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Evidence found and GRADE certainty

275 questions · 608 findings · 35 reviews · All outcomes

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No studies found 1 · 0.2%GRADE not reported 590 · 97%Very low 0 · 0%Low 5 · 0.8%Moderate 5 · 0.8%High 7 · 1.2%

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

Odds of higher caries (DMFT) category · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Higher national income was strongly associated with lower odds of poor oral health (OR 0.10, 95% CI 0.03 to 0.37; about 90% lower odds); not GRADE-rated.

1 finding from 1 review

Very high Human Development Index (HDI >=0.800) vs High Human Development Index (HDI 0.700-0.799)

Odds of higher caries (DMFT) category · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

HDI was not independently associated with DMFT category in the adjusted model (OR 1.82, 95% CI 0.32 to 10.47); not GRADE-rated.

1 finding from 1 review

High-intensity sweeteners other than stevia (aspartame, sucralose, saccharin) in food products vs Any comparator (dietary sugar, no treatment, or other sweetener)

Effects of non-stevia high-intensity sweeteners (aspartame, sucralose, saccharin) on cariogenic bacteria in dental plaque or saliva · healthy people

No eligible studies evaluated high-intensity sweeteners such as aspartame, sucralose, or saccharin for their effect on cariogenic bacteria.

1 finding from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

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

Mean DMFT in 12-year-olds rises as national income falls: 0.90 (very high income), 2.38 (high income), 3.30 (middle income) (Figure 2); not GRADE-rated.

3 findings from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs Single-surface ART with high-viscosity GIC

Restoration survival · Children with decayed primary molar teeth

Multi-surface ART/HVGIC restorations had lower reported survival (49% at 3 years) than single-surface restorations (ungraded).

1 finding from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs Single-surface ART with high-viscosity GIC

Restoration failure · Children (2-9 years) with caries in posterior primary teeth

Multi-surface ART restorations had a high reported mean annual failure rate (17%; ungraded).

1 finding from 1 review

Single-surface ART restoration using high-viscosity glass ionomer vs Multi-surface ART with high-viscosity GIC

Restoration failure · Children (2-9 years) with caries in posterior primary teeth

Single-surface ART restorations had a low reported mean annual failure rate (about 5%; ungraded).

1 finding from 1 review

Single-surface ART restoration using high-viscosity glass ionomer vs Multi-surface ART with high-viscosity GIC

Restoration survival · Children with decayed primary molar teeth

Single-surface ART/HVGIC restorations had high reported survival (86% at 3 years), significantly higher than multi-surface restorations (ungraded).

1 finding from 1 review

Very high Human Development Index (HDI >=0.800) vs High Human Development Index (HDI 0.700-0.799)

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

Mean DMFT was higher in high-HDI (3.41) than very-high-HDI (1.73) countries (ANOVA p<.01); descriptive country-level means only, not meta-analyzed or GRADE-rated.

2 findings from 1 review

Stevia (high-intensity/non-nutritive sweetener) in a daily snack vs Baseline (within-group change); white sugar snack is a parallel arm with no between-group effect size reported

Change in Mutans streptococci (MS) and Lactobacilli in saliva · Schoolchildren (6-9 years), high caries risk

The single stevia trial (Cocco 2019) reported a significant reduction in salivary Mutans streptococci and lactobacilli, but gave no effect size and was not GRADE-rated.

1 finding from 1 review
  • Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. 2024 All outcomes
    42 days · Schoolchildren in Italy, high caries risk; sweetener delivered as a daily snack · Single study (Cocco 2019); not pooled
    Cocco 2019 (the only high-intensity sweetener trial): the stevia snack showed a significant decrease in MS (P < .01) and in lactobacilli (P = .03) versus baseline, whereas the white-sugar snack showed no significant…
    1 study · 271 participants
    GRADE not reported

Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Lower unemployment rate vs Higher unemployment rate (low <=5% / medium >5-10% / high >10%)

Odds of higher caries (DMFT) category · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Unemployment rate was not independently associated with DMFT category in the adjusted model (OR 0.99, 95% CI 0.44 to 2.23); not GRADE-rated.

1 finding from 1 review

Higher number of lost teeth (per one additional lost tooth) vs Fewer lost teeth (continuous, per-tooth increment)

All-cause mortality (ACM) · Adults (any age) with a known number of remaining teeth, followed prospectively in cohort studies

Each additional lost tooth was associated with a multivariable-adjusted HR of 1.02 (95% CI 1.01 to 1.03) for all-cause mortality (11 studies, I2=89%), statistically significant; GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

3 findings from 1 review

Higher number of lost teeth (per one additional lost tooth) vs Fewer lost teeth (continuous, per-tooth increment)

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

Each additional lost tooth was associated with a multivariable-adjusted HR of 1.02 (95% CI 1.01 to 1.03) for ACVD-related events (13 studies, I2=75%), statistically significant; GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

3 findings from 1 review

ART sealant using high-viscosity glass ionomer (press-finger technique) vs Resin-based sealant

Development of carious lesions on sealed occlusal pits and fissures · Children with fully erupted permanent first molar teeth (mean age about 6 to 8 years)

At 48 months, no statistically significant difference was found between HVGIC and resin-based sealants (RR 0.62, 95% CI 0.31 to 1.21); evidence ungraded and at high risk of bias.

4 findings from 1 review
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High intake of sweets vs Lower/less intake of sweets

Dental caries · Primary school children in Ethiopia

A high intake of sweets was associated with higher odds of dental caries (OR 2.71, 95% CI 1.968-3.451; ungraded).

1 finding from 1 review