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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
5,762 questions in 263 reviews · Dental caries
current versionsNo studies 321 · 5.6%Ungraded 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No intervention or delayed intervention (non-intervention control; one trial's control received dental treatment plus an annual supervised toothbrushing session) Plaque indices (permanent and deciduous teeth) · Children aged 4 to 12 years attending primary school · 3 to 15 months Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | SoF (Plaque indices, follow-up 3 to 15 months): 'All 3 RCTs showed a reduction in plaque in the intervention group compared to control group'; 827 participants (3 RCTs); GRADE low; comment 'Data not suitable for… | 3 studies · 827 participants | Low |
Fluorescence camera (FC; VistaProof) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by setting (FC, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold, Laboratory using frozen teeth vs clinical (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 2.96 [0.36, 24.45] | NR | Ungraded |
Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth · During caries removal Operative caries management in adults and children (2013) · Cochrane | RR 0.23 [0.08, 0.69] | 2 studies · 141 participants | Moderate |
PDHA program with robust prevention vs PDHA program or PDHA program with intensive staffing Tooth decay-free children · Alaska children aged 5 to 18 years · 20 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percentage tooth decay-free >50% vs 8% | 1 study | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard More advanced caries lesion detection · Primary teeth with approximal surfaces · More advanced caries lesion threshold, LFpen, approximal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.958 [0.947, 0.968] | 5 studies | Ungraded |
Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal Failure of restorations · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth · 1 year Operative caries management in adults and children (2013) · Cochrane | RR 0.33 [0.01, 7.62] | 1 study · 32 participants | Very low |
Interdental brushing plus toothbrushing vs Toothbrushing alone Harms and adverse effects · Dentate adults aged 16 years and older Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults (2013) · Cochrane | Not estimable. Only 1 study reported adverse outcomes in terms of problems with the use of the assigned interdental cleaning aids. (See comment) In this comparison the single study (Jared 2005) asked participants to… | 1 study | Ungraded |
Stepwise excavation (two-stage caries removal, re-entry after an interval) vs One stage complete caries removal Progression of caries · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth Operative caries management in adults and children (2013) · Cochrane | None of the eight included studies reported on the primary outcome of progression of caries. | 0 studies | No studies |
Fluorescence camera (FC) vs Reference standard Initial caries lesion detection · Primary teeth with occlusal surfaces · Initial caries lesion threshold, FC, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.482 [0.433, 0.531] | 2 studies | Ungraded |
Pen-type laser fluorescence (LFpen; DIAGNOdent pen) vs Reference standard (histological examination, operative intervention, or other/visual examination) Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); pooled DOR for LFpen lower than for LF and FC. Heterogeneity I2=73%. Numeric pooled values not available in the… | NR | Ungraded |
No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) vs Complete caries removal Failure of restorations · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth · 1 year (2-year and 5-year data also available for Innes 2007) Operative caries management in adults and children (2013) · Cochrane | RR 0.08 [0.02, 0.26] | 1 study · 132 participants | Moderate |
Fluoride varnish vs Placebo or no treatment Proportion of children developing one or more new caries (primary/deciduous dentition, d(e/m)ft) · Children and adolescents aged 16 years or less · At least 1 year, Primary/deciduous dentition Fluoride varnishes for preventing dental caries in children and adolescents (2013) · Cochrane | RR 0.81 [0.62, 1.06] | 5 studies · 1228 participants | Ungraded |
Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children · 3 years, High-intensity training Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in BBTD prevalence 33 | 1 study | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard More advanced caries lesion detection · Permanent teeth with occlusal surfaces · More advanced caries lesion threshold, LFpen, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.724 [0.672, 0.772] | 10 studies | Ungraded |
Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No intervention or delayed intervention (non-intervention control; one trial's control received dental treatment plus an annual supervised toothbrushing session) Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children aged 4 to 12 years attending primary school · 15 months Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | PF 0.65 [0.12, 1.18] | 1 study · 60 participants | Low |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by reference standard (LF, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold, Other reference standard vs histological (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 0.62 [0.15, 2.46] | NR | Ungraded |
Interdental brushing plus toothbrushing vs Toothbrushing alone Bad breath (halitosis) · Dentate adults aged 16 years and older Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults (2013) · Cochrane | Not estimable. No included study assessed bad breath as an outcome. (See comment) | 0 studies | No studies |
Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario Projected Significant Caries (SiC) index · Alaska Native children (below age 18) · 20-year projection, Children overall Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Significant Caries (SiC) index, children 6.1 | 1 study | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing Gingivitis (bleeding and gingival indices; standardised across indices) · Dentate adults aged 16 years and older · 1 month (4 to 6 weeks) Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults (2013) · Cochrane | SMD -0.53 [-0.81, -0.24] | 7 studies · 326 participants | Low |
Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario Projected proportion of caries-free children (5-18 years) · Alaska Native children (below age 18) · 20-year projection, Baseline (pre-intervention) model Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Caries-free children 5-18 y (%) 0 | 1 study | Ungraded |
Intervention NR Caries occurrence on sealed teeth · 12 months, original datasets only (permanent teeth) The modified Ottawa method to establish the update need of a systematic review: glass-ionomer versus resin… (2013) | RR 2.61 [0.61, 11.14] | 2 studies | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard Initial caries lesion detection · Permanent teeth with occlusal surfaces · Initial caries lesion threshold, LFpen, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.818 [0.751, 0.873] | 9 studies | Ungraded |
Conventional glass-ionomer cement (GIC) fissure sealants vs Resin-based fissure sealants Caries occurrence on sealed teeth · Sealed permanent teeth · 12 months, 12 months (permanent teeth) The modified Ottawa method to establish the update need of a systematic review: glass-ionomer versus resin… (2013) | RR 1.66 [0.75, 3.68] | 5 studies · 1952 participants | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard More advanced caries lesion detection · Permanent teeth with approximal surfaces · More advanced caries lesion threshold, LFpen, approximal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.824 [0.761, 0.875] | 2 studies | Ungraded |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions · Initial caries lesions threshold Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); accuracy (sensitivity, specificity, DOR, PLR, NLR, sROC AUC) similar among LF, LFpen and FC. Heterogeneity I2=65%.… | NR | Ungraded |
Resin composite restorations (filling and bonding systems) containing antibacterial agents vs Composite restorations not containing antibacterial agents Secondary caries · Adults and adolescents in any age group with restorations in the permanent dentition and children with restorations in… Antibacterial agents in composite restorations for the prevention of dental caries (2013) · Cochrane | No studies were included in this review, as we were unable to find any trials directly comparing antibacterial containing composites to other active interventions or controls. | 0 studies | No studies |
Resin composite restorations (filling and bonding systems) containing antibacterial agents vs Composite restorations not containing antibacterial agents Costs (direct costs of interventions) · Adults and adolescents in any age group with restorations in the permanent dentition and children with restorations in… Antibacterial agents in composite restorations for the prevention of dental caries (2013) · Cochrane | No studies were included in this review, as we were unable to find any trials directly comparing antibacterial containing composites to other active interventions or controls. | 0 studies | No studies |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 6); pooled DOR higher for LF (and FC) than for LFpen. Heterogeneity I2=77%. Numeric pooled values not available in the… | NR | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard Initial caries lesion detection · Permanent teeth with approximal surfaces · Initial caries lesion threshold, LFpen, approximal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.842 [0.756, 0.907] | 2 studies | Ungraded |
Stepwise excavation (two-stage caries removal, re-entry after an interval) vs One stage complete caries removal Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth · During caries removal, Secondary dentition Operative caries management in adults and children (2013) · Cochrane | RR 0.51 [0.36, 0.72] | 3 studies · 454 participants | Moderate |
Dental care provided by dental health aide therapists (DHATs, mid-level providers) vs Dental care provided by dentists (or no comparison group) Technical performance / deficient restorations (DHATs vs dentists) · Alaska Native dental patients (children aged 6-17 and adults) and their caregivers · Cross-sectional (DHATs practising ~9 months to several years), Amalgam restorations Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Deficient restorations (%), DHAT vs dentist 12 vs 22 (DHAT vs dentist) | 2 studies | Ungraded |
DHAT-delivered dental care vs No comparison group Clinical care quality · Alaska dental health aide therapists · 9 months Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Four practising DHATs met Indian Health Service guidelines for record keeping and standards of care for cavity preparation and restoration, patient management, and patient safety. | 1 study | Ungraded |
Pen-type laser fluorescence (LFpen; DIAGNOdent pen) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by reference standard (LFpen, initial, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions · Initial caries lesions threshold, Other reference standard vs histological (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 4.41 [0.19, 103.92] | NR | Ungraded |
