Gap finder

Search review questions

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.

Limit to evidence status or GRADE (optional)

31 questions in 8 reviews · cluster CL0149

current versions
No studies 7 · 22.6%Ungraded 9 · 29%Very low 11 · 35.5%Low 2 · 6.5%Moderate 2 · 6.5%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

QuestionEffectEvidenceStatus / GRADE
Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste
Adverse effects / harms (side effects) · Children, adolescents and adults undergoing fixed (multi-bracket) orthodontic treatment · During treatment
Fluoride mouthrinses for prevention of initial caries in orthodontic patients - a systematic review and… (2025)
No side- or adverse effects were reported in any of the included reports.7 studies · 704 participantsUngraded
Ate or licked fluoride toothpaste vs Did not eat or lick fluoride toothpaste
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
Nine studies investigated whether children ate or licked toothpaste; measurement subjective so not meta-analyzed (Table 1). Findings mixed: some studies found no significant difference; others (e.g. Celeste 2016 OR up…9 studiesUngraded
Used a pea-sized amount of fluoride toothpaste or less vs Used more than a pea-sized amount
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 0.92 [0.66, 1.28]3 studies · 2037 participantsVery low
Started toothbrushing with fluoride toothpaste at or before 12 months (earlier start) vs Started after 12 months (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 0.83 [0.41, 1.67]1 study · 134 participantsVery low
Started toothbrushing with fluoride toothpaste before 4 years (earlier start) vs Started after 4 years (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 1.60 [0.77, 3.35]2 studies · 1484 participantsVery low
Fluoride toothpaste less than 1000 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 0.89 [0.52, 1.52]2 studies · 258 participantsVery low
Started toothbrushing with fluoride toothpaste before 24 months (earlier start) vs Started after 24 months (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 2.25 [1.19, 4.23]6 studies · 1223 participantsVery low
Fluoride toothpaste less than 1000 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 0.79 [0.62, 1.02]3 studies · 2037 participantsVery low
Started toothbrushing with fluoride toothpaste at or before 24 months (earlier start) vs Started after 24 months (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
RR 0.83 [0.61, 1.13]1 study · 3939 participantsVery low
Started toothbrushing with fluoride toothpaste at or before 12 months (earlier start) vs Started after 12 months (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
RR 0.98 [0.81, 1.18]2 studies · 260 participantsVery low
Started toothbrushing with fluoride toothpaste at or before 24 months (earlier start) vs Started after 24 months (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 1.12 [0.89, 1.42]5 studies · 3592 participantsVery low
Started toothbrushing with fluoride toothpaste before 12 months (earlier start) vs Started after 12 months (later start)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 1.22 [0.98, 1.52]7 studies · 4329 participantsVery low
Fluoride toothpaste 440 ppm (lower concentration) vs Fluoride toothpaste 1450 ppm (higher concentration)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
RR 0.72 [0.58, 0.89]1 study · 1009 participantsModerate
Fluoride toothpaste 550 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm (higher concentration)
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
RR 0.75 [0.57, 0.99]1 study · 959 participantsModerate
Used less than half of the brush of fluoride toothpaste vs Used half or more of the brush
Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years)
Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane
OR 0.77 [0.41, 1.46]2 studies · 258 participantsVery low
1400/250 ppm F (amine F/SnF2) toothpaste + mouthrinse, daily vs 1400/250 ppm F (NaF) toothpaste + mouthrinse, daily
Adverse effects · Orthodontic patients of any age with fixed braces (new DLs assessed at debond) · At debond (end of orthodontic treatment)
Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment (2019) · Cochrane
Additional SoF Table 2. Adverse effects: none of the trials reported this outcome.0 studiesNo studies
1450 ppm F toothpaste vs 440 ppm F toothpaste
Adverse effects of toothpaste · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)
Fluoride toothpastes of different concentrations for preventing dental caries (2019) · Cochrane
Adverse effects of toothpaste: no studies reported this outcome.0 studiesNo studies
1450 ppm F toothpaste vs 250 ppm F toothpaste
Adverse effects of toothpaste · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)
Fluoride toothpastes of different concentrations for preventing dental caries (2019) · Cochrane
Adverse effects of toothpaste: no studies reported this outcome.0 studiesNo studies
1055 to 1100 ppm F toothpaste vs 500 to 550 ppm F toothpaste
Adverse effects of toothpaste · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start) · 12 months
