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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · All outcomes

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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 gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs Fluoride in rinse

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

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in gel versus fluoride in rinse across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review

Conventional restorative treatment with resin composite (CRT-RC) vs Sealing

Treatment success (caries lesion arrest or restoration survival) · Children with dentin caries lesions in the outer half of dentin on occlusal surfaces of primary teeth

Conventional restorative treatment with resin composite gave a higher treatment success rate than resin sealing for outer-half occlusal dentin caries in primary teeth (2 studies; low certainty).

1 finding 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)

Specificity 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 meta-analysis tailored to Germany, pooled specificity of visual detection for advanced occlusal caries was 96.5% (95% CI 95 to 97) (ungraded).

3 findings from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo

Caries increment in permanent teeth · Children or adolescents

The NMR reported a difference between fluoride in gel and placebo at randomisation years 1954 to 1980; 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)

PPV 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 German private-practice setting, the positive predictive value of radiographic detection for all (initial and advanced) occlusal caries was 22.6% at an assumed prevalence of 11.0% (ungraded).

2 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)

NPV 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 German private-practice setting, the negative predictive value of visual detection for advanced occlusal caries was 85.9% at an assumed prevalence of 22.0% (ungraded).

2 findings from 1 review

Passive tobacco exposure (prenatal maternal smoking or postnatal secondhand/household smoke) vs No passive tobacco exposure (non-exposed children)

Dental caries · Children and adolescents (general population, aged under 20 years)

In children and adolescents, passive tobacco exposure (prenatal or postnatal) is associated with higher odds of dental caries (pooled OR 1.53, 95% CI 1.39 to 1.68; 21 studies), though heterogeneity was high (I2=86.5%); certainty of evidence not graded.

1 finding from 1 review

Dental caries during pregnancy vs Pregnant women without dental caries

Preterm birth stratified by clinical type (spontaneous vs iatrogenic vs term) · pregnant women

The planned subanalysis by type of preterm birth (spontaneous vs iatrogenic vs term) could not be performed because of the small number of cases and lack of information in the original studies.

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 · By type of PTB (spontaneous vs iatrogenic)
    no estimate extracted
    0 studies
    GRADE not reported

Prenatal passive tobacco exposure (maternal smoking during pregnancy / in the womb) vs No passive tobacco exposure (non-exposed children)

Caries presence in primary teeth · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

Prenatal (in-womb) tobacco exposure is associated with higher odds of caries in primary dentition (pooled OR 1.46, 95% CI 1.41 to 1.52; 4 studies; no heterogeneity); certainty not graded.

1 finding from 1 review

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

Laser fluorescence (LF) change · Patients with early caries lesions in permanent teeth (non-fluoridated water area)

For occlusal early caries lesions, adding CPP-ACP to fluorides produced significantly greater laser-fluorescence improvement than fluorides alone (favors the combination); not GRADE-rated.

2 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)

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 meta-analysis tailored to Egypt, the positive lr of visual detection for all (initial and advanced) occlusal caries was 3.73 (95% CI 3.1 to 4.4) (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)

PPV 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 Egyptian public health clinic setting, the positive predictive value of radiographic detection for advanced occlusal caries was 58.3% at an assumed prevalence of 19.0% (ungraded).

2 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)

PPV 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 German private-practice setting, the positive predictive value of visual detection for all (initial and advanced) occlusal caries was 82.0% at an assumed prevalence of 45.0% (ungraded).

2 findings from 1 review

Dental caries during pregnancy vs Pregnant women without dental caries

Preterm birth stratified by gestational age at birth (moderate-to-late 32 to <37, very 28 to <32, extremely <28 weeks) · pregnant women

The planned subanalysis of preterm birth by gestational age at birth (moderate-to-late, very, extremely preterm) could not be performed because of the small number of cases and lack of stratified data in the original studies.

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 · By gestational age at birth
    no estimate extracted
    0 studies
    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)

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 radiographic detection for all (initial and advanced) occlusal caries was 36.0% (95% CI 20 to 56) (ungraded).

3 findings from 1 review