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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Rubber/elastomeric cleaning stick plus toothbrushing vs Toothbrushing alone

Gingivitis · Adults, 16 years and older (dentate)

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes gingivitis (proportion of bleeding sites) compared with toothbrushing alone (very low certainty).

2 findings from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from heavily contaminated areas, individual studies gave inconsistent DMFT/dmft differences; the review did not pool them and drew no firm conclusion (ungraded).

4 findings from 1 review
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Sealant (any type) vs no treatment

Arrest or reversal of noncavitated approximal carious lesions · Children and adults with noncavitated carious lesions on approximal surfaces (primary and permanent teeth)

Sealant may be more effective than no treatment for arrest or reversal of approximal carious lesions (RR 2.41, 95% CI 1.26 to 4.58; low certainty).

1 finding from 1 review

440 to 550 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste

Caries increment, tooth index D(M)FT · Children and adolescents with immature permanent dentition (aged 5 to 16 years at study start)

440 to 550 ppm F toothpaste showed no clear difference in caries increment, tooth index D(M)FT compared with non-fluoride (0 ppm F) placebo toothpaste (low certainty).

1 finding from 1 review

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: effect size (f) for microbial load (log10 CFU) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

The weighted effect size favoured hardness (f=2.62) over colour (f=0.46) for discriminating microbial load, supporting hardness as the more reliable examination (ungraded).

1 finding from 1 review

1000 to 1250 ppm F toothpaste vs 250 ppm F toothpaste

Caries increment, surface index D(M)FS · Children and adolescents with immature permanent dentition (aged 5 to 16 years at study start)

1000 to 1250 ppm F toothpaste may leads to lower caries increment, surface index D(M)FS compared with 250 ppm F toothpaste (low certainty).

1 finding from 1 review

Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from weakly contaminated areas, individual cross-sectional studies reported mostly higher but inconsistent DMFT/dmft in exposed vs non-exposed children; the review did not pool the data and drew no firm conclusion (ungraded).

4 findings from 1 review
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1450 ppm F toothpaste vs 250 ppm F toothpaste

Caries increment, tooth index D(M)FT · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

1450 ppm F toothpaste showed no clear difference in caries increment, tooth index d(m)ft compared with 250 ppm F toothpaste (low certainty).

1 finding from 1 review

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

Plaque · Adults, 16 years and older (dentate)

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes plaque compared with flossing plus toothbrushing (very low certainty).

1 finding from 1 review

Longer follow-up vs Shorter follow-up

Annual increment in DMFS (D3) · Children and adolescents with permanent dentition

Not adjusted meta-regression beta was 0.43 per additional follow-up year.

5 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Not adjusted
    Meta-regression beta per year of follow-up 0.43 [0.04, 0.83]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings and age at baseline
    Meta-regression beta per year of follow-up 0.64 [0.31, 0.96]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings age at baseline and baseline caries experience
    Meta-regression beta per year of follow-up 0.37 [0.04, 0.70]
    22 studies · 11300 participants
    GRADE not reported
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  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up 0.46 [0.08, 0.83]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up 0.36 [-0.02, 0.73]
    22 studies · 11300 participants
    GRADE not reported

1000 to 1250 ppm F toothpaste vs 440 to 550 ppm F toothpaste

Caries increment, tooth index D(M)FT · Children and adolescents with immature permanent dentition (aged 5 to 16 years at study start)

1000 to 1250 ppm F toothpaste showed no clear difference in caries increment, tooth index D(M)FT compared with 440 to 550 ppm F toothpaste (low certainty).

1 finding from 1 review

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No liner (resin-based composite bonded directly to the tooth)

Postoperative hypersensitivity (POH), patient-reported (dichotomous yes/no) · Adults or children with a Class I or Class II resin-based composite restoration in a permanent posterior tooth

Dental cavity liner (e.g. calcium hydroxide, glass ionomer,… showed no clear difference in postoperative hypersensitivity (POH), patient-reported (dichotomous… compared with no liner (resin-based composite bonded directly to the tooth) (low certainty).

3 findings from 1 review

1450 ppm F toothpaste vs 250 ppm F toothpaste

Caries increment, surface index D(M)FS · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

1450 ppm F toothpaste showed no clear difference in caries increment, surface index d(m)fs compared with 250 ppm F toothpaste (low certainty).

1 finding from 1 review

1000 or 1100 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste

Caries increment, tooth index D(M)FT · Adults with mature permanent dentition (aged 18 to 93 years at study start)

1000 or 1100 ppm F toothpaste showed no clear difference in caries increment, tooth index DMFT compared with non-fluoride (0 ppm F) placebo toothpaste (low certainty).

1 finding from 1 review

12,500 ppm F (NaF/olaflur/dectaflur) amine fluoride gel vs Placebo gel

Number of participants with more severe DLs (severity of DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

The review found no eligible studies for this question.

1 finding from 1 review

2400 to 2800 ppm F toothpaste vs 1700 to 2200 ppm F toothpaste

Caries increment, tooth index D(M)FT · Children and adolescents with immature permanent dentition (aged 5 to 16 years at study start)

It is very uncertain whether 2400 to 2800 ppm F toothpaste changes caries increment, tooth index D(M)FT compared with 1700 to 2200 ppm F toothpaste (very low certainty).

1 finding from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children of mixed ages (mean approximately 12 years; no age separation)

In children of mixed ages from heavily contaminated areas, individual studies reported modestly higher DMFT/dmft in exposed children; the review did not pool them and drew no firm conclusion (ungraded).

5 findings from 1 review
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