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Evidence found and GRADE certainty

408 questions · 640 findings · 55 reviews · Oral Health

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No studies found 32 · 5%GRADE not reported 528 · 82.5%Very low 29 · 4.5%Low 44 · 6.9%Moderate 7 · 1.1%High 0 · 0%

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

Dental caries in children · Children of mothers assessed for smoking status during pregnancy (early childhood dental caries)

In the USA study, maternal smoking during pregnancy was associated with increased odds of childhood dental caries (OR 1.85, 95% CI 1.38 to 2.49).

15 findings from 1 review
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Analogue (conventional) radiographs vs Cone beam computed tomography (CBCT) (direct within-person / paired comparison); reference standard: histology

Diagnostic accuracy: analogue versus CBCT (within-person, not pooled) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • 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)
    Direct comparison analogue vs CBCT (within-person): 6 datasets from 3 studies (737 tooth sites or surfaces) provided data, but the results could not be pooled; only individual study results are shown (Figure 21). No…
    3 studies
    GRADE not reported

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

Diagnostic accuracy on surfaces with pit and fissure sealants · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

1 finding from 1 review
  • 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) · Pit and fissure sealants
    Pre-specified heterogeneity investigation of surfaces with pit and fissure sealants: no study reported the inclusion of sealants that would allow evaluation of early caries lesions.
    0 studies
    No studies found

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

Diagnostic accuracy in previously restored teeth (secondary caries) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

1 finding from 1 review
  • 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

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

Quantitative light-induced fluorescence (QLF) change · Patients with early caries lesions in permanent teeth (non-fluoridated water area)

Adding CPP-ACP to fluorides did not significantly change QLF outcomes for smooth-surface early caries lesions versus fluorides alone; not GRADE-rated.

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

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

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

Total lesion area divided by total surface area (visual) · Patients with early caries lesions in permanent teeth (non-fluoridated water area)

Adding CPP-ACP to fluorides did not significantly change the lesion-area outcome for smooth-surface early caries lesions versus fluorides alone; not GRADE-rated.

1 finding from 1 review

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of S. mutans in saliva · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

A few small studies report Streptococcus mutans relative abundance in caries versus caries-free children without pooling; the evidence is ungraded and not meta-analyzed.

1 finding from 1 review

Dental caries (ECC/severe ECC) as exposure/grouping vs Caries-free controls

Relative abundance of Veillonella spp. · Individuals assessed for dental caries, predominantly children with early childhood caries (ECC) or severe ECC (age about 1 to 4 years)

Evidence on whether Veillonella spp. relative abundance is higher or lower in children with dental caries than caries-free controls is inconsistent across 7 small observational studies; no pooled estimate was produced and the evidence is ungraded.

1 finding from 1 review

Remineralizing orthodontic adhesives vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel remineralization / anti-demineralization extent · Human teeth with early enamel lesions surrounding orthodontic brackets

No meta-analysis was conducted; most included in vitro studies reported significant remineralization with remineralizing orthodontic adhesives versus controls.

1 finding from 1 review

Remineralizing orthodontic adhesives vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Ion release · Human teeth with early enamel lesions surrounding orthodontic brackets

No meta-analysis was conducted; most studies reported increased ion release over time, but few reported peak values.

1 finding from 1 review

Er:YAG laser irradiation of enamel after demineralisation vs No anticaries intervention (untreated enamel)

Enamel surface microhardness · Demineralised / white-spot-lesion enamel (in vitro specimens)

In demineralised enamel, Er:YAG laser irradiation did not significantly change surface microhardness versus untreated control (SMD 0.66, 95% CI -1.12 to 2.44; 2 in vitro studies; ungraded).

1 finding from 1 review

Resin infiltration vs CPP-ACFP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration did not differ significantly from CPP-ACFP (SMD -0.52, 95% CI -1.16 to 0.12; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish was significantly better than CPP-ACP (SMD -0.78, 95% CI -1.33 to -0.24; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration was significantly better than fluoride varnish (SMD -0.70, 95% CI -1.18 to -0.21); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs P11-4 + fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration and P11-4 plus fluoride varnish did not differ significantly (SMD 0.01, 95% CI -0.62 to 0.65; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs Self-assembling peptide P11-4

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration did not differ significantly from P11-4 alone (SMD -0.39, 95% CI -0.97 to 0.20); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

SDF plus potassium iodide vs Split into two contrasts: (1) TCS paste (arrest 100%); (2) CPP-ACP (arrest 100%); SDF+KI arrest 54.8% at 24 months, p<.001

Caries arrest · Patients with early enamel carious lesions on permanent molars

SDF plus potassium iodide arrested 54.8% of early enamel lesions at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

P11-4 + fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · People or specimens with white spot lesions or early caries lesions

The NMA estimated an SMD of -0.78 for P11-4 + fluoride varnish versus CPP-ACP (95% CI -1.33 to -0.28).

1 finding from 1 review