Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

574 questions · 721 findings · 67 reviews

No studies found 93 · 12.9%GRADE not reported 450 · 62.4%Very low 82 · 11.4%Low 73 · 10.1%Moderate 21 · 2.9%High 2 · 0.3%

Children with dental caries vs Children without dental caries

Mean corpuscular volume (MCV) · Children or adolescents

MCV tends to be lower in children with dental caries, but the pooled difference is not statistically significant (MD -1.96 fL, 95% CI -4.02 to 0.10; very low certainty).

1 finding from 1 review

Children with dental caries vs Children without dental caries

Serum ferritin (ng/mL) · Children or adolescents

Serum ferritin tends to be lower in children with dental caries, but the pooled difference is not statistically significant (MD -3.96, 95% CI -8.48 to 0.57; very low certainty).

1 finding from 1 review

Children with dental caries vs Children without dental caries

Haemoglobin (g/dL) · Children or adolescents

Haemoglobin tends to be lower in children with dental caries, but the pooled difference is not statistically significant (MD -2.20 g/dL, 95% CI -4.59 to 0.19; very low certainty).

1 finding from 1 review

Caregiver help with child tooth brushing vs Children without dental caries

Dental caries · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Caregiver help with tooth brushing was associated with 65% lower odds of dental caries (OR 0.35, 95% CI 0.13 to 0.93; 3 studies; very high heterogeneity; not GRADE-rated).

1 finding from 1 review

Caregiver help with child tooth brushing vs Not applicable (single-group prevalence)

Caregiver help with tooth brushing prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 54% of children with caries in LMICs received caregiver help with tooth brushing (pooled prevalence 0.541, 95% CI 0.266 to 0.803; 3 studies; not GRADE-rated).

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

Maternal education attainment vs Children without dental caries

Dental caries (association with no formal maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

No formal maternal education showed a non-significant trend toward higher odds of dental caries (OR 1.34, 95% CI 0.76 to 2.36; 3 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Children without dental caries

Dental caries · Children (deciduous and/or permanent dentition) in low- and middle-income countries

High SES showed no significant association with dental caries (OR 1.03, 95% CI 0.81 to 1.31; 5 studies; not GRADE-rated).

2 findings from 1 review

Good brushing habits (>=2 daily tooth brushing) vs Children without dental caries

Dental caries · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Good brushing habits (>=2 daily) were associated with 35% lower odds of dental caries (OR 0.65, 95% CI 0.46 to 0.92; 7 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Children without dental caries

Dental caries (association with secondary/higher maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Secondary/higher maternal education showed no significant association with dental caries (OR 0.96, 95% CI 0.64 to 1.44; 7 studies; not GRADE-rated).

1 finding from 1 review

Maternal education attainment vs Children without dental caries

Dental caries (association with primary maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Primary maternal education was associated with 25% higher odds of dental caries (OR 1.25, 95% CI 1.02 to 1.54; 7 studies; not GRADE-rated).

1 finding from 1 review

Socioeconomic status category vs Children without dental caries

Dental caries (association with middle SES) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Middle SES showed no significant association with dental caries (OR 0.80, 95% CI 0.59 to 1.10; 7 studies; not GRADE-rated).

1 finding from 1 review

Sugary drinks/sweets consumption vs Children without dental caries

Dental caries (association with sugary drinks/sweets consumption) · Children (deciduous and/or permanent dentition) in low- and middle-income countries

Sugary drinks/sweets consumption was associated with about twice the odds of dental caries in LMIC children (OR 2.04, 95% CI 1.59 to 2.60; 7 studies; not GRADE-rated).

1 finding from 1 review

HIV-infected children on antiretroviral therapy (HI) vs HIV-exposed but uninfected children (HEU)

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

HIV-infected children on ART had higher odds of dental caries than HEU children in a cohort study (OR 2.88, 95% CI 1.71 to 4.84; ungraded).

2 findings from 1 review

HIV-infected children on antiretroviral therapy (HI) vs HIV-unexposed uninfected children (HUU)

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

HIV-infected children on ART had higher odds of dental caries than HUU children in case-control studies (OR 1.61, 95% CI 1.02 to 2.56; ungraded).

2 findings from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Intra-examiner reliability ranged from kappa 0.52 to 1.00 across 6 studies; certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Overall diagnostic accuracy (agreement) · Children and adults with primary or permanent dentition undergoing dental caries assessment

Where reported (about 5 studies, Table 2), overall diagnostic accuracy was high (about 93% to 97.6%); no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Specificity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the specificity of teledentistry caries diagnosis ranged from 83% to 100%; no pooled estimate and certainty not graded.

1 finding from 1 review