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Background: Clinical practice guidelines (CPGs) enhance health care and aid clinicians' decisions. Aim: To evaluate the quality of clinical guidelines in paediatric dentistry using the AGREE II tool. Design: PubMed, EMBASE, Scopus, LIVIVO, Lilacs, international guidelines websites, scientific societies, and gray literature were searched until September 2021. We included paediatric dental clinical guidelines and excluded drafts or guidelines for patients with special needs. Two independent reviewers performed quality assessment using the APPRAISAL OF GUIDELINES FOR RESEARCH & EVALUATION II (AGREE II) instrument. We calculated the mean overall domain scores (95% confidence interval) for each guideline. We used regression analysis to correlate the score of overall assessment and the six domains of AGREE II with guideline characteristics. Results: Forty‐four guidelines were included in this study. Highest mean score was for Domain 4 (Clarity of Presentation; 58%, 95% CI: 50.8–64.9), whereas the lowest was for Domain 5 (Applicability; 16%, 95% CI: 10.8–21.4). The reporting quality was improved in Domains 1–5 with reporting checklists (p <.001), whereas that of Domain 6 was improved by decreasing years since publication (p =.047). Conclusion: Paediatric dental guidelines do not comply with the methodological quality standard, especially in Domain 5 (Applicability). The AGREE reporting checklist should be implemented with a system to evaluate the certainty of evidence for future guidelines. [ABSTRACT FROM AUTHOR]

Background: Recently, trials have supported changes in deep caries management. However, reporting might lack details, affecting interpretation and implementation. Thus, we aimed to evaluate the adherence to the CONSORT statement and the risk of bias of randomized controlled trials (RCTs) on deep caries management published in pediatric dental journals. Methods: We searched PubMed for RCTs in six pediatric dental journals between 2010 and 2022, focusing on deep caries lesion management. Adherence to the CONSORT guideline and the risk of bias were assessed using a modified tool with 19 items; each scored from 0 to 2 (maximum of 38 points), and the Cochrane risk-of-bias (RoB 2) tool. We performed descriptive and regression analyses (α = 5%). Results: We analyzed 127 RCTs. The mean (standard deviation) CONSORT adherence score was 21.1 (6.7). Notably, 96.1% of the studies received a score of 2 for the "intervention" item, whereas 83.5% scored 0 for the "estimated effect size". The risk of bias assessment revealed that 40.2% of the RCTs were at high risk, 59% were at low risk, and 0.8% were at low risk. RCTs with a high risk of bias had lower CONSORT scores (p<0.001) than those with low or some concerns. RCTs published in journals without the endorsement of the CONSORT statement had lower scores than those in journals with the endorsement of the CONSORT statement. Older RCTs (6-10 years old and more than 10 years old) showed significantly lower CONSORT statement compliance than trials published recently within 5 years. Conclusion: Adherence to the CONSORT was relatively low among the investigated RCTs. Moreover, lower adherence to the CONSORT was associated with a higher risk of bias. Trial Registration: This study protocol was prospectively registered on the Open Science Framework - DOI (10.17605/OSF.IO/V6SYZ). [ABSTRACT FROM AUTHOR]

Background: There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate outcomes used in randomized clinical trials for caries prevention, pit and fissure sealants and fluoridated dentifrices, according to the Prentice criteria. Methods: A systematic review was conducted in MEDLINE (PubMed), LILACS and Scopus databases up to 05 October 2022. The grey literature and the list of eligible studies' references were also screened. The search was conducted, selecting randomized clinical trials focussed on dental caries prevention using pit and fissure sealants or fluoridated dentifrices and with at least one surrogate endpoint for cavitated caries lesions. The risk of each surrogate endpoint and for the occurrence of cavitated caries lesions was calculated and compared. The association between each surrogate and the presence of cavitation was quantified, and each outcome was assessed graphically for validity according to the Prentice criteria. Results: For pit and fissure sealants, from 1696 potentially eligible studies, 51 were included; while for fluoridated dentifrices, of 3887 potentially eligible studies, four were included. Possible surrogates assessed were retention of sealants, presence of white spot lesions, presence of plaque or marginal discoloration around the sealants, oral hygiene index, radiographic and fluorescence caries lesion assessments. However, only the retention of sealants and the presence of white spot lesions could be evaluated for their validity according to the Prentice criteria. Conclusion: Loss of retention of sealants and the presence of white spot lesions do not fulfil all of the Prentice criteria. Therefore, they cannot be considered valid surrogates for caries prevention. [ABSTRACT FROM AUTHOR]

