What do systematic reviews say?

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Sensitivity 0.88 [0.81, 0.92]
  36 studies
  GRADE not reported

Potassium containing toothpaste (5% potassium nitrate) vs Control toothpaste (without potassium)

Potassium containing toothpaste (5% potassium nitrate) showed no clear difference in subjective assessment of sensitivity compared with control toothpaste (without potassium); GRADE not reported.

• Potassium containing toothpastes for dentine hypersensitivity 2006 · Cochrane All outcomes

  6 to 8 weeks
  SMD -0.67 [-1.44, 0.10]
  3 studies · 206 participants
  GRADE not reported

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

AI algorithms have high pooled sensitivity (0.85) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%) and evidence of publication bias.

• Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes

  Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
  Sensitivity 0.85 [0.83, 0.93]
  20 studies · 29423 participants
  GRADE not reported

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

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.

• 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

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Sensitivity 0.50 [0.12, 0.88]
  1 study · 3895 participants
  Moderate

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Sensitivity 0.40 [0.05, 0.85]
  1 study · 4080 participants
  Moderate

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)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  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

Mouth self-examination (MSE) 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)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 2 (no pooled analysis): sensitivity 0.18 (95% CI 0.13 to 0.24), 0.09 (95% CI 0.04 to 0.15), 0.43 (95% CI 0.24 to 0.63), and 0.33 (95% CI 0.10 to 0.65) across the 4 studies. Prevalence 0.6% to 63.6%.…
  4 studies · 35059 participants
  Very low

Visual examination (VE) 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)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 1 (no pooled analysis): for the 7 studies with low prevalence (<=10%) sensitivity ranged from 0.50 (95% CI 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); for the 3 higher-prevalence studies…
  10 studies · 25568 participants
  Low