Non-Cochrane · aetiology · PM35263806
Caries in children with and without orofacial clefting: A systematic review and meta-analysis.
Grewcock Rebecca E, Innes Nicola P T, Mossey Peter A, et al. · Oral diseases · 2022 · PubMed · doi:10.1111/odi.14183
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
13
current version
GRADE rated
0
No studies
0
Included studies
32
linked below
No studies 0 · 0%Ungraded 13 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable groups of children without CL/P | 4647 children in the primary dentition from 20 studies (21 reports), 12 countries (2091 CL/P; 2556 non-CL/P; 3863 in meta-analyses [1655 CL/P; 2208 non-CL/P]) |
| Intervention | Cleft lip and/or palate (CL/P) (exposure) | CL/P (CLP most common; CL, CP, UCLP, BCLP also represented; 5 studies reported caries by cleft type) |
| Comparison | Children without CL/P (non-CL/P); national-data comparators excluded | Children without CL/P (n=2556) |
| Outcomes | Primary-dentition caries experience (dmft, dmfs, % caries experience, or other measure); secondary: care index (CI) and restorative index (RI); association of caries with cleft type | Caries experience higher in CL/P (overall SMD 0.46, 95% CI 0.15-0.77; 16 studies); dmft (3.2 vs 2.5), dmfs (4.1 vs 3.2) and % caries (64.84 vs 52.13) all higher in CL/P (Table 4); RI (5 studies) and CI (3 studies) described narratively (Table 5) |
| Study designs | Observational and epidemiological primary research with caries data from clinical examination (case-control and comparative cross-sectional); studies without isolable primary-dentition data, non-English, or using national comparators excluded | 20 studies (n=15 case-control; n=5 matched comparative cross-sectional) |
| Timing | No date restriction on searches | Studies published 1989-2021 |
Search date: November 2021 (PubMed to Nov 2021; Scopus to Nov 2021; Cochrane CENTRAL to 2021; Web of Science only to June 2017). Databases: PubMed (1946-Nov 2021); Scopus (Elsevier, 1996-Nov 2021); Web of Science (1900-Jun 2017); Cochrane Library (CENTRAL, 1996-2021)
Questions and results
Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)
Population: Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable children without CL/P
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Care index (CI = f/[d+m+f]) in the primary dentition The care index tended to be higher in children without CL/P (2 of 3 studies), suggesting more extraction-based caries management in children with CL/P; not pooled (narrative; ungraded). Source: Results (Care index and restorative index para); Table 5 · same question in other reviews | Two out of three studies for which the CI could be calculated (Nagappan 2019; Veiga 2016) showed a higher CI for non-CL/P children demonstrating a higher proportion of extraction-based treatment in CL/P children… | 3 studies | Ungraded |
Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) Mixed dentition In the mixed dentition, caries experience was significantly higher in children with CL/P (SMD 1.74, 95% CI 0.24-3.25; 4 studies; very high heterogeneity I2=99% driven by an outlier; ungraded). Source: Results (Meta-analysis para); Figure 2 (forest plot, subgroup 1.1.3) · same question in other reviews | SMD 1.74 [0.24, 3.25] | 4 studies · 789 participants | Ungraded |
Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) Primary dentition In the primary dentition, caries experience was significantly higher in children with CL/P than without (SMD 0.27, 95% CI 0.06-0.49; 10 studies; ungraded). Source: Results (Meta-analysis para); Figure 2 (forest plot, subgroup 1.1.1) · same question in other reviews | SMD 0.27 [0.06, 0.49] | 10 studies · 2366 participants | Ungraded |
Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) Primary and mixed dentition In the combined primary and mixed dentition, there was no evidence of a difference in caries experience between children with and without CL/P (SMD 0.09, 95% CI -0.59-0.76; 5 studies; ungraded). Source: Results (Meta-analysis para); Figure 2 (forest plot, subgroup 1.1.2) · same question in other reviews | SMD 0.09 [-0.59, 0.76] | 5 studies · 708 participants | Ungraded |
Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) Overall (all dentition groups) Children with CL/P have higher primary-dentition caries experience than children without CL/P (pooled random-effects SMD 0.46, 95% CI 0.15-0.77; 16 studies, 3863 children; not GRADE-rated). Source: Results (Meta-analysis para); Abstract; Figure 2 (forest plot, Total 95% CI diamond) · same question in other reviews | SMD 0.46 [0.15, 0.77] | 16 studies · 3863 participants | Ungraded |
Restorative index (RI = f/[d+f]) in the primary dentition The restorative index tended to be lower in children with CL/P (3 of 5 studies), indicating a lower proportion of restoratively managed carious teeth; not pooled (narrative; ungraded). Source: Results (Care index and restorative index para); Table 5 · same question in other reviews | Of the five studies for which the RI could be calculated, three of them (Dahllof 1989; Nagappan 2019; Veiga 2016) showed a lower RI for children with CL/P compared to children with no CL/P demonstrating a lower… | 5 studies | Ungraded |
Isolated cleft palate (CP) or other specific cleft type vs Cleft lip and palate (CLP) or other cleft type
Population: Children in the primary dentition with cleft lip and/or palate (CL/P)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caries experience by cleft type Whether cleft type is associated with caries experience could not be determined; the planned CP-versus-CL/P subgroup analysis was not possible owing to sparse isolated-CP data (5 studies described narratively; ungraded). Source: Results (Cleft type para); Implications for future research para; Table 3 · same question in other reviews | Five studies investigated caries experience by cleft type (Howe 2017; Kirchberg 2014; Mutarai 2008; Sunderji 2017; Zhu 2010). A subgroup analysis comparing CP and CL/P as different entities was not possible due to the… | 5 studies | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caries experience - % with caries (descriptive), primary dentition CL/P vs no CL/P; Table 4 (7 groups/6 studies) | % caries experience CL/P 64.84% vs no CL/P 52.13% | 6 studies | Ungraded |
Caries experience - mean dft (descriptive), primary dentition CL/P vs no CL/P; Table 4 (1 group/1 study, Howe 2017) | Mean dft (SD) CL/P 0.59 (SD 1.35) vs no CL/P 0.11 (SD 0.54) | 1 study | Ungraded |
Caries experience - mean dfs (descriptive), primary dentition CL/P vs no CL/P; Table 4 (1 group/1 study, Dahllof 1989) | Mean dfs (SD) CL/P 7 (SD 8.5) vs no CL/P 3.9 (SD 5.1) | 1 study | Ungraded |
Caries experience - mean dmfs (descriptive), primary dentition CL/P vs no CL/P; Table 4 (6 groups/4 studies) | Mean dmfs (SD) CL/P 4.1 (SD 3.52) vs no CL/P 3.2 (SD 2.75) | 4 studies | Ungraded |
Caries experience - mean dmft (descriptive), primary dentition CL/P vs no CL/P; Table 4 (15 groups/13 studies) | Mean dmft (SD) CL/P 3.2 (SD 2.22) vs no CL/P 2.5 (SD 1.53) | 13 studies | Ungraded |
Caries experience - % dft (descriptive), primary dentition CL/P vs no CL/P; Table 4 (1 group/1 study) | % dft CL/P 7.4 vs no CL/P 8.1 | 1 study | Ungraded |
Included primary studies 32
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Ahluwalia 2004 Dental caries, oral hygiene, and oral clearance in children with craniofacial disorders. PMID:14742659 | 1 other review | not stated | not extracted yet | not extracted yet |
| Chopra 2014 Oral health in 4-6 years children with cleft lip/palate: a case control study. PMID:25006561 | 1 other review | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Lucas 2000 Dental health indices and caries associated microflora in children with unilateral cleft lip and palate. PMID:11034026 | 1 other review | not stated | not extracted yet | not extracted yet |
| Sunderji 2017 Dental Caries Experience in Texan Children with Cleft Lip and Palate. PMID:29070163 | 1 other review | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Veiga 2017 Caries Experience and Periodontal Status in Children and Adolescents with Cleft Lip and Palate. PMID:28390464 | 1 other review | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Ahluwalia 2004 Dental Caries, Oral Hygiene, and Oral Clearance in Children with Craniofacial Disorders DOI:10.1177/154405910408300218 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Bokhout 1996 Increased caries prevalence in 2.5-year-old children with cleft lip and/or palate. PMID:9021319 | this review only | not stated | not extracted yet | not extracted yet |
