Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Illicit drug use vs People who do not use drugs

Periodontal disease · People who use drugs (PWUD): methamphetamine, heroin, opiate, cannabis and cocaine users

Illicit drug use was not significantly associated with periodontal disease (pooled OR 1.44, 95% CI 0.80-2.60; 5 studies; substantial heterogeneity I2=85%; ungraded).

1 finding from 1 review

Intervention not reported

Dental caries in permanent teeth · Children (permanent dentition) worldwide

In the Americas, the pooled prevalence of permanent-teeth caries in children was 48.9% (95% CI 37.6 to 60.3); certainty not graded.

1 finding from 1 review

LTF rs2073495 variant vs Reference allele/genotype

Dental caries · Individuals assessed for dental caries (cases with caries/high caries vs. caries-free or low/very-low-caries controls)

LTF rs2073495 showed no significant association with dental caries in a single study (OR 0.99, 95% CI 0.86 to 1.15; ungraded).

1 finding from 1 review

Intervention not reported

Dental caries in permanent teeth · Children (permanent dentition) worldwide

In Asia, the pooled prevalence of permanent-teeth caries in children was 58.8% (95% CI 53.4 to 64.0); certainty not graded.

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Tooth survival · Children with carious vital pulp exposure in primary incisors

Tooth survival was reported narratively in two trials and was not pooled.

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free participants (permanent dentition, D3) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

For low baseline caries experience, the annual decline in caries-free participants ranged 4.3% to 10.2% (9 studies; ungraded).

4 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    4.3% to 10.2%
    9 studies · 4811 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    0.8% to 10.2%
    18 studies · 12017 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: high
    0.8% to 2.2%
    2 studies · 5029 participants
    GRADE not reported
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    3.7% to 8.3%
    4 studies · 928 participants
    GRADE not reported

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 12-15 years (adolescents)

In adolescents (12-15 y) from heavily contaminated areas, individual studies gave inconsistent DMFT/dmft differences; the review did not pool them and drew no firm conclusion (ungraded).

4 findings from 1 review
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Sealant (any type) vs no treatment

Arrest or reversal of noncavitated approximal carious lesions · Children and adults with noncavitated carious lesions on approximal surfaces (primary and permanent teeth)

Sealant may be more effective than no treatment for arrest or reversal of approximal carious lesions (RR 2.41, 95% CI 1.26 to 4.58; low certainty).

1 finding from 1 review

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: effect size (f) for microbial load (log10 CFU) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

The weighted effect size favoured hardness (f=2.62) over colour (f=0.46) for discriminating microbial load, supporting hardness as the more reliable examination (ungraded).

1 finding from 1 review

Residence in weakly contaminated area (approx. 1-5 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from weakly contaminated areas, individual cross-sectional studies reported mostly higher but inconsistent DMFT/dmft in exposed vs non-exposed children; the review did not pool the data and drew no firm conclusion (ungraded).

4 findings from 1 review
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Longer follow-up vs Shorter follow-up

Annual increment in DMFS (D3) · Children and adolescents with permanent dentition

Not adjusted meta-regression beta was 0.43 per additional follow-up year.

5 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Not adjusted
    Meta-regression beta per year of follow-up 0.43 [0.04, 0.83]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings and age at baseline
    Meta-regression beta per year of follow-up 0.64 [0.31, 0.96]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings age at baseline and baseline caries experience
    Meta-regression beta per year of follow-up 0.37 [0.04, 0.70]
    22 studies · 11300 participants
    GRADE not reported
Show 2 more findings
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up 0.46 [0.08, 0.83]
    22 studies · 11300 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up 0.36 [-0.02, 0.73]
    22 studies · 11300 participants
    GRADE not reported

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children of mixed ages (mean approximately 12 years; no age separation)

In children of mixed ages from heavily contaminated areas, individual studies reported modestly higher DMFT/dmft in exposed children; the review did not pool them and drew no firm conclusion (ungraded).

5 findings from 1 review
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Longer follow-up vs Shorter follow-up

Annual increment in DMFT (D3) · Children and adolescents with permanent dentition

Not adjusted meta-regression beta was 0.18 per additional follow-up year.

5 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Not adjusted
    Meta-regression beta per year of follow-up 0.18 [-0.04, 0.40]
    13 studies · 24753 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings and age at baseline
    Meta-regression beta per year of follow-up 0.18 [0.02, 0.35]
    13 studies · 24753 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for bitewings age at baseline and baseline caries experience
    Meta-regression beta per year of follow-up 0.23 [0.06, 0.40]
    13 studies · 24753 participants
    GRADE not reported
Show 2 more findings
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-4 including relevance of evidence and risk of bias
    Meta-regression beta per year of follow-up -0.04 [-0.34, 0.26]
    13 studies · 24753 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per additional year of follow-up · Western or comparable populations · Adjusted for groups 1-3 including decade and preventive intervention
    Meta-regression beta per year of follow-up 0.07 [-0.24, 0.39]
    13 studies · 24753 participants
    GRADE not reported