Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

18 questions · 37 findings · 5 reviews · Periodontology

No studies found 0 · 0%GRADE not reported 34 · 91.9%Very low 0 · 0%Low 1 · 2.7%Moderate 2 · 5.4%High 0 · 0%

Placebo rinse vs Pre-treatment (baseline, same group)

Lactobacillus count (pre- vs post-treatment) · Medically healthy individuals (adults and children, 6-60 years)

Placebo rinse did not significantly change Lactobacillus counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Lactobacillus count (pre- vs post-treatment) · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Lactobacillus counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Chlorhexidine 0.12% mouthrinse vs Pre-treatment (baseline, same group)

Plaque · Medically healthy individuals (adults and children, 6-60 years)

0.12% chlorhexidine rinse reduced plaque relative to baseline; not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced plaque relative to its own baseline; not GRADE-rated.

1 finding from 1 review

Placebo rinse vs Pre-treatment (baseline, same group)

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Placebo rinse did not significantly change Streptococcus mutans counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Chlorhexidine 0.2% vs Pre-treatment (baseline, same group)

Plaque · Medically healthy individuals (adults and children, 6-60 years)

0.2% chlorhexidine rinse reduced plaque relative to baseline; not GRADE-rated.

1 finding from 1 review

Dental caries vs Caries-free controls

Periodontitis (prevalence) · adults

Using adjusted ORs, caries remained associated with higher periodontitis odds (OR 1.57).

3 findings from 1 review

Periodontitis vs No periodontitis (periodontal health or gingivitis)

Dental caries prevalence · adults

With a non-standard periodontitis definition, the association persisted (OR 1.38).

12 findings from 1 review
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Periodontal disease (periodontitis; clinical attachment loss >=4 mm) vs Adults without periodontal disease (healthy periodontal status; CAL <=3 mm)

Root caries (presence of root caries) · Adults (mean age ~53 years)

Adults with periodontal disease had significantly higher odds of root caries than those without (pooled OR 1.38, 95% CI 1.25 to 1.53; 2 observational studies; low certainty).

1 finding from 1 review

Periodontal therapy (scaling and root planing), post-treatment vs Pre-treatment (baseline, same group)

High salivary S. mutans (over 10^4 CFU/ml) · Periodontitis patients

High-level S. mutans did not change significantly after periodontal therapy (OR 1.54).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).

6 findings from 1 review
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Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

White spot lesion incidence · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

Most studies reported a lower incidence of white spot lesions with clear aligners than fixed appliances, but heterogeneous assessment methods precluded meta-analysis (ungraded).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded).

1 finding from 1 review

Consumption of xylitol chewing gum by women (mothers) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Xylitol sugar-free gum significantly reduced plaque quantity versus no-gum/control (SMD -0.743, 95% CI -1.148 to -0.338), with high heterogeneity (I2 = 86.0%; ungraded).

1 finding from 1 review

Gum chewing (sugar-free) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Sugar-free chewing gum significantly reduced plaque quantity versus no-gum/control (SMD -0.778, 95% CI -1.167 to -0.390), with high heterogeneity (I2 = 86.6%) and no GRADE rating (ungraded).

2 findings from 1 review