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What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 6: corrosion · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with corrosion, surveyed dentists most often preferred replacement over repair (pooled RR 1.59; p < 0.001); ungraded.

1 finding from 1 review

Dental treatments, care, and services (the decision context) vs No comparator

Fear of SARS-CoV-2 infection (COVID-19) as a barrier to dental treatment · (Potential) patients with freedom of choice regarding dental treatments, including parents and caregivers deciding for children or…

One study found that fear of SARS-CoV-2 infection led US patients to postpone and cancel dental treatments, with dental care most affected (38.1% delays; ungraded).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 4: marginal discoloration · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

Subgroup (HDI: Very high): pooled preference was replacement over repair for a defective amalgam restoration with marginal discoloration (RR 6.48); significant HDI variation, p = 0.01.

5 findings from 1 review
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Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs No biomimetic remineralization (control)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Control showed no significant difference in 24 h bond strength (MD 1.530, 95% CI -2.373 to 5.434; Moderate certainty).

3 findings from 1 review

Electronic cigarette use vs Non-smokers

IL-1β level · People who use electronic cigarettes

The review reports no significant e-cigarette effect on salivary IL-1β.

3 findings from 1 review

Higher national income (GNI per capita) vs Lower national income (GNI categories: middle <=$15,000 / high $15,001-25,000 / very high >$25,000)

Caries experience (mean DMFT) · 12-year-old children across European countries (national/regional epidemiological surveys, 2011-2022)

Mean DMFT in 12-year-olds rises as national income falls: 0.90 (very high income), 2.38 (high income), 3.30 (middle income) (Figure 2); not GRADE-rated.

3 findings from 1 review

Genetically predicted periodontitis vs Without periodontitis (lower genetic liability)

Lacunar stroke · European-ancestry adults

Genetically predicted periodontitis was associated with modestly higher odds of lacunar stroke (OR 1.24); ungraded MR, though the FDR-adjusted P was 0.064 for the primary IVW-FE method (ML-adjusted P 0.037).

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

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
    Studies not reported
    GRADE not reported

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Oral health-related quality of life · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

No included study reported oral health-related quality of life (a planned outcome), so no evidence is available.

1 finding from 1 review

Partial pulpotomy with permanent restoration after more than 14 days vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Permanent restoration after more than 14 days was associated with a pooled success rate of 23.2%.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Mean DMFT (decayed, missing, filled permanent teeth) · school‐age children and adolescents

Theory-based interventions showed no significant effect on DMFT scores (SMD -0.11; low certainty).

1 finding from 1 review