Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

410 questions · 836 findings · 55 reviews · All outcomes

No studies found 1 · 0.1%GRADE not reported 794 · 95%Very low 16 · 1.9%Low 12 · 1.4%Moderate 6 · 0.7%High 7 · 0.8%

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

Socioeconomic status category vs Not applicable (single-group prevalence)

Low SES prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 36% of children with caries in LMICs were of low SES (pooled prevalence 0.359, 95% CI 0.167 to 0.578; 4 studies; not GRADE-rated).

1 finding from 1 review

Longer follow-up vs Shorter follow-up

Annual increment in DMFS (D3) · Children and adolescents with permanent dentition

Not adjusted meta-regression beta was 0.43 per additional follow-up year.

5 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Not adjusted
    Meta-regression beta per year of follow-up 0.43 [0.04, 0.83]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings and age at baseline
    Meta-regression beta per year of follow-up 0.64 [0.31, 0.96]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings age at baseline and baseline caries experience
    Meta-regression beta per year of follow-up 0.37 [0.04, 0.70]
    22 studies · 11300 participants
    GRADE not reported
Show 2 more findings
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up 0.46 [0.08, 0.83]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up 0.36 [-0.02, 0.73]
    22 studies · 11300 participants
    GRADE not reported

Longer follow-up vs Shorter follow-up

Annual increment in DMFT (D3) · Children and adolescents with permanent dentition

Not adjusted meta-regression beta was 0.18 per additional follow-up year.

5 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Not adjusted
    Meta-regression beta per year of follow-up 0.18 [-0.04, 0.40]
    13 studies · 24753 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings and age at baseline
    Meta-regression beta per year of follow-up 0.18 [0.02, 0.35]
    13 studies · 24753 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings age at baseline and baseline caries experience
    Meta-regression beta per year of follow-up 0.23 [0.06, 0.40]
    13 studies · 24753 participants
    GRADE not reported
Show 2 more findings
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up -0.04 [-0.34, 0.26]
    13 studies · 24753 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up 0.07 [-0.24, 0.39]
    13 studies · 24753 participants
    GRADE not reported

Longer follow-up vs Shorter follow-up

Caries incidence rate per person-year at risk (D3) · Children and adolescents with permanent dentition

Adjusted for groups 1-4 including relevance of evidence and risk of bias meta-regression beta was -0.02 per additional follow-up year.

5 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up -0.02 [-0.05, 0.01]
    15 studies · 10768 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings age at baseline and baseline caries experience
    Meta-regression beta per year of follow-up 0.00 [-0.00, 0.01]
    15 studies · 10768 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings and age at baseline
    Meta-regression beta per year of follow-up 0.00 [-0.00, 0.01]
    15 studies · 10768 participants
    GRADE not reported
Show 2 more findings
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up -0.00 [-0.02, 0.02]
    15 studies · 10768 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Not adjusted
    Meta-regression beta per year of follow-up -0.00 [-0.01, 0.01]
    15 studies · 10768 participants
    GRADE not reported

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

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

Partial pulpotomy with one-unit longer follow-up vs Partial pulpotomy with one-unit shorter follow-up

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

In the high-risk-study-excluded sensitivity meta-regression, longer follow-up was associated with lower success.

1 finding from 1 review

Low socioeconomic status and family financial stress vs Higher socioeconomic status and lower stress

Salivary cortisol, cariogenic bacterial load and dental caries · Kindergarten-age children

In one cross-sectional study of children, low socioeconomic status, higher basal salivary cortisol and higher cariogenic bacterial counts were each independently associated with higher dental caries risk; not pooled (ungraded).

1 finding from 1 review

High maternal allostatic load (chronic stress) and low socioeconomic status vs Lower maternal allostatic load

Dental caries in children · Mother-child pairs

In one cross-sectional study, higher maternal allostatic load was associated with child dental caries experience and with health-related maternal care-taking behaviours; not pooled (ungraded).

1 finding from 1 review

Populations with low socioeconomic status (>=22.4% of the population with low SES) vs Populations with higher socioeconomic status (<22.4% of the population with low SES)

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

Populations with a higher proportion of people with low socioeconomic status had higher caries experience (pooled DMFT 15.99 vs 5.50), and meta-regression associated low SES with higher DMFT (about 10.35 more DMFT per unit; p=0.050); ungraded observational evidence.

5 findings from 1 review
Show 2 more findings

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free participants (permanent dentition, D3) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

For low baseline caries experience, the annual decline in caries-free participants ranged 4.3% to 10.2% (9 studies; ungraded).

4 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    4.3% to 10.2%
    9 studies · 4811 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    0.8% to 10.2%
    18 studies · 12017 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: high
    0.8% to 2.2%
    2 studies · 5029 participants
    GRADE not reported
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    3.7% to 8.3%
    4 studies · 928 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in DMFT (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFT increment ranged from 0.06 to 0.73 across 14 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    0.24 to 0.73
    6 studies · 16705 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries development in permanent teeth · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFS increment ranged from 0.07 to 1.77 across 26 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    0.07 to 0.53
    8 studies · 3735 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Dental caries: dmfs increment (primary teeth) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmfs increment ranged from -1.0 to 1.0 across 7 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free children (primary dentition, d3) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual decline in the percentage of caries-free children ranged from 3.8% to 12.2% across 6 studies (descriptive range, no pooled estimate; ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries incidence rate (first D3 lesion) per person-year at risk (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the pooled caries incidence rate was 0.11 per person-year at risk (95% CI 0.09 to 0.13; random-effects meta-analysis of 15 studies), i.e., about 11 of every 100 caries-free persons develop dentine caries each year (ungraded).

1 finding from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per person-year at risk · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    Incidence rate (per person-year at risk) 0.11 [0.09, 0.13]
    15 studies · 10768 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in dmft (primary dentition) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmft increment ranged from -0.3 to 0.3 across 4 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Populations with a low level of schooling (>=33.60% of the population with low schooling) vs Populations with a higher level of schooling (<33.60% of the population with low schooling)

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

Population level of schooling was not significantly associated with caries experience (DMFT) in subgroup meta-analysis or meta-regression; ungraded observational evidence with very high heterogeneity.

5 findings from 1 review
Show 2 more findings

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs Sorbitol (low-intensity sweetener)

Change in Mutans streptococci (MS) count in saliva · healthy people

Xylitol and sorbitol did not differ significantly for Mutans streptococci in saliva (SMD -0.16, 95% CI -0.44 to 0.12; 2 trials, P=.25); not GRADE-rated.

1 finding from 1 review