Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,323 questions · 5,762 findings · 263 reviews · Dental caries

No studies found 321 · 5.6%GRADE not reported 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%

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Other visual classification systems (unspecified or unique systems, e.g. Nyvad, Downer, Lussi, UniViSS) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection of enamel caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Probing pocket depth (PPD/PD) · Adults undergoing orthodontic treatment

Aligners may reduce pocket depth compared with fixed appliances in adults at 6-12 weeks (MD -0.42 mm, 95% CI -0.71 to -0.12; very low certainty).

1 finding from 1 review

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

Detection rate of oral pre-malignant and malignant lesions after referral (COE+vital rinsing vs COE alone) · Oral cavity cancer or potentially malignant disorder symptom-free individuals with tobacco habits

COE with vital rinsing (toluidine blue/tolonium chloride) showed no clear difference in detection rate of oral pre-malignant and malignant lesions after… compared with conventional oral examination (COE) alone (moderate certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

White spot lesions (WSLs), patient level · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in white spot lesion formation (patient level) between aligners and fixed appliances in adolescents at 9 months (RR 0.33, 95% CI 0.10 to 1.04; ungraded).

1 finding from 1 review

Gingivitis (assessed by gingival index or WHO criteria) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Gingival health at 6 months · Children and adolescents in the United Arab Emirates (Sharjah)

Gingivitis and high plaque levels were common among UAE children and adolescents, more likely in females and older children (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Inflammatory bowel disease (IBD) vs Healthy controls without IBD

DMFT/DMFS index (dental caries experience) · Patients with IBD (Crohn's disease and ulcerative colitis) and controls without IBD

Most included studies reported higher dental caries indices (DMF-t/DMF-s) in IBD patients (especially ulcerative colitis), but findings were inconsistent across studies and were not meta-analyzed or GRADE-rated.

1 finding from 1 review
  • Oral Health Status in Patients with Inflammatory Bowel Diseases: A Systematic Review. 2021 All outcomes
    Hospital/clinic-based case-control and cross-sectional studies in 11 countries; 15 studies total (1748 participants: 1104 Crohn's disease, 534 ulcerative colitis, 110 IBD-form unspecified)
    Not meta-analyzed (heterogeneity of caries indices). Abstract: "in most studies, patients with IBD were characterized by higher values of caries indices." Table 3 examples (IBD/subtype vs control): Zhang 2020 DMF-t…
    Studies not reported
    GRADE not reported

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Overall survival, post-surgery chemotherapy vs surgery alone (no radiotherapy) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Surgery +/- radiotherapy + (adjuvant) chemotherapy showed no clear difference in overall survival, adjuvant chemotherapy vs observation alone… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

1 finding from 1 review

Tooth wear assessment (primary teeth) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Tooth wear prevalence · School children (primary dentition) in the United Arab Emirates (Abu Dhabi)

One study reported a very high prevalence of tooth wear (97.6%) in the primary dentition of school children in Abu Dhabi, associated with older age, mouth breathing and anterior deep bite (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Fluoride concentration relative to the acceptable range (electrometric ion-selective electrode measurement; acceptable range mostly 0.6-0.8 ppmF) vs None (descriptive proportion meta-analysis)

Water samples with fluoride concentration outside the acceptable range · Artificially fluoridated public water supply in Brazilian cities (water samples under external control)

In Brazilian cities using external control, more than half of artificially fluoridated public water supply samples (pooled 56.6%, 95% CI 45.5 to 67.3) had fluoride concentrations outside the acceptable range, with very high heterogeneity (I2=99.5%); ungraded.

3 findings from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

White spot lesions were also measured by laser fluorescence in 3 sealant-vs-no-sealant studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Digital radiographs vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Fluoride-releasing compomer bonding agent did not show a statistically significant reduction in new white spot lesions versus non-fluoride compomer bonding agent (very low certainty).

1 finding from 1 review

Non-selective carious tissue removal and conventional restoration (CR) vs Selective carious tissue removal (selective excavation, SE)

Lesion progression · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…
1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

S. mutans presence · Adolescents/teenagers undergoing orthodontic treatment

A single study found no significant difference in S. mutans presence between aligners and fixed appliances in adolescents at 1 month (RR 0.86, 95% CI 0.64 to 1.14; ungraded).

1 finding from 1 review