What do systematic reviews say?

Early childhood caries (ECC) vs Caries-free controls

Veillonella spp. mean relative abundance was higher in ECC children, without a comparative effect estimate or CI.

• A systematic review of Streptococcus Mutans and Veillonellae species interactions in dental caries progression:… 2025 All outcomes

  Indonesia
  Mean relative abundance (%) ECC 3.29 (SD 6.83) vs caries-free 2.13 (SD 2.30)
  1 study · 87 participants
  GRADE not reported
• Meta-Analysis Using NGS Data: The Veillonella Species in Dental Caries. 2022 All outcomes

  Saliva and supragingival biofilm (pooled) · Overall (all sample types)
  MD 2.22 [0.54, 3.90]
  6 studies · 319 participants
  Very low
• Meta-Analysis Using NGS Data: The Veillonella Species in Dental Caries. 2022 All outcomes

  Saliva · Saliva
  MD -1.05 [-7.67, 5.57]
  2 studies · 161 participants
  GRADE not reported

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

Maternal smoking during pregnancy was associated with higher odds of dental caries in children (OR 1.78, 95% CI 1.55 to 2.05; ungraded).

• Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis. 2024 All outcomes

  Overall
  OR 1.78 [1.55, 2.05]
  12 studies · 90405 participants
  GRADE not reported
• Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis. 2024 All outcomes

  Study region: Australia
  OR 1.68 [1.35, 2.10]
  1 study
  GRADE not reported
• Correlation Between Maternal Smoking During Pregnancy and Dental Caries in Children: A Systematic Review and… 2021 All outcomes

  Community/population-based (multiple countries) · Children's age: over 3 years
  OR 1.56 [1.46, 1.67]
  3 studies
  GRADE not reported

Interdental brushing plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
  Not estimable. No included study assessed caries as an outcome. (See comment)
  0 studies
  No studies found

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
  Not estimable. No included study assessed caries as an outcome. (See comment)
  0 studies
  No studies found

Interdental brushing plus toothbrushing vs Toothbrushing alone

It is very uncertain whether interdental brushing plus toothbrushing changes gingivitis (gingival index) compared with toothbrushing alone (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.53 [-0.83, -0.23]
  1 study · 62 participants
  Very low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.05 [-0.13, 0.03]
  1 study · 31 participants
  Very low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  4 weeks (1 month)
  MD -0.53 [-0.83, -0.23]
  1 study · 62 participants
  Very low

Interdental brushing plus toothbrushing vs Toothbrushing alone

Interdental brushing plus toothbrushing may leads to lower plaque compared with toothbrushing alone (low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  SMD -1.07 [-1.51, -0.63]
  2 studies · 93 participants
  Low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  4 weeks (1 month)
  MD -0.95 [-1.34, -0.56]
  1 study · 62 participants
  Very low

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

Interdental brushing plus toothbrushing may leads to lower gingivitis (proportion of bleeding sites) compared with flossing plus toothbrushing (low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  4 to 6 weeks
  MD -0.06 [-0.08, -0.03]
  6 studies · 234 participants
  Low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  4 to 6 weeks
  SMD -0.40 [-0.70, -0.11]
  3 studies · 183 participants
  Low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  1 month (4 to 6 weeks)
  SMD -0.53 [-0.81, -0.24]
  7 studies · 326 participants
  Low

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

It is very uncertain whether interdental brushing plus toothbrushing changes plaque compared with flossing plus toothbrushing (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month (4 to 6 weeks)
  SMD -0.47 [-0.84, -0.11]
  5 studies · 290 participants
  Very low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  1 month (4 to 6 weeks)
  SMD 0.10 [-0.13, 0.33]
  7 studies · 326 participants
  Low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  3 months (12 weeks)
  SMD -2.14 [-5.25, 0.97]
  2 studies · 107 participants
  Very low

Interdental brushing plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Harms and adverse outcomes (SoF): Neither study reported any information about adverse events. Jared 2005 assessed adverse events (participants issued a symptom diary) but did not report the findings; Graziani 2017 did…
  1 study
  GRADE not reported
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
  Not estimable. Only 1 study reported adverse outcomes in terms of problems with the use of the assigned interdental cleaning aids. (See comment) In this comparison the single study (Jared 2005) asked participants to…
  1 study
  GRADE not reported

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Five studies reported there were no adverse events. Two studies reported on problems with the use of interdental brushes or floss, which sometimes caused soreness. (Six studies reported on adverse events; none…
  6 studies
  GRADE not reported
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
  Not estimable. 2 studies reported adverse outcomes in terms of problems with the use of the assigned interdental cleaning aids. We were unable to pool data. (See comment) Three further studies reported that no adverse…
  5 studies
  GRADE not reported