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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
555 questions in 21 reviews · intervention: Caries detection/diagnosis · outcome domain: Diagnostic accuracy
current versionsNo studies 19 · 3.4%Ungraded 489 · 88.1%Very low 17 · 3.1%Low 23 · 4.1%Moderate 7 · 1.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Intervention categories, outcome domains and clusters are a proposed key pending human validation. Clear all filters
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Intervention NR Difference in summary sensitivity (NMA, Analysis 2) · Electrical conductance vs Imaging Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Sensitivity difference (95% CrI) 0.33 [0.15, 0.47] | NR | Ungraded |
Fluorescence-based devices vs Reference standard (histology, operative excavation, or enhanced visual examination) Specificity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 2: network meta-analysis (all studies evaluating >=2 index tests) Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity 0.83 [0.75, 0.89] | 64 studies · 24567 participants | Low |
Visual or visual-tactile classification (e.g., ICDAS, ERK) vs Reference standard (histology, operative excavation, or enhanced visual examination) Specificity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 1: fully within-person comparison (studies evaluating >=3 index tests) Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity 0.85 [0.74, 0.93] | 19 studies · 2849 participants | Ungraded |
Intervention NR Difference in summary sensitivity (NMA, Analysis 2) · Fluorescence vs Visual Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Sensitivity difference (95% CrI) -0.07 [-0.16, 0.01] | NR | Ungraded |
Random forest classifier using KEGG Orthology features vs Caries versus healthy disease-state labels External disease-state discrimination · Oral microbiome samples from four selected case-control studies Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. (2022) | AUC 0.75 | 4 studies | Ungraded |
Intervention NR Difference in summary specificity (NMA, Analysis 2) · Imaging vs Visual Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity difference (95% CrI) 0.08 [0.01, 0.16] | NR | Ungraded |
Intervention NR Difference in summary specificity (NMA, Analysis 2) · Transillumination vs Visual Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity difference (95% CrI) 0.01 [-0.13, 0.12] | NR | Ungraded |
Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction Dental caries detection accuracy · Dental images of human beings · Geetha et al., 2020; backpropagation Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. (2022) | Accuracy 97.1 | 1 study · 105 participants | Ungraded |
Electrical conductance or impedance vs Reference standard (histology, operative excavation, or enhanced visual examination) Specificity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 2: network meta-analysis (all studies evaluating >=2 index tests) Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity 0.72 [0.44, 0.89] | 64 studies · 24567 participants | Low |
Intervention NR Difference in summary specificity (NMA, Analysis 2) · Electrical conductance vs Visual Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity difference (95% CrI) -0.08 [-0.37, 0.10] | NR | Ungraded |
Intervention NR Difference in summary sensitivity (NMA, Analysis 2) · Electrical conductance vs Transillumination Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Sensitivity difference (95% CrI) 0.06 [-0.12, 0.22] | NR | Ungraded |
Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction Molar caries detection accuracy · Dental images of human beings · Lee et al., 2018; CNN Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. (2022) | Accuracy 89 | 1 study · 3000 participants | Ungraded |
Imaging (analog or digital radiographs) vs Reference standard (histology, operative excavation, or enhanced visual examination) Sensitivity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 2: network meta-analysis (all studies evaluating >=2 index tests) Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Sensitivity 0.50 [0.40, 0.59] | 64 studies · 24567 participants | Low |
Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction Occlusal caries detection accuracy · Dental images of human beings · Casalegno et al., 2018; CNN Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. (2022) | Accuracy 83.6 | 1 study · 217 participants | Ungraded |
Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction Occlusal caries detection accuracy · Dental images of human beings · Moutselos et al., 2019; MASK R-CNN; most common class Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. (2022) | Accuracy 88.9 | 1 study · 88 participants | Ungraded |
Intervention NR Difference in summary specificity (NMA, Analysis 2) · Fluorescence vs Visual Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity difference (95% CrI) 0.02 [-0.07, 0.11] | NR | Ungraded |
Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction Occlusal caries detection accuracy · Dental images of human beings · Moutselos et al., 2019; MASK R-CNN; center pixel class Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. (2022) | Accuracy 77.8 | 1 study · 88 participants | Ungraded |
Imaging (analog or digital radiographs) vs Reference standard (histology, operative excavation, or enhanced visual examination) Specificity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 1: fully within-person comparison (studies evaluating >=3 index tests) Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Specificity 0.92 [0.84, 0.96] | 19 studies · 2849 participants | Ungraded |
Intervention NR Difference in summary sensitivity (NMA, Analysis 2) · Transillumination vs Visual Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022) | Sensitivity difference (95% CrI) -0.06 [-0.19, 0.05] | NR | Ungraded |
Oral cytology (e.g. OralCDx brush biopsy, CytID) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Outcome NR · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Oral cytology (e.g. brush biopsy) was added to the list of eligible index tests in this update; no eligible studies evaluated it (evidence gap). | 0 studies | No studies |
Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | AUC 0.72 | 8 studies | Ungraded |
Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation) Specificity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), Non-histology reference standard (excavation, radiographs, separation) Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Specificity 0.86 [0.76, 0.92] | NR | Ungraded |
Analogue (conventional) radiographs vs Reference standard (histology, excavation, or enhanced visual examination) Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.44 [0.38, 0.50] | 51 studies | Ungraded |
