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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)

Caries development in permanent teeth · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFS increment ranged from 0.07 to 1.77 across 26 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: low
    0.07 to 0.53
    8 studies · 3735 participants
    GRADE not reported

2400 to 2800 ppm F toothpaste vs 1450 to 1500 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)

2400 to 2800 ppm F toothpaste showed no clear difference in caries increment, tooth index D(M)FT compared with 1450 to 1500 ppm F toothpaste (low certainty).

1 finding from 1 review

2400 to 2800 ppm F toothpaste vs 250 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)

2400 to 2800 ppm F toothpaste may leads to lower caries increment, tooth index D(M)FT compared with 250 ppm F toothpaste (low certainty).

1 finding from 1 review

Er:YAG laser preparation combined with acid-etching vs Acid-etching (phosphoric acid)

Sealant retention rate (completely retained) · Children with permanent molars requiring pit-and-fissure sealants

At 12 months, Er:YAG laser combined with acid-etching significantly improved sealant retention versus acid-etching alone (OR 0.39, 95% CI 0.19 to 0.80, favouring laser+acid; ungraded, single study).

4 findings from 1 review
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Mineral trioxide aggregate (MTA) pulpotomy dressing vs Platelet-rich fibrin (PRF)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found no difference in pulpotomy success between MTA and platelet-rich fibrin (both 100% through 24 months; not pooled; ungraded).

1 finding from 1 review

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

Side effects · Adults, 16 years and older (dentate)
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: mean difference in log10 CFU (microbial load) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

For yellow-vs-other colour compared with soft-vs-harder hardness, hardness was significantly the more discriminant test (pooled WMD -3.87, 95% CI -4.46 to -2.87; ungraded).

6 findings from 1 review
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30% SDF solution (applied annually) vs Fluoride varnish

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

30% SDF solution (applied annually) was more effective than 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.41, 95% CI 1.2 to 1.66; high certainty).

3 findings from 1 review

Laser enamel preparation vs Enameloplasty

Any planned outcome (sealant retention, caries, etc.) · Patients with premolars/molars requiring pit-and-fissure sealants

No eligible studies compared laser preparation with enameloplasty for fissure sealant placement (evidence gap).

1 finding from 1 review

Flossing plus toothbrushing vs Toothbrushing alone

Side effects · Adults, 16 years and older (dentate)
1 finding from 1 review

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

Dental caries: dmfs increment (primary teeth) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmfs increment ranged from -1.0 to 1.0 across 7 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

1.23% APF gel 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)

1.23% APF gel was probably more effective than no treatment for arrest or reversal of occlusal carious lesions (RR 2.13, 95% CI 1.79 to 2.54; moderate certainty).

1 finding from 1 review

38% silver diamine fluoride vs 12% 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 annually) was more effective than 12% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.27, 95% CI 1.16 to 1.4; high certainty).

4 findings from 1 review
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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 Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review

38% silver diamine fluoride vs placebo

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

38% silver diamine fluoride reduced root-caries increment (DMFRS/DFRS) versus placebo, MD −0.33 (95% CI −0.39 to −0.28) (ungraded).

3 findings from 1 review

Slow-release fluoride device (fluoride glass beads) vs Fluoride mouthrinse

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

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

MTA and calcium hydroxide had similar clinical and radiographic pulpotomy success at 6 months (RR 1.00, 95% CI 0.94 to 1.06; 2 RCTs; ungraded).

2 findings from 1 review