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Introduction: The nonsurgical endodontic retreatment (NERT) is the first choice of dental ministration when primary/initial endodontic treatment fails. The present study aimed to investigate the presence of postoperative pain (POP) after NERT in permanent asymptomatic teeth as well as possible factors associated with POP. Materials and Methods: A comprehensive search of literature was performed in Pubmed/MEDLINE, Embase, Scopus and Web of Science databases, up to January 2023; including randomized clinical trials and prospective studies. The risk of bias was assessed with RoB 2.0 and ROBINS-I tools. Subgroups analyses were conducted to evaluate the differences in the incidence or level of POP between the number of visits, the use/not use of solvent, the removal technique of gutta-percha, and the period of POP analysis. Mean differences and confidence intervals (CI) of 95% were used as measures of effect, and meta-regression was used along with subgroup analysis. The certainty of evidence was assessed using GRADE, and the probability value of <0.05 was considered significant. Results: Twenty-four studies were selected, with thirteen included in the meta-analysis. There was a statistical difference between the incidence of POP after 24 h (95% CI, 0.28 to 0.52) and one week (95% CI, 0.02 to 0.13) from the endodontic retreatment (P<0.01). However, there was no statistical difference between different techniques, number of visits and use of solvent (P>0.05) in the same period. In addition, the certainty of evidence was very low. Conclusions: Post-operative pain is a common response to NERT, independent of the retreatment technique(s) applied, number of visits and use of solvent(s); with very low certainty of evidence as well as low risk of bias. Moreover, the current analysis showed a (very) serious risk of inconsistency and imprecision. However, POP was significantly reduced within 1 week of the NERT. [ABSTRACT FROM AUTHOR]

Background: Selective outcome reporting (SOR) is a bias that occurs when the primary outcome of a randomised clinical trial (RCT) is omitted or changed. Aim: To evaluate the prevalence of SOR in RCTs on restorative treatment in primary teeth. Design: We conducted an electronic search on ClinicalTrials.gov and the World Health Organization platform (International Clinical Trials Registry Platform) on 1st of April 2021, with no registry time or language restrictions. We included RCT protocols that evaluated restorative treatments in primary teeth and excluded trials that did not have a complete publication in a scientific journal. The chi‐squared test was used to identify the association between SOR and variables as a discrepancy in the follow‐up period, the timing of registration, the type of sponsorship and the type of study design (α = 5%). Results: Of the 294 identified protocols, 30 were included in the study. 83.3% of trials were registered retrospectively. SOR was observed in 53.3% (n = 16) of the published trials and was significantly associated with a discrepancy in the follow‐up period (p =.017). Conclusions: The high prevalence of SOR in RCTs on restorative treatment proves that this is a prominent threat. A proper preregistered protocol, declaration of any protocol deviation and allowance of stakeholders to compare the protocol with that of the submitted papers will achieve transparency. [ABSTRACT FROM AUTHOR]

Objective: To perform a systematic review and meta‐analysis of the performance of different methods for detecting carious lesions in permanent and primary teeth, considering all types of tooth surface. Methods: Two reviewers searched PubMed, Embase, Scopus and other sources up to November 2020 to identify published and nonpublished studies in English. We focused on three caries detection methods: visual inspection (VI), radiographic (RX) and fluorescence‐based (LF). We included studies investigating at least one of these methods which (a) assessed the accuracy of the method in detecting caries lesions; (b) considered occlusal, proximal or free smooth surfaces in primary or permanent teeth; (c) used a reference standard other than one of the three methods; and (d) reported data on sample size and accuracy. Multilevel analyses, meta‐regressions and comparisons of bivariate summary receiver operating characteristics curves were undertaken. Results: Two hundred and forty manuscripts from 14 129 articles initially identified met the inclusion criteria. VI was better than RX on occlusal surfaces at all caries lesion thresholds and proximal surfaces of permanent teeth only at all lesion thresholds in laboratory setting. LF was slightly better than VI for advanced lesions on occlusal surfaces of permanent teeth in the clinical setting and for all lesions on proximal surfaces of permanent teeth in the laboratory setting. Still, LF was worse than VI for advanced occlusal lesions in permanent teeth in the laboratory setting. Although LF showed slightly better performance than VI with advanced lesions, the latter had significantly higher specificity than other methods in all settings. Conclusion: Visual caries detection alone is adequate for most patients in daily clinical practice regardless of tooth type or surface. [ABSTRACT FROM AUTHOR]

