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Evidence found and GRADE certainty

88 questions · 99 findings · 17 reviews · Oral Health

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No studies found 3 · 3%GRADE not reported 76 · 76.8%Very low 3 · 3%Low 10 · 10.1%Moderate 7 · 7.1%High 0 · 0%

ACTIVA bioactive restorative material vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 1 year in permanent teeth, the effect of ACTIVA versus GIC on secondary caries is very uncertain (RR 22.80, 95% CI 0.89-584.17; very low certainty).

1 finding from 1 review

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Prevalence and severity of oral and TMJ diseases/conditions (periodontal status and dental caries) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

1 finding from 1 review

Bioactive restorative materials (RMGIC and compomer combined) vs Resin composite restoration

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

In deciduous teeth at 1 year, pooled bioactive materials (RMGIC and compomer) showed no significant difference from resin composite in secondary caries (RR 0.54, 95% CI 0.07-4.10; ungraded).

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs Caries-free status

CA VI concentration · Individuals assessed for dental caries (mainly children aged 2-9 years; one study in adults aged 18-24 years)

Salivary CA VI concentration is significantly lower in individuals with dental caries than in caries-free individuals (SMD -0.672, 95% CI -1.011 to -0.332; not GRADE-rated).

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs Caries-free status

CA VI activity · Children (age about 2-9 years) across the 7 meta-analyzed activity samples; excludes Kivela 1999 adults (18-24 years), qualitative only…

Salivary/biofilm CA VI activity is significantly higher in individuals with dental caries than in caries-free individuals (SMD 0.894, 95% CI 0.386 to 1.392; not GRADE-rated).

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-6 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-6 levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 11.60 pg/mL, 95% CI 6.27 to 16.94; 11 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-8 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-8 levels are higher in children and young adults with active dental caries than in controls but the difference is not statistically significant (SMD 57.20 pg/mL, 95% CI -18.60 to 133.00; 7 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

TNF-α level · Children and young adults (3-25 years)

Salivary TNF-α levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 14.81 pg/mL, 95% CI 4.76 to 24.86; 7 studies); ungraded.

1 finding from 1 review

Dental caries vs Caries-free status

Relative abundance of S. mutans in saliva · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

The relative abundance of S. mutans in saliva is significantly higher in caries-active than caries-free individuals (pooled SMD 1.48, 95% CI 0.45 to 2.50), but heterogeneity is very high (I2=90%); ungraded.

1 finding from 1 review

Dental caries vs Caries-free status

Oral microbial community composition and diversity (other caries-associated taxa; alpha- and beta-diversity) · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

No oral microbial taxon other than S. mutans was consistently associated with caries; alpha-diversity mostly did not differ between caries-active and caries-free groups and beta-diversity findings were mixed (ungraded, narrative).

1 finding from 1 review
  • Streptococcus mutans and Caries: A Systematic Review and Meta-Analysis. 2025 All outcomes
    Cross-sectional · Clinical oral-microbiome studies; saliva and/or supragingival plaque samples; 7 countries; DNA/RNA-based sequencing or microarray
    Narrative synthesis (no pooled estimate): no bacterial genus or species other than S. mutans was consistently (reported in more than 2 studies) associated with caries-active status (Table 3; 15 of 19 studies for…
    Studies not reported
    GRADE not reported

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

HAART (highly active antiretroviral therapy, >=3 drugs) vs HIV-positive not receiving HAART (standard ART or HAART-naive)

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

Among HIV+ children, HAART versus no HAART showed no significant difference in the odds of dental caries by DMFT in cross-sectional studies (OR 1.29, 95% CI 0.59 to 2.84; ungraded).

2 findings from 1 review

HAART (highly active antiretroviral therapy, >=3 drugs) vs HIV-positive not receiving HAART (standard ART or HAART-naive)

Dental caries in permanent teeth · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART was associated with a significantly higher DMFT index than no HAART in case-control studies (MD 2.02, 95% CI 1.24 to 2.80; ungraded).

1 finding from 1 review

HAART (highly active antiretroviral therapy, >=3 drugs) vs HIV-positive not receiving HAART (standard ART or HAART-naive)

Caries in primary teeth: dmft (3 years) · Children and adolescents (<18 years) living with HIV (CLWH)

Among HIV+ children, HAART versus no HAART showed no significant difference in the dmft index in case-control studies (MD 0.66, 95% CI -0.26 to 1.58; ungraded).

1 finding from 1 review

Bio-active restorative materials vs Any conventional restorative material

Treatment failure (planned; no eligible studies) · Children with carious primary teeth after vital or non-vital pulp therapy

No eligible studies were found evaluating bio-active restorative materials for restoring carious primary teeth after pulp therapy.

1 finding from 1 review

Bio-active restorative materials vs Any restorative material or technique

Not applicable (no eligible studies) · Children with carious primary teeth (no pulp therapy)

No eligible RCTs assessed new bio-active restorative materials in carious primary teeth; this is an evidence gap identified by the review.

1 finding from 1 review

Orthodontic adhesives containing bioactive glass (BAG) particles/nanoparticles (including fluoride- or Ga-doped BAG) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Ion release (fluoride, calcium, phosphate) · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, among the 5 BAG ion-release studies only Ga-doped BAG (GaMBN, Song [31]) reported a significant increase (phosphate, up to 14 days); a general significant fluoride/calcium/phosphate increase across all 5 is not supported (ungraded).

1 finding from 1 review

Orthodontic adhesives containing bioactive glass (BAG) particles/nanoparticles (including Ag-, Zn-, fluoride-, or Ga-doped BAG) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel remineralization / anti-demineralization extent · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, most bioactive glass-containing orthodontic adhesives (9 of 13 studies) showed significant enamel remineralization/anti-demineralization versus control, but the evidence is weak (predominantly high risk of bias, methodological heterogeneity, no meta-analysis; ungraded).

1 finding from 1 review