Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

96 questions · 190 findings · 27 reviews

No studies found 5 · 2.6%GRADE not reported 176 · 92.6%Very low 8 · 4.2%Low 1 · 0.5%Moderate 0 · 0%High 0 · 0%

Caries experience measurement (mean D(M)FS, enamel lesions included) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries · European adolescents aged 12–19 years

Mean caries experience (DMFS) in subgroup 'Examination type: full-mouth' was 6.56 (95% CI 4.55 to 9.47; 12 studies).

11 findings from 1 review
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Enamel caries quantification (DeS/DeT within total D(M)FS/D(M)FT) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Enamel caries proportion · European adolescents aged 12–19 years

Enamel caries made up about half of total caries experience (pooled proportion 0.50, 95% CI 0.39 to 0.65; 7 studies; higher in 12–15 than 16–19-year-olds; not GRADE-rated).

3 findings from 1 review

Higher dental caries experience vs Caries-free controls

Poor oral health-related quality of life (OHRQoL) · Children aged 3-12 years

Higher dental caries experience was associated with substantially higher odds of poor OHRQoL (OR 1.66, 95% CI 1.43-1.88; 6 studies; high heterogeneity I2=83.5%; ungraded).

1 finding from 1 review

Electronic cigarette use vs Non-smokers

DMFT/DMFS index (dental caries experience) · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

A meta-analysis of 3 studies compared DMFT/DMFS in e-cigarette users vs non-smokers, but the pooled effect appears only in Figure 3A (unavailable) and heterogeneity was very high (I2=98%); the effect of vaping on dental caries remains unclear (ungraded).

1 finding from 1 review

Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline

Future caries experience (dmft/dmfs) · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Children with mutans streptococci at baseline had a greater future caries experience (SMD 0.85, a large effect; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children with dental caries

Oral-health promotion programs were associated with markedly lower odds of DMFT/S in children (OR 0.19, 95% CI 0.10 to 0.39; ungraded, very high heterogeneity I2=98.5%).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, OHPPs showed no significant effect on DMFT/S (OR 0.29, 95% CI 0.08 to 1.01; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children younger than 6 years (healthy except for dental caries)

In children younger than 6 years, OHPPs were associated with lower odds of DMFT/S (OR 0.14, 95% CI 0.05 to 0.39; ungraded).

1 finding from 1 review

Learning disability (CLD) vs No learning disability (CNLD)

Early childhood caries experience (mean dmft) · Children aged 1-18 years

In primary teeth, meta-analysis found no evidence of a difference in caries experience (dmft/deft) between children with and without learning disabilities (SMD 0.41, 95% CI -0.14 to 0.96; 8 studies; certainty not graded).

4 findings from 1 review
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Learning disability (CLD) vs No learning disability (CNLD)

Dental caries in permanent teeth · Children aged 1-18 years

Across all learning disabilities, meta-analysis found no evidence of a difference in permanent-tooth caries experience (DMFT) between children with and without learning disabilities (SMD -0.43, 95% CI -0.91 to 0.05; 16 studies; certainty not graded).

4 findings from 1 review
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Lower unemployment rate vs Higher unemployment rate (low <=5% / medium >5-10% / high >10%)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT tended to increase with unemployment rate (low 1.23, medium 2.08, high 2.38; ANOVA p<.05); descriptive country-level means only, not meta-analyzed or GRADE-rated.

3 findings from 1 review

Higher per-capita expenditure on dental health care vs Lower per-capita expenditure on dental health care (USD bands: $0-50 / $51-100 / >$100)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Countries with higher per-capita dental expenditure had lower mean DMFT (>$100: 0.96; $51-100: 2.14; $0-50: 3.06) (Figure 4); not GRADE-rated.

3 findings from 1 review

All dental health care expenditure strata vs No comparator

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

The overall pooled mean DMFT was 2.10 across all dental health care expenditure strata.

1 finding from 1 review