The aims of this study were: (1) to evaluate the overall reproducibility and accuracy of the International Caries Detection and Assessment System (ICDAS) for assessing coronal caries lesions, and (2) to investigate the use of systems associated with the ICDAS for activity assessment of coronal caries lesions. Specific search strategies were adopted to identify studies published up to 2016. For the first objective, we selected studies that assessed primary coronal caries lesions using the ICDAS as a reference standard. A total of 54 studies were included. Meta-analyses summarized the results concerning reproducibility and accuracy (correlation with histology, summary ROC curves [SROC], and diagnostic odds ratio [DOR]). The latter 2 were expressed at D1/D3 levels. The heterogeneity of the studies was also assessed. Reproducibility values (pooled) were > 0.65. The ICDAS mostly presented a good overall performance as most areas under SROC were > 0.75 at D1 and > 0.90 at D3; DOR ≥6. For the second objective, we selected studies investigating activity assessment associated with the ICDAS. The meta-analyses pooled results based on the same methodology and parameters as above. Longitudinal findings regarding caries progression were described to estimate the validity of these systems. On average, the systems for activity assessment of caries lesions showed moderate values concerning reproducibility and overall performance. Active caries lesions were more prone to progress than inactive ones after 2 years. In conclusion, the ICDAS presented a substantial level of reproducibility and accuracy for assessing primary coronal caries lesions. Additional systems associated with the ICDAS that classify caries lesion activity can be useful as they are moderately reproducible and accurate. [ABSTRACT FROM AUTHOR]

Aim: To assess the undergraduate students' performance in detecting and staging caries and assessing activity using visual inspection. Design: Two independent reviewers searched the literature through PubMed/MEDLINE, Scopus, Lilacs databases, and OpenSINGLE. Meta‐analyses summarized the results concerning reproducibility and accuracy at D1 (considering all lesions) and D3 (including only cavitated lesions or lesions into dentin) levels. For activity, we considered sound surfaces plus inactive caries lesions vs active lesions. Meta‐regression assessed the effect of methodological variables on the outcomes. Results: Fourteen studies were included. The mean reproducibility values were ≥0.52, except for interexaminer agreement when assessing caries activity (0.39; 95% CI 0.10‐0.67). The intra‐examiner reproducibility tended to be higher than the interexaminer reproducibility. Overall, undergraduate students' performance in staging caries lesions using visual examination was good (AUC>0.85 and DOR>25). The sensitivity values were moderate; however, these were associated with excellent specificity values. Despite few pooled studies, caries activity assessment revealed moderate overall performance, with lower pooled sensitivity than pooled specificity. Students' education level and background clinical experience had no influence on the accuracy and reproducibility of the visual inspection. Conclusion: Undergraduate students' performance in detecting and staging caries using visual inspection was good, although caries activity assessment still requires improvement. [ABSTRACT FROM AUTHOR]

Objectives: To determine the severity of dental caries in South American Indigenous peoples. Methods: A systematic review was conducted regarding the severity of dental caries in South American Indigenous peoples using the following electronic databases: MEDLINE/PubMed, SCOPUS, SciELO, LILACS and grey literature up to March 2018. Literature search was conducted up to March 2018. No restrictions on language or year of publication were applied. Descriptive analysis and meta‐analysis of studies were performed to determine mean dmft/DMFT index (decayed, missing and filled teeth) and temporal trends for selected age brackets. Results: The search strategy retrieved 698 studies, of which 70 full‐text articles were assessed for eligibility and 28 were included in the qualitative analysis. Finally, 18 papers were included in the meta‐analysis. Publication year ranged from 1964 to 2018. Mean dmft for 5‐year‐old children was 5.73 (95% CI 4.67‐6.79), and mean DMFT for 12‐year‐olds was 3.14 (95% CI 1.88‐4.40). Estimated DMFT for 15‐19 years, 35‐44 years and 65‐74 years was 5.53 (95% CI 2.97‐8.09), 19.41 (95% CI 11.88‐26.93) and 28.19 (24.83‐31.55), respectively. DMFT was higher than that reported in general population surveys in Brazil, Chile, Uruguay and Venezuela for all age brackets with available data. Heterogeneity was observed in all age brackets, ranging from 79.7 to 99.7%. Conclusion: Dental caries remains a significant public health problem for South American Indigenous peoples. Prevention and treatment strategies that consider cultural specificities are needed. [ABSTRACT FROM AUTHOR]

