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Evidence found and GRADE certainty

3,556 questions · 10,375 findings · 429 reviews · Oral Health

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No studies found 1,344 · 13%GRADE not reported 6,832 · 65.9%Very low 1,228 · 11.8%Low 613 · 5.9%Moderate 290 · 2.8%High 68 · 0.7%

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Nd:YAG laser vs No anticaries intervention (untreated enamel)

Enamel acid resistance (cross-sectional microhardness) · Human enamel in pits and fissures (in situ / ex vivo)

Nd:YAG laser increased enamel acid resistance versus untreated enamel in pits and fissures (ungraded, 1 ex-vivo study, no pooled estimate).

1 finding from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries in children · Children aged 4 to 6 years whose mothers' prenatal vitamin D status was assessed

Among children aged 4-6 years, prenatal vitamin D deficiency is associated with significantly higher odds of dental caries (OR 1.44, 95% CI 1.32-1.56); ungraded.

1 finding from 1 review

Intralesional triamcinolone vs Intralesional salvianolic acid B

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

It is very uncertain whether intralesional triamcinolone changes maximal mouth opening (interincisal distance) compared with intralesional salvianolic acid B (very low certainty).

1 finding from 1 review

Cranberry extract or cranberry flavonoid fractions vs No extract or vehicle control; other antimicrobial agents

Antioxidant capacity · Streptococcus mutans (in vitro cultures and biofilms)

No meta-analysis was conducted; one included study reported antioxidant properties of cranberry fractions.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

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

Pooling two trials, SDF and ART/glass ionomer cement showed no clear difference in tooth-level caries arrestment (OR 1.22, wide CI; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

Aesthetics · Children and adults (with or without carious lesions)
1 finding from 1 review

SDF (given at a particular frequency, concentration, or duration) vs SDF (given at a different frequency, concentration, or duration)

Adverse effects · Children and adults (with or without carious lesions)
1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Calcium ions released in acidic solution · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation did not significantly change calcium ions released into acidic solution versus untreated control (SMD -0.40, 95% CI -0.96 to 0.15; 6 in vitro studies, I2=80%; ungraded).

1 finding from 1 review

Original development of CAMBRA (Caries Management by Risk Assessment) or CAT (Caries-risk Assessment Tool) multivariable models vs Not applicable

Model development with reported performance measures (per CHARMS) · Individuals of any age at risk of caries increment

No original CAMBRA or CAT model-development studies reporting performance measures according to CHARMS were found (evidence gap); these tools appeared only as validated models within other studies.

1 finding from 1 review

Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)

Pulp necrosis · Vital teeth restored with indirect restorations

Pulp necrosis incidence among treated by prosthodontists was 1.87% (subgroup analysis; not GRADE-rated).

23 findings from 1 review
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Resin infiltration vs CPP-ACFP

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…

Resin infiltration did not differ significantly from CPP-ACFP (SMD -0.52, 95% CI -1.16 to 0.12; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Access to oral healthcare (referral pathways, documentation processes, operating efficiencies, staffing, visits for oral health issues, uptake of fluoride varnish/other preventive treatment, and visits to an oral health professional) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
    19 studies
    GRADE not reported

Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline

Development of any (cavitated or non-cavitated) carious lesion · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Preschool children with mutans streptococci at baseline probably have about four times higher odds of developing early childhood caries (OR 4.13; moderate certainty).

10 findings from 1 review
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P11-4 + fluoride varnish vs CPP-ACP

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 CPP-ACP (SMD -0.78, 95% CI -1.33 to -0.24; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Multivariable caries prediction model vs Additional prediction model(s)

Coronal caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

168 findings from 1 review
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ACTIVA bioactive restorative material vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 1 year in permanent teeth, the effect of ACTIVA versus GIC on secondary caries is very uncertain (RR 22.80, 95% CI 0.89-584.17; very low certainty).

1 finding from 1 review

Tooth location

Pulp necrosis · Vital teeth

One study reported a 7.1% incidence in mandibular posterior teeth.

8 findings from 1 review
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Edentulism (complete or partial missing teeth) vs Individuals without edentulism

Oral health-related quality of life · Indian elderly

One study found edentulism did not affect OHRQoL (dichotomous); ungraded.

3 findings from 1 review