What do systematic reviews say?

Digital radiographs vs Reference standard (histology, excavation, or enhanced visual examination)

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Specificity 0.87 [0.82, 0.91]
  40 studies
  GRADE not reported

Optical coherence tomography (OCT) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Sensitivity 0.94 [0.88, 0.97]
  10 studies
  GRADE not reported

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs)

The review found no eligible studies for this question.

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  No eligible studies. All included studies assessed occlusal surfaces only ('All studies assessed the use of the electrical conductance devices on occlusal surfaces.'); proximal surfaces were a planned surface subgroup…
  0 studies
  No studies found

Optical coherence tomography (OCT) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Specificity 0.83 [0.68, 0.91]
  10 studies
  GRADE not reported

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

The review found no eligible studies for this question.

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Restorations (secondary caries)
  Pre-specified heterogeneity investigation of teeth with previously applied restorations (secondary caries): no study intentionally included restored teeth in its sample. Studies evaluating secondary caries were…
  0 studies
  No studies found

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs)

The review found no eligible studies for this question.

• Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  No eligible studies. 'No studies reported the inclusion of a low prevalence (0% to 14%) of d3/D3 of tooth surfaces'; all included studies reported d3/D3 prevalence of 15% or above, so the planned low-prevalence…
  0 studies
  No studies found

Transillumination and optical coherence tomography devices (all illumination devices combined: NIR, OCT, and FOTI/DIFOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  Sensitivity 0.75 [0.62, 0.85]
  23 studies
  Low

Electrical conductance (e.g. electronic caries monitor, ECM) vs Reference standard: histology or enhanced visual-tactile examination

The review found no eligible studies for this question.

• Tests to detect and inform the diagnosis of root caries 2020 · Cochrane All outcomes
  Electrical conductance was a pre-specified eligible index test but no diagnostic test accuracy study of electrical conductance was included. A study evaluating the electronic caries monitor (ECM) (Wicht 2002) was…
  0 studies
  No studies found

VistaProof (Durr Dental; blue fluorescence, 405 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Analysed as a separate index test (coupled forest plot and SROC plot, Figure 24 / Figure 25; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 18 datasets, 2402 tooth sites.
  17 studies
  GRADE not reported

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Analysed as a separate index test (coupled forest plot and SROC plot, Figure 22 / Figure 23; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 34 datasets, 6842 tooth sites.
  32 studies
  GRADE not reported

Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Analysed as a separate index test (coupled forest plot and SROC plot, Figure 22 / Figure 23; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 46 datasets, 7316 tooth sites.
  45 studies
  GRADE not reported

Red fluorescence devices (DIAGNOdent, DIAGNOdent pen, MidWest; excitation wavelength >655 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  DOR 12.75 [9.74, 16.68]
  68 studies
  GRADE not reported

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Medium dentine-caries prevalence (15% to 34%)
  DOR 15.39 [11.07, 21.41]
  Studies not reported
  GRADE not reported

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Histology or excavation reference standard
  DOR 13.49 [10.25, 17.76]
  Studies not reported
  GRADE not reported

Spectra caries detection device (Air Techniques; blue fluorescence) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  The Spectra caries detection device fits into the blue fluorescence category but no studies provided data for inclusion in the meta-analysis (Markowitz 2015).
  1 study
  GRADE not reported

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Permanent/mixed dentition
  DOR 15.21 [11.35, 20.37]
  Studies not reported
  GRADE not reported

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Low dentine-caries prevalence (<=14%)
  DOR 11.10 [6.88, 17.91]
  Studies not reported
  GRADE not reported

Canary System (Quantum Dental Technologies; red fluorescence, scale 0-100) vs Reference standard: histology, enhanced visual examination with or without radiographs, or excavation

The review found no eligible studies for this question.

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  The Canary System was not used by any included study.
  0 studies
  No studies found

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Sensitivity 0.60 [0.54, 0.65]
  79 studies
  Low

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  DOR 14.12 [11.17, 17.84]
  79 studies
  Low