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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · Oral Health

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No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

Fluoride in rinse vs no treatment

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between fluoride in rinse and no treatment at every displayed randomization year; certainty was not graded.

1 finding from 1 review

Fluoride in dentifrice vs placebo

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between fluoride in dentifrice and placebo at every displayed randomization year; certainty was not graded.

1 finding from 1 review

Women who experienced preterm birth vs Women who did not experience preterm birth (term)

Decayed, missing, filled surfaces (DMFS) · pregnant women

Women who experienced preterm birth did not have a significantly different DMFS than those who did not (mean difference -0.15, 95% CI -3.40 to 3.09; 3 studies; I2=89%); certainty of evidence not graded.

1 finding from 1 review
  • Dental caries and preterm birth: a systematic review and meta-analysis. 2018 All outcomes
    Pregnant women assessed around delivery in observational studies across multiple countries (Mexico, Malawi, India, France, Jordan, Finland, Tanzania); mostly retrospective cohort and case-control designs
    MD -0.15 [-3.40, 3.09]
    3 studies · 2594 participants
    GRADE not reported

Radiographic caries detection vs Reference standard (often histological; also invasive opening)

Advanced proximal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled sensitivity for radiographic detection of advanced proximal lesions was 0.444 (95% CI 0.38 to 0.51).

8 findings from 1 review
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Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for advanced occlusal caries was 0.53 (95% CI 0.46 to 0.62) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled sensitivity of visual detection for all (initial and advanced) occlusal caries was 49.1% (95% CI 40 to 58) (ungraded).

3 findings from 1 review

Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, the negative lr of radiographic detection for all (initial and advanced) proximal caries was 0.65 (95% CI 0.57 to 0.74) (ungraded).

3 findings from 1 review

Fluoride in dentifrice vs no treatment

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between fluoride in dentifrice and no treatment at every displayed randomization year; certainty was not graded.

1 finding from 1 review

Conventional restorative treatment with compomer vs Other network treatments

Treatment success rate · Primary teeth with dentin caries lesions on occlusal surfaces

CRT with compomer ranked first for treatment success in the occlusal-surface network (low certainty).

1 finding from 1 review

Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)

Visual inspection scores · Patients with early caries lesions in permanent teeth (non-fluoridated water area)

Two trials reported visual inspection scores but could not be pooled (different criteria, missing standard deviations) and gave inconsistent findings, so no quantitative conclusion could be drawn.

1 finding from 1 review

Postnatal passive tobacco exposure (secondhand/household smoke in infancy) vs No passive tobacco exposure (non-exposed children)

Dental caries in permanent teeth · Children and adolescents with permanent dentition

Postnatal (infancy) tobacco exposure is associated with higher odds of caries in permanent dentition (pooled OR 1.30, 95% CI 1.25 to 1.34; 9 studies; no heterogeneity); certainty not graded.

1 finding from 1 review

Women who experienced preterm birth vs Women who did not experience preterm birth (term)

Dental caries · pregnant women

Women who experienced preterm birth did not have significantly higher DMFT than those who did not (mean difference 1.56, 95% CI -0.28 to 3.41; 5 studies; I2=92%); certainty of evidence not graded.

1 finding from 1 review
  • Dental caries and preterm birth: a systematic review and meta-analysis. 2018 All outcomes
    Pregnant women assessed around delivery in observational studies across multiple countries (Mexico, Malawi, India, France, Jordan, Finland, Tanzania); mostly retrospective cohort and case-control designs
    MD 1.56 [-0.28, 3.41]
    5 studies · 2963 participants
    GRADE not reported

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the positive lr of radiographic detection for advanced proximal caries was 9.82 (95% CI 7.3 to 13.3) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, pooled specificity of radiographic detection for advanced proximal caries was 95.5% (95% CI 94 to 97) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of visual detection for all (initial and advanced) occlusal caries was 0.19 (95% CI 0.15 to 0.25) (ungraded).

3 findings from 1 review

Placebo vs no treatment

Caries increment in permanent teeth · Children or adolescents

The NMR reported an SMD by randomisation year; no GRADE assessment was reported.

1 finding from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the positive lr of radiographic detection for all (initial and advanced) occlusal caries was 1.74 (95% CI 1.3 to 2.4) (ungraded).

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for all (initial and advanced) occlusal caries was 0.79 (95% CI 0.65 to 0.96) (ungraded).

3 findings from 1 review