Fluoride toothpastes of different concentrations for preventing dental caries (2019) · Cochrane
Adverse effects of toothpaste: not estimable. "There were no reports on adverse effects, but some children complained about the taste of the dentifrice" (Cardoso 2014); 195 participants (1 RCT); low-certainty.1 study · 195 participantsLow
Zinc chloride + sodium fluoride dentifrice vs Control dentifrice (sodium fluoride)
Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced…
Interventions for managing halitosis (2019) · Cochrane
Payne 2011 reported 19 non-oral and 12 oral adverse effects. The oral effects were tingling sensation in lips, dry mouth or sore gums.1 studyUngraded
Fluoride toothpaste (any concentration; pooled across comparisons) vs Lower-concentration or non-fluoride toothpaste (pooled across comparisons)
Adverse effects of toothpaste · Children and adolescents with immature permanent dentition (aged 5 to 16 years at study start) · Closest to 36 months
Fluoride toothpastes of different concentrations for preventing dental caries (2019) · Cochrane
16 studies assessed possible side effects, principally oral (soft tissue) pathologies and tooth staining. 6 studies reported no untoward events; 6 reported greater staining in the stannous fluoride group; 1 reported no…16 studiesUngraded
1500 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste
Adverse effects of toothpaste · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start) · 24 months
Fluoride toothpastes of different concentrations for preventing dental caries (2019) · Cochrane
Adverse effects of toothpaste: not estimable; 0 events reported (Fan 2008); 998 participants (1 RCT); low-certainty.1 study · 998 participantsLow
1000 or 1100 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste
Adverse effects of toothpaste · Adults with mature permanent dentition (aged 18 to 93 years at study start)
Fluoride toothpastes of different concentrations for preventing dental caries (2019) · Cochrane
Adverse effects of toothpaste: no studies reported this outcome.0 studiesNo studies
Sodium bicarbonate toothpaste vs Control toothpaste (without sodium bicarbonate)
Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · 6 weeks
Interventions for managing halitosis (2019) · Cochrane
Adverse events reported by Lomax 2017 were not related to the interventions.1 study · 148 participantsUngraded
Patient-used 5000 ppm F toothpaste, daily vs 1450 ppm F (conventional) toothpaste, daily
Adverse effects · Orthodontic patients of any age with fixed braces (new DLs assessed at debond) · At debond (end of orthodontic treatment)
Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment (2019) · Cochrane
SoF 3. Adverse effects: none of the trials reported this outcome.0 studiesNo studies
0.3% triclosan + PVM/MA + sodium fluoride toothpaste vs Sodium fluoride (control) toothpaste
Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · mean 1 week
Interventions for managing halitosis (2019) · Cochrane
Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events.0 studiesNo studies
Fluoride toothpaste containing 10% xylitol vs Fluoride toothpaste (fluoride-only, no xylitol)
Adverse effects · Children with permanent teeth (schoolchildren) · 2.5 to 3 years
Xylitol‐containing products for preventing dental caries in children and adults (2015) · Cochrane
Adverse effects: both studies reported that there were no adverse effects in either the xylitol or control group.2 studies · 4216 participantsUngraded
Triclosan/copolymer-containing fluoride toothpaste vs Fluoride toothpaste without triclosan
Adverse effects (tooth staining, Meckel Stain Score, 6 months) · Children and adults (aged 16 years or less = children, over 16 = adults) without periodontitis at baseline; in… · 6 months
Triclosan/copolymer containing toothpastes for oral health (2013) · Cochrane
MD -0.15 [-0.60, 0.30]1 study · 325 participantsUngraded
Fluoride toothpaste vs Placebo (non-fluoride) toothpaste
Enamel fluorosis (adverse effect) · Children and adolescents aged 16 years or less · At least 1 year
Fluoride toothpastes for preventing dental caries in children and adolescents (2003) · Cochrane
Fluorosis data have not been reported in any of the trials.0 studiesNo studies
Fluoride toothpaste vs Placebo (non-fluoride) toothpaste
Acquiring extrinsic tooth staining (adverse effect; stannous fluoride toothpaste) · Children and adolescents aged 16 years or less · At least 1 year
Fluoride toothpastes for preventing dental caries in children and adolescents (2003) · Cochrane
RD 0.24 [0.19, 0.30]5 studies · 3948 participantsUngraded
Fluoride toothpaste vs Placebo (non-fluoride) toothpaste
Oral soft tissue lesions (adverse effect) · Children and adolescents aged 16 years or less · At least 1 year
Fluoride toothpastes for preventing dental caries in children and adolescents (2003) · Cochrane
Oral soft tissue lesions reported in 3 trials, none of which with complete or useable data; all three stated "no lesions attributable to product use were noted".3 studiesUngraded