visits) compared with generic advice letter to see a dentist (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Dental development / dental age (mineralization chronology) · Children or adolescents

No significant overall difference in dental development between CLWH on ART and healthy controls (three studies, narrative synthesis).

1 finding from 1 review

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

Acute necrotising ulcerative gingivitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Acute necrotising ulcerative gingivitis was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Periodontal disease (gingivitis/periodontitis) · Children or adolescents

CLWH on ART had significantly higher prevalence of periodontal disease than healthy controls (pooled OR 3.11, 95% CI 1.62 to 5.97; moderate heterogeneity).

1 finding from 1 review

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

Parotid hypertrophy prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Parotid hypertrophy was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Traditional screening (referral card given if the inspecting dentist judges the child needs to see a dentist) vs No screening

Dental attendance · School children (aged 4 to 15 years), primary and secondary schools in the UK and India
1 finding from 1 review
  • School dental screening programmes for oral health 2022 · Cochrane All outcomes
    3 to 4 months
    Data not pooled; 6281 participants (4 RCTs); Very low. There was substantial heterogeneity, in part due to study design (3 cluster-RCTs and 1 individually randomised trial). We are unable to draw conclusions about this…
    4 studies · 6281 participants
    Very low

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

Dental development and maturation · Children and adolescents (<18 years) living with HIV (CLWH)

A single small study suggested delayed dental development in CLWH on ART, but the evidence was insufficient to draw conclusions (very low certainty).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Angular cheilitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No eligible studies compared angular cheilitis between different ART regimens.

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Dental caries prevalence · Children or adolescents

In permanent dentition, CLWH on ART had higher caries prevalence than healthy controls (OR 2.49, 95% CI 1.86 to 3.32; single study).

3 findings from 1 review

Gum chewing (sugar-free) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Sugar-free chewing gum significantly reduced plaque quantity versus no-gum/control (SMD -0.778, 95% CI -1.167 to -0.390), with high heterogeneity (I2 = 86.6%) and no GRADE rating (ungraded).

2 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Mucocele · Children or adolescents

No significant difference in mucocele between groups (OR 3.03, 95% CI 0.12 to 75.37; single study).

1 finding from 1 review

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

Mucocele prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in mucocele between CLWH with and without ART (very low certainty).

1 finding from 1 review

Referral letter based on the common-sense model (CSM) of self-regulation vs Standard referral letter

Proportion of children with treated/untreated caries (receipt of dental care) · School children, primary schools in the USA

It is very uncertain whether referral letter based on the common-sense model (CSM) of… changes proportion of children with treated/untreated caries (receipt of… compared with standard referral letter (very low certainty).

1 finding from 1 review

Criteria-based screening with specific (personalised) referral letter vs Criteria-based screening with non-specific referral letter

Dental attendance at orthodontist · School children, secondary school in the UK (aged 11 to 13 years)

It is very uncertain whether criteria-based screening with specific (personalised) referral letter changes dental attendance at orthodontist compared with criteria-based screening with non-specific referral letter (very low certainty).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Dental development and maturation · Children and adolescents (<18 years) living with HIV (CLWH)

No eligible studies compared dental development and maturation between different ART regimens.

1 finding from 1 review

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

Angular cheilitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in angular cheilitis between CLWH with and without ART (very low certainty).

1 finding from 1 review

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

Ulcerative stomatitis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Ulcerative stomatitis was significantly more prevalent in treatment-naive CLWH than in those on ART (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Acute necrotizing ulcerative gingivitis/periodontitis (WHO clinical stage 3) · Children or adolescents

No eligible studies reported acute necrotizing ulcerative gingivitis/periodontitis.

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Chronic herpes simplex infection (WHO clinical stage 4) · Children or adolescents

No eligible studies reported chronic herpes simplex infection.

1 finding from 1 review