Background A previous systematic review showed that atraumatic restorative treatment ( ART) can be an option to restore the occlusoproximal cavities in primary teeth; however, few studies fulfilled the criteria of inclusion to generate a high level of evidence. Aim To update the existing systematic review and address questions regarding survival rate of ART restorations compared to the conventional approach in occlusoproximal cavities in primary molars. Design The search was extended beyond the original search through the PubMed/ MEDLINE database up to February 2016. Furthermore, Web of Science and EMBASE were searched. The inclusion criteria were subjects related to the scope of the systematic review. After selection by title and abstract, potentially eligible articles were read in full and included in accordance with exclusion criteria. Meta-analysis was carried out with the outcome being the survival rate of restorations. Results The search strategy identified 560 potentially relevant studies, in addition to 127 from the original systematic review. A total of four articles were included in the qualitative and quantitative analyses. Meta-analysis showed no statistically significant difference between ART and conventional approaches in survival rate of occlusoproximal cavities (OR = 0.887, 95% CI: 0.574-1.371). Conclusion ART restorations have similar survival rate compared to conventional treatment and can be considered an option to restore occlusoproximal cavities in primary molars. [ABSTRACT FROM AUTHOR]

Background Studies have suggested that in the presence of approximal cavities, the approximal surface in contact with this one shows a higher risk in the development of caries lesions. Aim To evaluate the ability of dental materials to prevent and to arrest caries lesion in approximal surfaces in contact with occlusoproximal restorations. Design Two independent reviewers performed a literature search in PubMed through November 2014. The inclusion criteria were: (1) subject related to the scope of this systematic review, (2) study with follow-up, (3) not performed in specific groups, (4) to have a comparison group. After selection by title and abstract, potentially eligible articles were read in full. Meta-analysis was carried out considering the outcome as caries lesion progression or arrestment. Results The search strategy identified 772 potentially relevant studies, and 10 of them were included in the review (six laboratory studies and four longitudinal trials). For the longitudinal clinical trials, no difference was verified among the materials (OR = 0.680,95%CI:0.233-1.983). When a meta-analysis was performed for laboratory studies, GIC was significantly associated with better ability to arrest caries lesions (OR = 0.153,95%CI:0.060-0.391). Conclusions In laboratory studies, GIC shows better ability to arrest caries lesion in approximal adjacent surfaces, but this ability was not confirmed in longitudinal clinical trials. [ABSTRACT FROM AUTHOR]

Background. Fluoride released from glass ionomer cements (GICs) is capable of preventing caries lesions. However, the preventive effect in margins of occlusal and occlusoproximal restorations have not been proved. The aim of this study was to evaluate the ability of GIC to prevent caries lesions in margins of occlusal and occlusoproximal restorations in primary teeth compared with that of other restorative materials. Types of Studies Reviewed. The authors conducted a literature search in PubMed and MEDLINE to verify the clinical trials available on the outcome of caries lesions. The inclusion criteria were that the subject related to the scope of this systematic review, the study had a follow-up, and the study was not performed in specific groups. The authors performed all meta-analyses by considering the secondary caries rates for the restorations in clinical trials. Results. The search strategy identified 450 potentially relevant studies, and the authors included 8 of them in the review. The main reasons for exclusion were that the studies were not related to the scope of this review or were not longitudinal trials. The secondary caries rate of the occlusal restorations was not different among the restorative materials (odds ratio, 1.2; 95% confidence interval, 0.5-3.1). For occlusoproximal analysis, GIC was associated significantly with better ability to prevent caries lesions (odds ratio, 1.7; 95% confidence interval, 1.2-2.5). Conclusions and Practical Implications. Because new caries lesions in the margins of restorations are the main reason for failure and replacement of restorations in primary teeth, it is important to know whether there is a benefit in using GICs in both occlusal and occlusoproximal cavities. [ABSTRACT FROM AUTHOR]

Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature. The eligible studies were those which (1) assessed the accuracy of the visual method for detecting caries lesions on occlusal, approximal or smooth surfaces, in primary or permanent teeth, (2) used a reference standard, and (3) reported data about sample size and accuracy of the methods. Aspects related to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study considered its prognosis, 79 studies did not consider a clinically relevant outcome, and only 1 evaluated a patient-centred outcome. Concerning methodological quality, the majority of the studies presented a high risk of bias in sample selection. In conclusion, studies on the accuracy of the visual method for caries detection should consider clinically relevant outcomes besides accuracy; moreover, they should be conducted with higher methodological quality, mainly regarding sample selection. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives This study aimed to perform a systematic review on the prevalence of, and trends in, dental trauma in permanent teeth in 'Latin America and Caribbean' region and possible factors associated with this injury. Methods Literature search was carried out, in PubMed database up to 07 July 2011, for articles written in Portuguese, Spanish, or English reporting on dental trauma prevalence in the Latin American and Caribbean countries. Meta-analyses were undertaken by using random effects modeling to satisfy the purposes of this review. Pooled estimates were calculated with a confidence interval of 95% (95% CI) both for prevalence and odds ratios ( OR). Results This online searching strategy collected and listed 2436 articles on this topic. After evaluating their titles and abstracts, only 24 were finally selected for complete review and data collection. All studies had been performed during adolescence, mostly in 12-year-old adolescents. The pooled prevalence of dental trauma in permanent teeth was 18.6%. Positive summary association of dental trauma with boys (pooled OR = 1.72; 95% CI: 1.57-1.89), inadequate lip coverage (pooled OR = 2.26; 95% CI: 1.45-3.52), and increased overjet (>5 mm) (pooled OR = 1.98; 95% CI: 1.61-2.44) were observed across all meta-analysis models. Differences in estimation could be observed when different criteria were used for evaluating dental trauma. On the other hand, prevalence of dental trauma did not tend to show sudden changes over time, despite criteria used. Prevalence of dental trauma after 2000s tended to decrease over time. Conclusions Approximately 15-20% of the adolescents in Latin American and Caribbean countries have shown some type of dental trauma in permanent teeth, and it seems there is a trend of decreasing prevalence of dental trauma in the studied areas of this region. Boys, adolescents presenting inadequate lip coverage, or an increased overjet greater than 5 mm are more likely to have traumatic dental injuries. [ABSTRACT FROM AUTHOR]

Background Atraumatic restorative treatment ( ART) has demonstrated good longevity when used for single-surface restorations, but lower success rates are reported for occlusoproximal surfaces. Aim This systematic review and meta-analysis aimed to verify the pooled success rate of occlusoproximal ART restorations in primary teeth considering the outcomes: longevity, pulp damage, or caries lesion progression. Design Literature searching was carried out on the studies reporting clinical trials indexed in Pub Med and in English language, comprising the outcomes. A meta-analysis was undertaken considering the results from reviewed studies. Results An initial search resulted in 126 articles, and three of them were finally selected. The main reasons for excluding articles were the absence of control group, as amalgam, composite resin, or compomer restorations to be compared with ART (hand excavation + high-viscous GIC). The pooled estimate (odds ratio; 95% confidence interval) for ART approach success was 1.04 (0.65-1.66). Conclusion Atraumatic restorative treatment restorations performed with high-viscous GIC present similar survival/success rates to conventional approach using composite resin or amalgam for occlusoproximal restorations in primary teeth and can be suggested as a good option for occlusoproximal cavities in primary molars. In addition, further randomized controlled clinical investigations concerning occlusoproximal restorations in primary teeth are still necessary. [ABSTRACT FROM AUTHOR]

