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Evidence found and GRADE certainty

1,692 questions · 2,586 findings · 180 reviews · Dental caries

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No studies found 194 · 7.5%GRADE not reported 1,937 · 74.9%Very low 248 · 9.6%Low 136 · 5.3%Moderate 52 · 2%High 19 · 0.7%

Dental caries during pregnancy vs Pregnant women without dental caries

Preterm birth stratified by clinical type (spontaneous vs iatrogenic vs term) · pregnant women

The planned subanalysis by type of preterm birth (spontaneous vs iatrogenic vs term) could not be performed because of the small number of cases and lack of information in the original studies.

1 finding from 1 review
  • Dental caries and preterm birth: a systematic review and meta-analysis. 2018 All outcomes
    Pregnant women assessed around delivery in observational studies across multiple countries (Mexico, Malawi, India, France, Jordan, Finland, Tanzania); mostly retrospective cohort and case-control designs · By type of PTB (spontaneous vs iatrogenic)
    no estimate extracted
    0 studies
    GRADE not reported

Dental caries during pregnancy vs Pregnant women without dental caries

Preterm birth stratified by gestational age at birth (moderate-to-late 32 to <37, very 28 to <32, extremely <28 weeks) · pregnant women

The planned subanalysis of preterm birth by gestational age at birth (moderate-to-late, very, extremely preterm) could not be performed because of the small number of cases and lack of stratified data in the original studies.

1 finding from 1 review
  • Dental caries and preterm birth: a systematic review and meta-analysis. 2018 All outcomes
    Pregnant women assessed around delivery in observational studies across multiple countries (Mexico, Malawi, India, France, Jordan, Finland, Tanzania); mostly retrospective cohort and case-control designs · By gestational age at birth
    no estimate extracted
    0 studies
    GRADE not reported

Dental caries during pregnancy vs Pregnant women without dental caries

Gestational age (preterm birth < 37 weeks) · pregnant women

Pregnant women with dental caries did not have a significantly increased risk of preterm birth (pooled OR 1.16, 95% CI 0.90 to 1.49; 5 studies; I2=35%); certainty of evidence not graded.

1 finding from 1 review
  • Dental caries and preterm birth: a systematic review and meta-analysis. 2018 All outcomes
    Pregnant women assessed around delivery in observational studies across multiple countries (Mexico, Malawi, India, France, Jordan, Finland, Tanzania); mostly retrospective cohort and case-control designs
    OR 1.16 [0.90, 1.49]
    5 studies · 4246 participants
    GRADE not reported

High-dose vitamin D3 supplementation during pregnancy (2400 IU/day from pregnancy week 24 to 1 week postpartum, in addition to the recommended 400 IU/day) vs Low-dose (standard) vitamin D supplementation as recommended in national pregnancy guidelines

Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether high-dose vitamin D3 supplementation during pregnancy (2400 IU/day… changes caries presence in primary teeth compared with low-dose (standard) vitamin D supplementation as recommended in… (very low certainty).

1 finding from 1 review

Repair of a defective amalgam restoration in a permanent molar or premolar tooth (with amalgam) vs Replacement of a defective amalgam restoration in a permanent molar or premolar tooth (with amalgam)

Presence of clinical symptoms (pain, swelling, diagnosis of pulpitis, abscess formation) · Adults (16 years or over) with one or more defective amalgam restoration(s) in a molar or premolar tooth/teeth

The review found no eligible studies for this question.

1 finding from 1 review

Repair of a defective resin composite restoration in a permanent molar or premolar tooth (with resin composite) vs Replacement of a defective resin composite restoration in a permanent molar or premolar tooth (with resin composite)

Presence of clinical symptoms (pain, swelling, diagnosis of pulpitis, abscess formation) · Adults (16 years or over) with one or more defective resin composite restoration(s) in a molar or premolar tooth/teeth

The review found no eligible studies for this question.

1 finding from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries prevalence · Children aged 2 to 8 years

The review reported 44% dental caries prevalence among children of mothers with low prenatal vitamin D.

2 findings from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

Pooled ECC prevalence in Tunisia was 38% (95% CI 24-51), significantly lower than Egypt and Sudan.

10 findings from 1 review
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Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Dental caries prevalence · Primary school children in Ethiopia

Among studies using systematic random sampling, the pooled prevalence of dental caries was 35% (ungraded; CI not reported).

4 findings from 1 review
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Cariogram multivariable caries-risk model (including modified/reduced-predictor versions) vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance of the Cariogram for caries increment (positive likelihood ratio, LR+) · Children/adolescents (coronal caries) and older adults (root caries); populations from areas with varying caries risk

Modified Cariogram models showed modest positive likelihood ratios (LR+ ~1.1-3.8) for predicting caries increment, generally below the useful threshold; no pooled estimate; ungraded.

