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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 |
|---|---|---|---|
Fluoride varnish vs Placebo or no treatment Adverse effects / specific side effects (oral allergic reactions, mucosal irritation, adverse symptoms such as nausea, gagging, vomiting) · Children and adolescents aged 16 years or less · At least 1 year Fluoride varnishes for preventing dental caries in children and adolescents (2013) · Cochrane | Three trials (Salazar 2008; Skold 2005; Weintraub 2006) provided data reporting no adverse effects. There was little information concerning possible adverse effects; no pooled estimate was possible. | 3 studies | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing Plaque (plaque 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 0.10 [-0.13, 0.33] | 7 studies · 326 participants | Low |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by reference standard (LF, 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 4.13 [1.24, 13.76] | NR | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing Gingivitis (bleeding and gingival indices; standardised across indices) · Dentate adults aged 16 years and older · 3 months (12 weeks) Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults (2013) · Cochrane | SMD -1.98 [-5.42, 1.47] | 2 studies · 107 participants | Very low |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing 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 |
Resin composite restorations (filling and bonding systems) containing antibacterial agents vs Composite restorations not containing antibacterial agents Patient's view and satisfaction with the treatment · 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 |
Fluoride varnish vs Placebo or no treatment Caries increment in primary/deciduous teeth: decayed, (extraction indicated/missing) and filled teeth d(e/m)ft (prevented fraction) · 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 | PF 0.65 [0.48, 0.82] | 2 studies · 322 participants | 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 posterior 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 |
Interdental brushing plus toothbrushing vs Toothbrushing alone Quality of life · 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 quality of life as an outcome. (See comment) | 0 studies | No studies |
Resin-based fissure sealants vs Glass-ionomer cement-based fissure sealants Retention-to-caries risk ratio (RCR) · Patients with fissure-sealed permanent molar teeth · Longest follow-up per trial, Sensitivity analysis Validity of sealant retention as surrogate for caries prevention--a systematic review. (2013) | Mean RCR (retention-to-caries risk ratio); t-test of difference Resin vs GIC difference not statistically significant (p=0.069); sensitivity-analysis mean RCRs not reported | 14 studies | 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) | Sensitivity 0.777 [0.706, 0.838] | 2 studies | Ungraded |
DHAT-delivered dental care vs Dentist-delivered dental care Composite 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 composite restorations 15% vs 12% | 2 studies | Ungraded |
Resin composite restorations (filling and bonding systems) containing antibacterial agents vs Composite restorations not containing antibacterial agents Adverse effects · 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 |
Fluorescence camera (FC) vs Reference standard More advanced caries lesion detection · Primary teeth with occlusal surfaces · More advanced caries lesion threshold, FC, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.898 [0.867, 0.924] | 2 studies | Ungraded |
Pen-type laser fluorescence (LFpen) vs Reference standard Initial caries lesion detection · Primary teeth with occlusal surfaces · Initial caries lesion threshold, LFpen, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.719 [0.677, 0.757] | 5 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) Changes in dental attendance · Children aged 4 to 12 years attending primary school Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | Worthington 2001 found no change in reported dental visits over the course of the programmes, with 97% of children at baseline reporting visiting the dentist every 2 years. | 1 study | Ungraded |
Interdental brushing plus toothbrushing vs Toothbrushing alone Gingivitis (Loe-Silness gingival index, interproximal; scale 0 to 4) · Dentate adults aged 16 years and older · 4 weeks (1 month) Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults (2013) · Cochrane | MD -0.53 [-0.83, -0.23] | 1 study · 62 participants | Very low |
Pen-type laser fluorescence (LFpen; DIAGNOdent pen) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by setting (LFpen, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold, Laboratory vs clinical (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 0.35 [0.04, 2.99] | NR | Ungraded |
Glass-ionomer cement-based fissure sealants vs No comparator (within-material surrogate-validity regression) Association between loss of complete retention risk and caries occurrence risk · Patients with fissure-sealed permanent molar teeth · At least 24 months, Main analysis Validity of sealant retention as surrogate for caries prevention--a systematic review. (2013) | Regression slope (ln caries risk on ln retention-loss risk) 0.81 [-0.07, 1.68] | 22 studies · 3768 participants | Ungraded |
Intervention NR Risk of loss of complete retention · Main analysis; resin-based (Mat 1) Validity of sealant retention as surrogate for caries prevention--a systematic review. (2013) | Mean risk (proportion of sealed teeth) 0.36 (SD 0.23) | 54 studies | Ungraded |
Fluorescence camera (FC) vs Reference standard Initial caries lesion detection · Permanent teeth with occlusal surfaces · Initial caries lesion threshold, FC, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.708 [0.669, 0.745] | 8 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) | Specificity 0.712 [0.690, 0.734] | 27 studies | Ungraded |
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, Operative intervention vs histological (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 3.01 [1.26, 7.20] | NR | Ungraded |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by reference standard (LF, initial, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions · Initial caries lesions threshold, Operative intervention vs histological (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 0.91 [0.37, 2.22] | NR | 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) Behavioural outcomes (reported and/or other measures, e.g. data tracking toothbrushes and collecting food wrappers) · Children aged 4 to 12 years attending primary school Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | No other behavioural outcomes (e.g. objective toothbrush tracking or food-wrapper collection) were measured by the four included studies. | 0 studies | No studies |
