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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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Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Dental caries prevalence · Adult residents of slums and non-slum urban settings of LMICs

Dental caries prevalence in LMIC urban/slum populations ranges widely (13%-76%); not GRADE-rated (narrative synthesis).

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Probiotics vs placebo or control

Salivary pH · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to salivary pH versus control (MD -0.12 pH units, 95%CI -0.72 to 0.48; very low certainty).

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Sensitivity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Association between orthodontic treatment duration and ICLs incidence · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

ICLs incidence increased with longer orthodontic treatment duration (meta-regression P<.01; ungraded).

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the number of dental caries versus control (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo control

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF markedly increased individual-level caries arrestment versus placebo (OR 18.10; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Glass ionomer cement (GIC) plus fluoride varnish

Caries arrest · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with glass ionomer cement (GIC) plus fluoride varnish (very low certainty).

1 finding from 1 review

Breastfeeding for <6 months vs Breastfeeding for ≥6 months

Early childhood caries (ECC) · Preschool children (<6 years)

In cohort studies, breastfeeding for <6 vs ≥6 months was not significantly associated with early childhood caries (RR 0.97, 95% CI 0.88-1.06; ungraded).

2 findings from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs no intervention

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol significantly reduced Mutans streptococci in dental plaque compared with no treatment (SMD -0.73, 95% CI -1.09 to -0.37; 5 trials, I2=53%; not GRADE-rated).

1 finding from 1 review

Not applicable (single-group prevalence) vs Not applicable (single-group prevalence)

Poor (inadequate) oral hygiene (prevalence) · Children (<18 years) with intellectual and developmental disabilities (IDD) in India

Poor oral hygiene affects about 38% of children with IDD in India (pooled prevalence 0.38, 95% CI 0.21-0.59; high heterogeneity; ungraded).

1 finding from 1 review

Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal

Treatment success (caries lesion arrest or restoration survival) · Patients with deep carious lesions in permanent (mainly posterior) teeth

Minimally invasive caries removal showed a marginally higher mean restoration success rate than conventional removal (83.6% vs 75.4%), but the difference was not statistically significant (Mann-Whitney U, p > 0.05); certainty of evidence was not graded.

1 finding from 1 review

Orthodontic adhesives containing bioactive glass (BAG) particles/nanoparticles (including fluoride- or Ga-doped BAG) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Ion release (fluoride, calcium, phosphate) · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, among the 5 BAG ion-release studies only Ga-doped BAG (GaMBN, Song [31]) reported a significant increase (phosphate, up to 14 days); a general significant fluoride/calcium/phosphate increase across all 5 is not supported (ungraded).

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Caries presence in primary teeth · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

It is very uncertain whether oral health education/promotion (oral hygiene advice plus diet and… changes caries presence in primary teeth compared with standard care (very low certainty).

1 finding from 1 review

nCaF2 primer vs Control Transbond primer

Streptococcus mutans count · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

nCaF2 primer differed in S. mutans count only at T1, with certainty not graded.

1 finding from 1 review

Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride)

Biofilm formation (reduction) · Streptococcus mutans (in vitro cultures and biofilms)

Grape seed extract reduces S. mutans biofilm formation in vitro (5 studies; ungraded).

1 finding from 1 review

Advice about a healthy diet (including breastfeeding promotion and sugar avoidance) and feeding practices (e.g. relating to bottle-feeding and sleep) for infants and young children vs usual care

Caries in primary teeth: dmft (3 years) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether advice about a healthy diet (including breastfeeding promotion and… changes dmft index score (decayed, missing, filled primary teeth; range 0-20) compared with standard care (very low certainty).

1 finding from 1 review