Background: Fluorescence-based methods have been proposed to aid caries lesion detection. Summarizing and analysing findings of studies about fluorescence-based methods could clarify their real benefits. Objective: We aimed to perform a comprehensive systematic review and meta-analysis to evaluate the accuracy of fluorescence-based methods in detecting caries lesions. Data Source: Two independent reviewers searched PubMed, Embase and Scopus through June 2012 to identify papers/articles published. Other sources were checked to identify non-published literature. Study Eligibility Criteria, Participants and Diagnostic Methods: The eligibility criteria were studies that: (1) have assessed the accuracy of fluorescence-based methods of detecting caries lesions on occlusal, approximal or smooth surfaces, in both primary or permanent human teeth, in the laboratory or clinical setting; (2) have used a reference standard; and (3) have reported sufficient data relating to the sample size and the accuracy of methods. Study Appraisal and Synthesis Methods: A diagnostic 2×2 table was extracted from included studies to calculate the pooled sensitivity, specificity and overall accuracy parameters (Diagnostic Odds Ratio and Summary Receiver-Operating curve). The analyses were performed separately for each method and different characteristics of the studies. The quality of the studies and heterogeneity were also evaluated. Results: Seventy five studies met the inclusion criteria from the 434 articles initially identified. The search of the grey or non-published literature did not identify any further studies. In general, the analysis demonstrated that the fluorescence-based method tend to have similar accuracy for all types of teeth, dental surfaces or settings. There was a trend of better performance of fluorescence methods in detecting more advanced caries lesions. We also observed moderate to high heterogeneity and evidenced publication bias. Conclusions: Fluorescence-based devices have similar overall performance; however, better accuracy in detecting more advanced caries lesions has been observed. [ABSTRACT FROM AUTHOR]

Background: Smoking is a major risk factor for periodontitis and tooth loss. Smoking cessation has a positive impact in periodontal treatment. However, so far, no systematic review has evaluated the effect of smoking cessation on tooth loss. Therefore, this review aimed to evaluate if smoking cessation reduces the risk of tooth loss. Methods: Observational (cross-sectional and longitudinal) studies that investigated the association between smoking cessation and tooth loss were included. MEDLINE, EMBASE and LILACS databases were searched for articles published up to November 2018. Pooled results for subgroups of current and former smokers were compared in meta-analysis. Meta-regression was used to test the influence of smoking status on estimates and explore the heterogeneity. Results: Of 230 potentially relevant publications, 21 studies were included in the qualitative review and 12 in the quantitative analysis. Meta-analysis of cross-sectional studies did not show any differences between former and current smokers in the chance of losing 1 or more teeth (OR = 1.00; 95% CI = 0.80 to 1.24, I2 = 80%), losing more than 8 teeth (OR = 1.02; 95% CI = 0.78 to 1.32, I2 = 0%) or being edentulous (OR = 1.37; 95% CI = 0.94 to 1.99, I2 = 98%). Meta-analysis from longitudinal studies showed that, when compared to never smokers, former smokers presented no increased risk of tooth loss (RR = 1.15; 95% CI = 0.98 to 1.35, I2 = 76%), while current smokers presented an increased risk of tooth loss (RR = 2.60; 95% CI = 2.29 to 2.96, I2 = 61%). Meta-regression showed that, among former smokers, the time of cessation was the variable that better explained heterogeneity (approximately 60%). Conclusions: Risk for tooth loss in former smokers is comparable to that of never smokers. Moreover, former smokers have a reduced risk of tooth loss, when compared to current smokers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic review and meta-analysis was to assess the impact of dental caries on the oral health-related quality of life (OHRQoL) of preschool children. Methods: A literature search was undertaken through PubMed/MEDLINE, Scopus, and TRIP databases to verify available studies about the topic. Two reviewers independently selected the studies, extracted the data, and assessed the bias risk. Global meta-analysis was carried out comparing means and standard deviations of the OHRQoL overall score from preschool children with and without caries. Subgroup analysis was conducted using different cutoff points for caries: decayed, missing, or filled teeth (dmft) greater than or equal to one and greater than or equal to six. Results: From 597 potentially eligible studies, 63 were selected for full-text analysis and 29 were included in the review: 12 for quantitative analysis and 17 for qualitative analysis. Most studies were conducted in Brazil; Early Childhood Oral Health Impact Scale (ECOHIS) was the instrument used in most studies to evaluate OHRQoL. A dmft index at least of one was sufficient to negatively impact the OHRQoL of preschool children, although a higher cutoff point for caries augmented the difference between groups. Bias risk was low. Conclusions: Caries might be associated with negative impact on the oral health-related quality of life of preschool children, and this association tends to increase as the disease severity worsens. [ABSTRACT FROM AUTHOR]