Scandinavian and North American Moist Snuff and Periodontitis: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
AIM: To answer the focused PECOS question: in humans (P), what is the effect of Scandinavian or North American moist snuff (MS) (E), in comparison to non-use (C), in terms of periodontitis (O) as demonstrated in clinical studies (S)? METHODS: Electronic databases (MEDLINE, EMBASE and Cochrane) and grey literature were searched for relevant studies reporting clinical and/or patient-reported periodontal outcomes. Qualitative and quantitative syntheses (random-effects meta-analysis with pooled odds ratios [ORs] or effect sizes [ESs] and 95% confidence intervals [CIs]) were performed to determine the associations between MS use and primary (periodontitis) or secondary outcomes (gingival recession, gingivitis). Risk of bias (Newcastle-Ottawa scale) and certainty of evidence (GRADE) were assessed. RESULTS: Twenty-two mostly cross-sectional studies from Sweden (n = 11), the United States (n = 10) and Norway (n = 1) were included. MS use was most frequently associated with buccal recession. Qualitatively, an association between MS use and periodontitis (n = 16) was judged to be unlikely. Based on studies with high clinical heterogeneity, no significant associations were found between MS use and periodontitis (n = 2 [12,775 participants], OR = 1.49 [CI: 0.71-3.16]), recessions (n = 9 [3719 participants], ES = -0.04 [CI: -0.98 to 0.90]) or gingivitis (n = 3 [1429 participants], ES = 0.09 [CI: -0.36 to 0.55]). The certainty of evidence was judged to be very low. CONCLUSION: The current evidence, mostly based on cross-sectional studies and very low certainty, suggests that Scandinavian or North American MS use is not associated with periodontitis. PROSPERO: CRD42023417652.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.024 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".