| Bokhout 1996/1997 Incidence of Dental Caries in the Primary Dentition in Children with a Cleft Lip and/or Palate DOI:10.1159/000262366 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Bokhout 1997 Incidence of dental caries in the primary dentition in children with a cleft lip and/or palate. PMID:8955987 | this review only | not stated | not extracted yet | not extracted yet |
| Chaudhari 2021 Factors Affecting High Caries Risk in Children With and Without Cleft Lip and/or Palate: A Cross-Sectional Study. PMID:33349037 | this review only | not stated | not extracted yet | not extracted yet |
| Dahllof 1989 Caries, gingivitis, and dental abnormalities in preschool children with cleft lip and/or palate. PMID:2788042 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Hewson 2001 Dental experience of cleft affected children in the west of Ireland DOI:10.1002/j.1875-595x.2001.tb00825.x | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Hewson 2001 Dental experience of cleft affected children in the west of Ireland. PMID:11569666 | this review only | not stated | not extracted yet | not extracted yet |
| Howe 2017 Dental Decay Phenotype in Nonsyndromic Orofacial Clefting. PMID:28535364 | this review only | not stated | not extracted yet | not extracted yet |
| King 2013 Caries Experience of Chinese Children with Cleft Lip and Palate DOI:10.1597/11-133 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| King 2013 Caries experience of chinese children with cleft lip and palate. PMID:22376053 | this review only | not stated | not extracted yet | not extracted yet |
| Kirchberg 2014 Dental Caries in the Primary Dentition of German Children with Cleft Lip, Alveolus, and Palate DOI:10.1597/12-106 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Kirchberg 2014 Dental caries in the primary dentition of german children with cleft lip, alveolus, and palate. PMID:23237430 | this review only | not stated | not extracted yet | not extracted yet |
| Lucas 2000 Dental Health Indices and Caries Associated Microflora in Children with Unilateral Cleft Lip and Palate DOI:10.1597/1545-1569_2000_037_0447_dhiaca_2.0.co_2 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Malay 2021 matched by author and year (probable) | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Mutarai 2008 Factors Influencing Early Childhood Caries of Cleft Lip and/or Palate Children Aged 18 to 36 Months in Southern Thailand DOI:10.1597/07-017.1 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Mutarai 2008 Factors influencing early childhood caries of cleft lip and/or palate children aged 18 to 36 months in southern Thailand. PMID:18788870 | this review only | not stated | not extracted yet | not extracted yet |
| Nagappan 2019 Oral Health-Related Quality of Life and Dental Caries Status in Children With Orofacial Cleft: An Indian Outlook. PMID:31198331 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Parapanisiou 2009 Oral health status and behaviour of Greek patients with cleft lip and palate DOI:10.1007/bf03321606 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Parapanisiou 2009 Oral health status and behaviour of Greek patients with cleft lip and palate. PMID:19627672 | this review only | not stated | not extracted yet | not extracted yet |
| Rawashdeh 2011 matched by author and year (probable) | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Rawashdeh 2011 Dental and oral hygiene status in Jordanian children with cleft lip and palate: a comparison between unilateral and bilateral clefts. PMID:21226848 | this review only | not stated | not extracted yet | not extracted yet |
| Sundell 2016 Caries prevalence and enamel defects in 5- and 10-year-old children with cleft lip and/or palate: A case-control study DOI:10.3109/00016357.2015.1044562 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Sundell 2016 Caries prevalence and enamel defects in 5- and 10-year-old children with cleft lip and/or palate: A case-control study. PMID:25972142 | this review only | not stated | not extracted yet | not extracted yet |
| Tannure 2012 Caries experience in individuals with cleft lip and palate. PMID:22583885 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Zhu 2010 Caries Experience in Individuals with Cleft Lip and/or Palate in China DOI:10.1597/07-076.1 | this review only | Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) | not extracted yet | not extracted yet |
| Zhu 2010 Caries experience in individuals with cleft lip and/or palate in China. PMID:20078202 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).