Conventional bitewing radiography, E-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.42 [0.28, 0.57] | 9 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Reference standard: enhanced visual (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.47 [0.29, 0.66] | 8 studies | Ungraded |
Conventional bitewing radiography, E-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 31.40 [14.31, 68.93] | 5 studies | Ungraded |
Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation) Sensitivity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), Primary/mixed dentition Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Sensitivity 0.87 [0.80, 0.92] | NR | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Permanent dentition (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.44 [0.37, 0.51] | NR | Ungraded |
Digital bitewing radiography, phosphor plate (PSP) vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Specificity 0.60 [0.20, 0.90] | 1 study | Ungraded |
Visual classification: ICDAS (International Caries Detection and Assessment System) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation) Specificity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies) Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Specificity 0.76 [0.67, 0.83] | 36 studies | Ungraded |
Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Specificity 0.88 [0.74, 0.95] | 8 studies | Ungraded |
Cone beam computed tomography (CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Proximal surfaces (CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Specificity 0.90 [0.77, 0.96] | NR | Ungraded |
Dental imaging (analog or digital radiographs) vs Visual classification Difference in sensitivity · Children or adults asymptomatic or suspected of enamel caries; extracted teeth · Analysis 1: fully within-person comparison Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2021) | Difference in sensitivity -0.34 [-0.49, -0.17] | 19 studies · 2849 participants | Ungraded |
Digital bitewing radiography, phosphor plate (PSP) vs Direct visual examination after tooth separation or bioptical cavity preparation Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.83 [0.77, 0.88] | 1 study | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Dentine-caries (D3) prevalence medium 15-34% (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.51 [0.40, 0.61] | NR | Ungraded |
Near-infrared (NIR) transillumination vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography) Sensitivity for detection of enamel/early caries · Children or adults presenting asymptomatically or suspected of having enamel caries (clinical/in vivo studies);… · Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately) Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries (2021) · Cochrane | Sensitivity 0.58 [0.46, 0.68] | 5 studies | Ungraded |
Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation) Specificity for detection of enamel caries · Asymptomatic children or adults presenting for clinical examination (in vivo studies), or extracted teeth of children… · Up to 3 months between index test and reference standard (in vivo studies), High prevalence of dentine caries (>= 35%) Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries (2021) · Cochrane | Specificity 0.75 [0.66, 0.82] | NR | Ungraded |
Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 8.7 [4.2, 18.1] | 3 studies | Ungraded |
Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Specificity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Summary of findings 4 (no pooled analysis): specificity 0.99 (95% CI 0.99 to 1.00), 1.00 (95% CI 0.91 to 1.00), and 0.72 (95% CI 0.63 to 0.80) across the 3 studies. Certainty VERY LOW. | 3 studies · 3600 participants | Very low |
Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs) Sensitivity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or… · Up to 3 months between index test and reference standard (in vivo studies), Permanent dentition Electrical conductance for the detection of dental caries (2021) · Cochrane | Permanent dentition (4 studies): sensitivity ranged from 0.55 to 0.65. | 4 studies | Ungraded |
Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Sensitivity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Summary of findings 4 (no pooled analysis): sensitivity 0.85 (95% CI 0.81 to 0.88), 0.82 (95% CI 0.57 to 0.96), and 0.94 (95% CI 0.70 to 1.00) across the 3 studies. Prevalence 12.2% to 30.9%. Certainty VERY LOW. | 3 studies · 3600 participants | Very low |
Conventional bitewing radiography, D-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Specificity 0.99 [0.96, 0.999] | 1 study | Ungraded |
Digital bitewing radiography, sensor-based (CCD/CMOS) vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (caries detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Caries detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 5.01 [2.83, 8.88] | 12 studies | Ungraded |
Visual examination (VE) vs Cavity preparation or biopsy (operative validation) Diagnostic accuracy for occlusal caries detection at the caries detection level (D0 versus D1-D4) · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | AUC 0.70 | 2 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Permanent dentition (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Specificity 0.90 [0.85, 0.93] | NR | Ungraded |
Conventional bitewing radiography, F-speed film vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | Sensitivity 0.42 [0.29, 0.56] | 3 studies | Ungraded |
Conventional bitewing radiography (E-speed film) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography) Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | Sensitivity 0.48 [0.21, 0.77] | 2 studies | Ungraded |
Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination) Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted… · Up to 3 months between index test and reference standard (in vivo studies), Dentine-caries (D3) prevalence low <15% (non-CBCT) Imaging modalities to inform the detection and diagnosis of early caries (2021) · Cochrane | Sensitivity 0.36 [0.25, 0.47] | NR | Ungraded |
Digital bitewing radiography, sensor-based (CCD/CMOS) vs Histological validation of dental tissues (gold standard) Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro) · Dentin detection level Systematic review and meta-analysis of diagnostic studies of proximal surface caries. (2021) | DOR 12.84 [6.56, 25.13] | 4 studies | Ungraded |
Visual examination (VE) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography) Diagnostic accuracy for occlusal caries detection at the dentin caries detection level (D0-2 versus D3-4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. (2021) | Sensitivity 0.46 [0.20, 0.73] | 8 studies | Ungraded |