1 finding from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents and older adults; multiple countries · Model validation studies
    Six validation studies (5 coronal, 1 root) evaluated modified Cariogram models (not the original model per se). Review-stated LR+ range 1.1-3.8 (with one exception). LR+ was not substantially changed by excluding the…
    6 studies
    GRADE not reported

Cariogram multivariable caries-risk model (including modified/reduced-predictor versions) vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance of the Cariogram for caries increment (negative likelihood ratio, LR-) · Children/adolescents (coronal caries) and older adults (root caries); populations from areas with varying caries risk

Modified Cariogram models showed negative likelihood ratios of about 0.5-0.61, above the useful rule-out threshold; no pooled estimate; ungraded.

1 finding from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents and older adults; multiple countries · Model validation studies
    Review-stated LR- range 0.5-0.61 across the Cariogram validation models (with one exception). Model performance was largely unaffected by removing the predictors mutans streptococci in saliva, saliva secretion and…
    6 studies
    GRADE not reported

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for root caries increment (negative likelihood ratio, LR-) · Older adults (aged 52-95; mean 52-73) at risk of root caries increment

The single root-caries validation study (Hayes 2017) showed LR- of 0.34-0.41, above the useful rule-out threshold; no pooled estimate; ungraded.

2 findings from 1 review

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for root caries increment (positive likelihood ratio, LR+) · Older adults (aged 52-95; mean 52-73) at risk of root caries increment

Developmental root-caries prediction models were generally modest, except Sanchez-Garcia 2011 (LR+ 7.09) which reached the useful threshold; no pooled estimate; ungraded.

2 findings from 1 review

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for coronal caries increment (negative likelihood ratio, LR-) · Children and adolescents (aged 2-19) at risk of coronal caries increment (caries onset or progression)

Some developmental coronal-caries models achieved useful negative likelihood ratios (LR-<=0.20), but performance varied widely; no pooled estimate; ungraded.

2 findings from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents; no geographical restriction · Model development studies
    No meta-analysis. Per-model LR- (Table 2) for the 8 development studies ranged roughly 0.11-0.94 (e.g. Angulo 0.94, Demers 0.14-0.40, Gao 2010 0.11-0.30). Overall across all 66 models LR- ranged 0.0-1.1; LR-<=0.20…
    8 studies
    GRADE not reported
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents; no geographical restriction · Model validation studies
    No meta-analysis. Per-model LR- (Table 2) across the 9 validation studies ranged from about 0.14 to 1.13 (e.g. Gao 2013 NUS-CRA 0.26, CAMBRA 0.14-0.31, CAT up to ~1.10; Campus 0.20; Pang 2020 low-risk 1.13). Overall…
    9 studies
    GRADE not reported

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for coronal caries increment (positive likelihood ratio, LR+) · Children and adolescents (aged 2-19) at risk of coronal caries increment (caries onset or progression)

Most externally validated coronal-caries models showed modest LR+ (<5); only Campus 2012 and Gao 2013 NUS-CRA reached the useful threshold; no pooled estimate; ungraded.

2 findings from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents; no geographical restriction · Model validation studies
    No meta-analysis. Per-model LR+ (Table 2) across the 9 validation studies (31 coronal models) ranged roughly 0.78-5.53 (e.g. Beck 1.62-3.00, Christian/CAMBRA 1.09-1.14, Gao 2013 CAT ~1.03 to NUS-CRA 5.31, Campus 5.53,…
    9 studies
    GRADE not reported
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents; no geographical restriction (11 countries across all studies) · Model development studies
    No meta-analysis (heterogeneity precluded pooling); performance given per model as LR+ recalculated by the review authors (Table 2). Across the 8 development studies (23 coronal models) LR+ spanned roughly 1.31-10.26…
    8 studies
    GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in primary teeth compared with standard care (very low certainty).

1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in top front four teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in top front four teeth compared with standard care (very low certainty).

1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Child microbiological presence (any mutans streptococci colonisation) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

Package of oral health education/promotion including oral hygiene… showed no clear difference in child microbiological presence (mutans streptococci colonisation) compared with standard care; GRADE not reported.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Mother microbiological presence (high-level mutans streptococci / lactobacilli) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

Oral health education/promotion (oral hygiene advice plus diet and… showed no clear difference in mother microbiological presence (high-level mutans streptococci /… compared with standard care; GRADE not reported.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Caries presence in primary teeth · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

It is very uncertain whether oral health education/promotion (oral hygiene advice plus diet and… changes caries presence in primary teeth compared with standard care (very low certainty).

1 finding from 1 review