Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,703 questions · 15,007 findings · 1,416 reviews

No studies found 2,881 · 19.2%GRADE not reported 1,551 · 10.3%Very low 3,111 · 20.7%Low 3,881 · 25.9%Moderate 2,669 · 17.8%High 914 · 6.1%

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Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Streptococcus mutans colonization reduction (narrative; no CFU data reported) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines produced a sustained reduction in Streptococcus mutans colonization on teeth in animal models (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

Hall technique vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, the Hall technique had significantly higher treatment success than placebo (OR 163.59; moderate certainty).

1 finding from 1 review

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

Incidence of initial caries around brackets, aesthetic-zone teeth only · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

When only aesthetic-zone teeth (incisors and canines) were considered, two studies reported a significant reduction in initial caries incidence favoring fluoride mouthrinse (ungraded, narrative; no pooled estimate).

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Salivary / secretory IgA (SIgA) antibody response (immunogenicity) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines, particularly via mucosal (intranasal) routes, elicited increased salivary/secretory IgA responses in the animal studies (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

Inactivated-bacteria tablets vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Improved caries prognosis via restored oral microbiota · Patients after dental filling

Adjuvant postbiotics after dental filling improve caries prognosis by restoring the oral microbiota in one RCT (ungraded).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    14 days · Clinical; salivary/plaque sampling
    One RCT reported that adjuvant postbiotic tablets after dental filling improved caries prognosis by restoring oral microbiota diversity, structure and function and reducing potentially pathogenic bacteria (Liu 2024);…
    1 study
    GRADE not reported

Atraumatic restorative treatment vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, ART had significantly higher treatment success than placebo (OR 16.18).

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Serum IgG antibody response (immunogenicity) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines elicited increased serum IgG antibody responses across the animal studies (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

Conventional restoration vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, conventional restorations had significantly higher treatment success than placebo (OR 44.66).

1 finding from 1 review

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

Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).

1 finding from 1 review

Postbiotic products (postbiotic toothpaste; heat-killed/postbiotic oral lozenges; inactivated-bacteria tablets) vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Streptococcus mutans count · Humans at risk of dental caries (children aged 6-12 years; adults with dental caries)

Postbiotic products reduce salivary S. mutans counts in human trials, though not always significantly (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Daily for 14 days to 4 weeks · Clinical; salivary/plaque sampling
    Three RCTs reported reduced salivary S. mutans counts after postbiotic intervention; the reduction was statistically significant in Lin 2022 but non-significant in Basir 2022; no pooled estimate.
    3 studies
    GRADE not reported

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Development of >=1 new carious lesion (caries incidence) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

In preclinical animal models, anticaries vaccines significantly reduced dental caries risk (pooled RR 0.53, 95% CI 0.46 to 0.62; random-effects), but the evidence is ungraded and limited to short-term animal studies.

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, SDF had significantly higher treatment success than placebo (OR 33.62).

1 finding from 1 review

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

Incidence of initial enamel caries / white spot lesions adjacent to bracket base (subject level, dichotomized) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Adding a fluoride mouthrinse to daily fluoride toothpaste produced a small reduction in the incidence of initial caries/white spot lesions adjacent to brackets (pooled risk difference -0.07, 95% CI -0.14 to -0.01; 5 studies, 491 subjects), but the authors judged the overall evidence inconclusive (ungraded).

1 finding from 1 review

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

Side effects or other adverse events · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

No adverse effects were reported in any of the seven included studies (ungraded).

1 finding from 1 review

Adjunctive antimicrobial photodynamic therapy (aPDT) applied after subgingival instrumentation (SI) vs Subgingival instrumentation (SI) alone (hand or power-driven, or both), or SI plus placebo/sham aPDT

Pocket closure · Adults (> 18 years) with a clinical diagnosis of periodontitis, receiving active (non-surgical anti-infective) treatment
2 findings from 1 review