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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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Cetylpyridinium chloride mouthwash vs Blank control

Plaque · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

CPC mouthwash may reduce plaque-related indexes versus blank control in the short term, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

SDF plus potassium iodide vs Split into two contrasts: (1) TCS paste (arrest 100%); (2) CPP-ACP (arrest 100%); SDF+KI arrest 54.8% at 24 months, p<.001

Caries arrest · Patients with early enamel carious lesions on permanent molars

SDF plus potassium iodide arrested 54.8% of early enamel lesions at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

P11-4 + fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · People or specimens with white spot lesions or early caries lesions

The NMA estimated an SMD of -0.78 for P11-4 + fluoride varnish versus CPP-ACP (95% CI -1.33 to -0.28).

1 finding from 1 review

Sentinel node biopsy (neck dissection only if biopsy positive) vs Elective neck dissection

Locoregional recurrence · Adults with oral cavity or oropharyngeal cancer

Sentinel node biopsy (neck dissection only if biopsy positive) showed no clear difference in locoregional recurrence compared with elective neck dissection (low certainty).

1 finding from 1 review

Self-assembling peptide P11-4 vs Placebo or no active treatment

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Self-assembling peptide P11-4 significantly improved remineralization versus control (SMD -0.56, 95% CI -0.96 to -0.15); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Compomer (Dyract) vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

Over 2 or more years in deciduous teeth, secondary caries did not differ significantly between compomer and RMGIC (RR 1.68, 95% CI 0.87-3.25; low certainty).

1 finding from 1 review

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Recurrence · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)
1 finding from 1 review

Herbal mouthwash vs placebo

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.

1 finding from 1 review

38% SDF + potassium iodide solution (applied annually) vs Tricalcium silicate (TCS) paste (applied twice daily)

Remineralization/arrest of early enamel carious lesions · Patients with early enamel carious lesions on permanent molars

For early enamel lesions, annual SDF+KI was significantly LESS effective than twice-daily tricalcium silicate paste (54.8% vs 100% arrested; p<0.001; ungraded).

1 finding from 1 review

Gum chewing (sugar-free) vs No chewing gum

Salivary flow rate · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

Across 19 studies the effect of gum chewing on stimulated and/or unstimulated salivary flow rate was mixed (9 positive, 10 no effect); this broad outcome was not meta-analyzed.

1 finding from 1 review

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for coronal caries increment (negative likelihood ratio, LR-) · Children and adolescents (aged 2-19) at risk of coronal caries increment (caries onset or progression)

Some developmental coronal-caries models achieved useful negative likelihood ratios (LR-<=0.20), but performance varied widely; no pooled estimate; ungraded.

2 findings from 1 review
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents; no geographical restriction · Model development studies
    No meta-analysis. Per-model LR- (Table 2) for the 8 development studies ranged roughly 0.11-0.94 (e.g. Angulo 0.94, Demers 0.14-0.40, Gao 2010 0.11-0.30). Overall across all 66 models LR- ranged 0.0-1.1; LR-<=0.20…
    8 studies
    GRADE not reported
  • Multivariable prediction models of caries increment: a systematic review and critical appraisal. 2023 All outcomes
    Follow-up >=1 year (included studies 1-5 years) · Oral health care; children/adolescents; no geographical restriction · Model validation studies
    No meta-analysis. Per-model LR- (Table 2) across the 9 validation studies ranged from about 0.14 to 1.13 (e.g. Gao 2013 NUS-CRA 0.26, CAMBRA 0.14-0.31, CAT up to ~1.10; Campus 0.20; Pang 2020 low-risk 1.13). Overall…
    9 studies
    GRADE not reported

P11-4 + fluoride varnish vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish was significantly better than fluoride varnish alone (SMD -0.71, 95% CI -1.13 to -0.29); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children (<19 years)

Children with vitamin D deficiency had a 22% higher risk of dental caries than those with normal vitamin D levels (unadjusted RR 1.22; ungraded).

5 findings from 1 review
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Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Reduction in frequency and severity of drooling · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin significantly reduced DSFS scores versus placebo (SMD -0.80, 95% CI -1.25 to -0.36; ungraded subgroup).

3 findings from 1 review

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children with permanent dentition (>12 years)

In children with permanent dentition, vitamin D deficiency was associated with a 28% higher caries risk (RR 1.28; ungraded).

1 finding from 1 review