Intervention NR Caries occurrence on sealed teeth · 6 months, original datasets only (permanent teeth) The modified Ottawa method to establish the update need of a systematic review: glass-ionomer versus resin… (2013) | RR 1.81 [0.39, 8.37] | 3 studies | Ungraded |
Intervention NR Risk of loss of complete retention · Main analysis; GIC-based (Mat 2) Validity of sealant retention as surrogate for caries prevention--a systematic review. (2013) | Mean risk (proportion of sealed teeth) 0.84 (SD 0.19) | 22 studies | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard Initial caries lesion detection · Primary teeth with approximal surfaces · Initial caries lesion threshold, LFpen, approximal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.354 [0.324, 0.385] | 5 studies | Ungraded |
A permanent restorative material or technique (e.g. amalgam; glass ionomer (type I-IV); composite resin (macrofilled, microfilled, hybrid, nanofilled); resin-modified glass ionomer (compomer, giomer); cement/cermet; stainless steel or nickel-chrome crown; pre-fabricated resin/porcelain veneer facing; microabrasion) vs A different permanent restorative material or technique Outcome NR · Children and adolescents under 18 years with amelogenesis imperfecta requiring restorative care of anterior teeth,… Interventions for the restorative care of amelogenesis imperfecta in children and adolescents (2013) · Cochrane | Main results: No studies met the inclusion criteria for this review. Effects of interventions: No studies met the inclusion criteria. | 0 studies | No studies |
PDHA program vs Baseline pre-intervention scenario Clinic-based dental care utilization · Alaska children · 20 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percentage-point increase 15 | 1 study | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard More advanced caries lesion detection · Permanent teeth with occlusal surfaces · More advanced caries lesion threshold, LFpen, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.718 [0.683, 0.751] | 10 studies | Ungraded |
Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario Projected receipt of school-based prevention services · Alaska Native children (below age 18) · 20-year projection Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Children receiving school-based prevention services (%) >90 | 1 study | Ungraded |
Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No intervention or delayed intervention (non-intervention control; one trial's control received dental treatment plus an annual supervised toothbrushing session) Change in oral health knowledge and skills · Children aged 4 to 12 years attending primary school Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | Worthington 2001 reported changes in oral health knowledge and skills: improvement was apparent in both intervention and control groups at the 4-month follow-up (phase one) but greater in the intervention group (34%… | 1 study | Ungraded |
Stepwise excavation (two-stage caries removal, re-entry after an interval) vs One stage complete caries removal Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth · During caries removal, Primary dentition Operative caries management in adults and children (2013) · Cochrane | RR 0.31 [0.17, 0.57] | 2 studies · 173 participants | Moderate |
Pen-type laser fluorescence (LFpen; DIAGNOdent pen) vs Reference standard (histological examination, operative intervention, or other/visual examination) Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Primary teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); pooled DOR intermediate for LFpen among the three methods. Heterogeneity I2=31%. Numeric pooled values not available… | NR | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing Interproximal caries · Dentate adults aged 16 years and older Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults (2013) · Cochrane | Not estimable. No included study assessed caries as an outcome. (See comment) | 0 studies | No studies |
DHAT-delivered dental care vs Dentist-delivered dental care Amalgam restoration deficiency · Alaska dental health aide therapists Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Proportion of deficient amalgam restorations 12% vs 22% | 2 studies | Ungraded |
Stepwise excavation (two-stage caries removal, re-entry after an interval) vs One stage complete caries removal Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth · 1 year Operative caries management in adults and children (2013) · Cochrane | RR 0.78 [0.39, 1.58] | 2 studies · 278 participants | Moderate |
Pen-type laser fluorescence (LFpen; DIAGNOdent pen) vs Reference standard (histological examination, operative intervention, or other/visual examination) Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, approximal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); LFpen showed similar values at both thresholds. Heterogeneity I2=84%. Numeric pooled values not available in the… | NR | Ungraded |
DHAT-delivered dental care vs Dentist-delivered dental care Caregiver satisfaction · Caregivers of Alaska Native children aged 6 to 17 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Proportion usually or always satisfied >90% | 1 study | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard More advanced caries lesion detection · Primary teeth with occlusal surfaces · More advanced caries lesion threshold, LFpen, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.864 [0.834, 0.890] | 5 studies | Ungraded |
Laser fluorescence (LF) vs Reference standard Initial caries lesion detection · Permanent teeth with occlusal surfaces · Initial caries lesion threshold, LF, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.779 [0.763, 0.794] | 27 studies | Ungraded |