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MEDLINE\/PubMed, Web of Science, Embase, Scopus, Lilacs, SciELO, and Google Scholar databases were searched up to September 2025. Methodological quality was assessed by Newcastle\u2010Ottawa Scale and QUADAS\u20102. Qualitative synthesis was performed using all included studies. Thirteen studies that assessed the oral microbiota composition through high\u2010throughput sequencing platforms were included comprising 740 caries\u2010free participants at the baseline.\n                    <jats:italic>Alloprevotella<\/jats:italic>\n                    spp. and\n                    <jats:italic>Megasphaera<\/jats:italic>\n                    spp. were exclusively highly abundant in children who developed caries, whereas\n                    <jats:italic>Peptostreptococcus<\/jats:italic>\n                    spp. was exclusively highly abundant in caries\u2010free children. The diagnostic value of the oral microbiota composition showed specificity, sensitivity, accuracy, and area under the receiver operating characteristics curve ranging from 0.6 to 1.0, 0.75 to 0.90, 0.73 to 0.93, and from 0.51 to 0.94, respectively. High risk of bias was found for the index test. The available evidence does not support the use of oral microbiota composition as a screening test to identify children at risk for caries development. Studies conducted at the species level are likely to provide results with greater sensitivity and specificity, improving risk assessment and understanding of caries\u2010associated microbiota (PROSPERO CRD42023495648).\n                  <\/jats:p>","DOI":"10.1111\/eos.70069","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T11:09:34Z","timestamp":1770116974000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of the oral microbiota as screening test to identify children at risk for caries development. 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