Fluoride varnish vs Placebo or no treatment Proportion of children developing one or more new caries (permanent dentition, D(M)FT) · Children and adolescents aged 16 years or less · At least 1 year Fluoride varnishes for preventing dental caries in children and adolescents (2013) · Cochrane | RR 0.75 [0.53, 1.05] | 5 studies · 3253 participants | Ungraded |
Laser fluorescence (LF) vs Reference standard More advanced caries lesion detection · Permanent teeth with occlusal surfaces · More advanced caries lesion threshold, LF, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.779 [0.765, 0.794] | 37 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, approximal 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 8); only LFpen had sufficient studies to pool; similar values at both thresholds. Heterogeneity I2=93%. Numeric pooled… | NR | Ungraded |
Resin-based fissure sealants vs No comparator (within-material surrogate-validity regression) Association between loss of complete retention risk and caries occurrence risk · Patients with fissure-sealed permanent molar teeth · At least 24 months, Main analysis Validity of sealant retention as surrogate for caries prevention--a systematic review. (2013) | Regression slope (ln caries risk on ln retention-loss risk) 0.89 [0.56, 1.23] | 54 studies · 17377 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, Medium-intensity training Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in BBTD prevalence 18 | 1 study | Ungraded |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by setting (LF, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions · More advanced (dentine/cavitated) caries lesions threshold, Laboratory vs clinical (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 0.28 [0.12, 0.66] | NR | 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) | Sensitivity 0.831 [0.723, 0.909] | 5 studies | Ungraded |
DHAT-delivered dental care vs Dentist-delivered dental care Consistency of diagnosis and postoperative complications · Alaska dental health aide therapists Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | There was no significant difference between DHATs and dentists in consistency of diagnosis or postoperative complications. | 1 study | Ungraded |
Community and caregiver oral health education (training community volunteers, health workers and site coordinators; caregiver counselling; oral health media campaign) vs Pre-intervention baseline (and sites that discontinued the prevention program) Reduction in prevalence of baby bottle tooth decay (BBTD) · Alaska Native and American Indian Head Start (preschool) children · 3 to 8 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in BBTD prevalence 25 | 1 study | Ungraded |
Ongoing BBTD Prevention Program vs BBTD Prevention Program discontinued in 1989 Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children · 1986 to 1994, Program discontinued Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in tooth decay rate 15 | 1 study | Ungraded |
Fluorescence camera (FC; VistaProof) 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 highest for FC among the three methods. Heterogeneity I2=80%. Numeric pooled values not available in the… | NR | Ungraded |
PDHA program vs Baseline pre-intervention scenario Mean decayed missing and filled teeth · Alaska children below age 5 years · 20 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Mean DMFT 7.4 to 4.9 | 1 study | Ungraded |
Ongoing BBTD Prevention Program vs BBTD Prevention Program discontinued in 1989 Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children · 1986 to 1994, Program maintained Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in tooth decay rate 28 | 1 study | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing Quality of life · 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 quality of life as an outcome. (See comment) | 0 studies | No studies |
Intervention NR Caries occurrence on sealed teeth · 24 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 2.10 [1.23, 3.58] | 4 studies | Ungraded |
Laser fluorescence (LF) vs Reference standard More advanced caries lesion detection · Permanent teeth with occlusal surfaces · More advanced caries lesion threshold, LF, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.809 [0.791, 0.827] | 37 studies | Ungraded |
Glass-ionomer cement-based fissure sealants vs No comparator (within-material surrogate-validity regression) Association between loss of complete retention risk and caries occurrence risk · Patients with fissure-sealed permanent molar teeth · Longest follow-up per trial, Sensitivity analysis Validity of sealant retention as surrogate for caries prevention--a systematic review. (2013) | Regression slope (ln caries risk on ln retention-loss risk) 1.44 [0.71, 2.18] | 14 studies · 2307 participants | 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) Adverse events · Children aged 4 to 12 years attending primary school Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | No study reported any adverse events. | 0 studies | No studies |
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, approximal 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 8); only LFpen had sufficient studies to pool. Heterogeneity I2=84%. Numeric pooled values not available in the provided… | NR | Ungraded |
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by setting (LF, 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 0.45 [0.12, 1.67] | NR | Ungraded |
Pen-type laser fluorescence (LFpen; DIAGNOdent pen) vs Reference standard (histological examination, operative intervention, or other/visual examination) Relative DOR by setting (LFpen, 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 1.27 [0.18, 8.79] | NR | Ungraded |
Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs 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 0.27 [0.05, 1.60] | 3 studies · 172 participants | Low |
Laser fluorescence (LF) vs Reference standard More advanced caries lesion detection · Primary teeth with occlusal surfaces · More advanced caries lesion threshold, LF, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.672 [0.616, 0.725] | 13 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) · Primary 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 7); accuracy similar among the three methods. Heterogeneity I2=0%. Numeric pooled values not available in the provided… | NR | Ungraded |
DHAT-delivered dental care vs Dentist-delivered dental care Stainless steel crown preparation and placement deficiency · Alaska dental health aide therapists Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Proportion deficient 0% for preparations; 3% vs 9% for placements | 2 studies | Ungraded |