Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

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%

Tooth wear assessment (primary teeth) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Tooth wear prevalence · School children (primary dentition) in the United Arab Emirates (Abu Dhabi)

One study reported a very high prevalence of tooth wear (97.6%) in the primary dentition of school children in Abu Dhabi, associated with older age, mouth breathing and anterior deep bite (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Fluoride concentration relative to the acceptable range (electrometric ion-selective electrode measurement; acceptable range mostly 0.6-0.8 ppmF) vs None (descriptive proportion meta-analysis)

Water samples with fluoride concentration outside the acceptable range · Artificially fluoridated public water supply in Brazilian cities (water samples under external control)

In Brazilian cities using external control, more than half of artificially fluoridated public water supply samples (pooled 56.6%, 95% CI 45.5 to 67.3) had fluoride concentrations outside the acceptable range, with very high heterogeneity (I2=99.5%); ungraded.

3 findings from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

White spot lesions were also measured by laser fluorescence in 3 sealant-vs-no-sealant studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Fluoride-releasing compomer bonding agent did not show a statistically significant reduction in new white spot lesions versus non-fluoride compomer bonding agent (very low certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

S. mutans presence · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in S. mutans presence between aligners and fixed appliances in adolescents at 1 month (RR 0.86, 95% CI 0.64 to 1.14; ungraded).

1 finding from 1 review

Gum chewing (sugar-free) vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.

2 findings from 1 review

Fluorescence-based devices vs Visual classification

Difference in sensitivity · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies)

Fluorescence and visual classification had similar sensitivity in the fully within-person analysis.

1 finding from 1 review

Intervention not reported

Initiation of white spot lesions (WSL), visual-tactile assessment

The intervention showed no clear difference in initiation of white spot lesions (WSL), visual-tactile assessment; GRADE not reported.

1 finding from 1 review

Habit of tooth cleaning vs No habit of tooth cleaning

Dental caries · Individuals in Ethiopia assessed for dental caries

The habit of tooth cleaning was not significantly associated with dental caries (OR 0.71, 95% CI 0.17 to 2.96); certainty not graded.

1 finding from 1 review

Sweet food consumption (frequent) vs No/less frequent sweet food consumption

Dental caries · Individuals in Ethiopia assessed for dental caries

Sweet food consumption was associated with significantly higher odds of dental caries (OR 2.4, 95% CI 1.91 to 3.01); certainty not graded.

1 finding from 1 review

External control of fluoride concentration vs Not applicable

Water samples with fluoride concentration above the acceptable range · Brazilian cities in the Northeast region with artificially fluoridated public water supplies

In the Northeast region, 0.2% of samples were above the acceptable range.

1 finding from 1 review

Problem-driven / less regular dental visiting vs More frequent / regular dental visits

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

A higher frequency of dental visits was associated with lower caries, while problem-driven visiting was associated with higher severe early childhood caries (narrative synthesis; not GRADE-rated).

1 finding from 1 review

1-19 remaining teeth vs 20-32 remaining teeth

Atherosclerotic cardiovascular disease (ACVD)-related events (morbidity and mortality) · Adults (any age) with a known number of remaining teeth, followed prospectively in cohort studies

In prospective cohorts, adults with 1-19 teeth had a higher cumulative incidence of ACVD-related events than adults with 20-32 teeth (RR 1.69, 95% CI 1.13 to 2.53; 2 cohort studies, I2=60%); GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

1 finding from 1 review

Special health care needs vs None (descriptive; compared across disability types)

Oral health status and treatment needs · Arab children with special health care needs in Ras Al Khaimah

One study found very high caries (85.2%) and high unmet treatment needs among children with special healthcare needs, varying by disability type (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Restorative dental treatment under general anesthesia vs Before treatment (before-after)

Oral health-related quality of life (child and family) · Preschool children in the United Arab Emirates receiving dental general anesthesia

One study found restorative dental treatment under general anesthesia significantly improved oral health-related quality of life for preschool children and their families (narrative synthesis; not GRADE-rated).

1 finding from 1 review