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Evidence found and GRADE certainty

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

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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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Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in DMFT (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFT increment ranged from 0.06 to 0.73 across 14 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
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  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    0.24 to 0.73
    6 studies · 16705 participants
    GRADE not reported

Oral irrigation plus toothbrushing vs Toothbrushing alone

Periodontitis (probing pocket depth) · Adults, 16 years and older (dentate)
1 finding from 1 review

Intervention not reported

Dental caries prevalence · Children (<12 years) and adolescents (12-18 years) with type 1 diabetes

Caries prevalence was lowest among those with good metabolic control at 47% (95% CI 0.30 to 0.64); certainty not graded.

1 finding from 1 review

38% silver diamine fluoride vs placebo

Root carious lesions arrest · Older adults with root carious lesions (exposed root surfaces)

One review reported SDF may reduce progression of root caries, with no numeric result (ungraded).

3 findings from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in the United Kingdom

In UK studies, OHPPs were associated with lower DMFT/S (OR 0.04, 95% CI 0.00 to 0.58; ungraded).

1 finding from 1 review

Intervention not reported

Dental caries prevalence · Children (<12 years) and adolescents (12-18 years) with type 1 diabetes

Caries prevalence in European studies was 57% (95% CI 0.41 to 0.72); certainty not graded.

1 finding from 1 review

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

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 38% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.21, 95% CI 1.12 to 1.3; high certainty).

4 findings from 1 review
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Patient-used 5000 ppm F toothpaste, daily vs 1450 to 1500 ppm F toothpaste

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

Sealant (any type) vs no treatment

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

Sealant was probably more effective than no treatment for arrest or reversal of occlusal carious lesions (RR 1.98, 95% CI 1.61 to 2.44; moderate certainty).

1 finding from 1 review

2400 to 2800 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)

2400 to 2800 ppm F toothpaste may leads to lower caries increment, tooth index D(M)FT compared with non-fluoride (0 ppm F) placebo toothpaste (low certainty).

1 finding from 1 review

Oral irrigation plus toothbrushing vs Toothbrushing alone

Gingivitis · Adults, 16 years and older (dentate)

It is very uncertain whether oral irrigation plus toothbrushing changes gingivitis (gingival index) compared with toothbrushing alone (very low certainty).

2 findings from 1 review

Longer follow-up vs Shorter follow-up

Caries incidence rate per person-year at risk (D3) · Children and adolescents with permanent dentition

Adjusted for groups 1-4 including relevance of evidence and risk of bias meta-regression beta was -0.02 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 · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up -0.02 [-0.05, 0.01]
    15 studies · 10768 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 0.00 [-0.00, 0.01]
    15 studies · 10768 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 0.00 [-0.00, 0.01]
    15 studies · 10768 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 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up -0.00 [-0.02, 0.02]
    15 studies · 10768 participants
    GRADE not reported
  • 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 -0.00 [-0.01, 0.01]
    15 studies · 10768 participants
    GRADE not reported

1400/250 ppm F (amine F/SnF2) toothpaste + mouthrinse, daily vs 1400/250 ppm F (NaF) toothpaste + mouthrinse, daily

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

Placebo rinse vs Pre-treatment (baseline, same group)

Lactobacillus count (pre- vs post-treatment) · Medically healthy individuals (adults and children, 6-60 years)

Placebo rinse did not significantly change Lactobacillus counts relative to baseline; not GRADE-rated.

1 finding from 1 review

1450 to 1500 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste

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

1450 to 1500 ppm F toothpaste probably leads to lower caries increment, surface index D(M)FS compared with non-fluoride (0 ppm F) placebo toothpaste (moderate certainty).

1 finding from 1 review

Laser enamel preparation alone (Er,Cr:YSGG or CO2 laser) vs Acid-etching (phosphoric acid)

Development of >=1 new carious lesion (caries incidence) · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

In the single study reporting it, caries incidence was 0% in both the laser-alone and acid-etching groups (ungraded, single study).

1 finding from 1 review

1700 to 2200 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)

1700 to 2200 ppm F toothpaste may leads to lower caries increment, tooth index D(M)FT compared with non-fluoride (0 ppm F) placebo toothpaste (low certainty).

1 finding from 1 review