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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 |
|---|---|---|---|
Intervention NR Technical performance / deficient preparations (DHATs) · Composite preparations Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Deficient preparations (%) 0 | 2 studies | Ungraded |
Conventional glass-ionomer cement (GIC) fissure sealants vs Resin-based fissure sealants Caries occurrence on sealed teeth · Sealed permanent teeth · 6 months, 6 months (permanent teeth) The modified Ottawa method to establish the update need of a systematic review: glass-ionomer versus resin… (2013) | RR 2.04 [0.62, 6.70] | 6 studies · 1944 participants | Ungraded |
Conventional glass-ionomer cement (GIC) fissure sealants vs Resin-based fissure sealants Caries occurrence on sealed teeth · Sealed permanent teeth · 24 months, 24 months (permanent teeth) The modified Ottawa method to establish the update need of a systematic review: glass-ionomer versus resin… (2013) | RR 1.51 [1.00, 2.28] | 8 studies · 2810 participants | Ungraded |
Resin-based fissure sealants vs Glass-ionomer cement-based fissure sealants Retention-to-caries risk ratio (RCR) · 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) | Mean RCR (retention-to-caries risk ratio); t-test of difference Resin mean RCR 9.64 (SD 24.58) vs GIC 13.68 (SD 13.72); p=0.017 | 62 studies | Ungraded |
Interdental brushing plus toothbrushing vs Toothbrushing alone 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 |
Resin composite restorations (filling and bonding systems) containing antibacterial agents vs Composite restorations not containing antibacterial agents Postoperative sensitivity, marginal adaptation, anatomic form and other clinical outcomes (USPHS restoration quality; includes tooth vitality and pulpitis) · 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 |
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) | Sensitivity 0.795 [0.730, 0.850] | 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) Caries increment measured by the difference in decayed, missing and filled teeth (dmft/DMFT) · Children aged 4 to 12 years attending primary school · 2 years Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | PF 0.49 | 1 study | 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 dental care utilisation · Alaska Native children (below age 18) · 20-year projection Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Projected dental care utilisation (%) 90 | 1 study | Ungraded |
Fluorescence camera (FC) vs Reference standard More advanced caries lesion detection · Permanent teeth with occlusal surfaces · More advanced caries lesion threshold, FC, occlusal, permanent teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.669 [0.627, 0.708] | 8 studies | Ungraded |
Dental care provided by dental health aide therapists (DHATs, mid-level providers) vs Dental care provided by dentists (or no comparison group) Quality of dental record keeping by DHATs · Alaska Native dental patients (children aged 6-17 and adults) and their caregivers · Cross-sectional (DHATs practising ~9 months to several years) Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Record keeping by DHATs was consistent with evaluation criteria; the 4 practising DHATs met Indian Health Service guidelines on record keeping. | 2 studies | Ungraded |
Intervention NR Risk of caries occurrence · 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) 0.12 (SD 0.14) | 54 studies | 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 · 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) 0.53 [-0.27, 1.32] | 14 studies · 3154 participants | Ungraded |
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 vs clinical (reference) Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | RDOR 3.83 [0.53, 27.73] | 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) Frequency of cariogenic food and drink consumption · Children aged 4 to 12 years attending primary school Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | Worthington 2001: few children had problems identifying foods containing sugar; only 15% of intervention and 19% of control participants reported routinely consuming sugary snacks on arriving home from school; snacking… | 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 Operative caries management in adults and children (2013) · Cochrane | RR 0.44 [0.33, 0.60] | 4 studies · 627 participants | Moderate |
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) | Specificity 0.870 [0.843, 0.895] | 5 studies | Ungraded |
Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate Baby bottle tooth decay prevalence · Alaska Native Head Start children · 3 years, Alaska Native site Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent increase in BBTD prevalence 20 | 1 study | Ungraded |
Fluoride varnish vs Placebo or no treatment Caries increment in permanent teeth: decayed, (missing) and filled teeth D(M)FT (prevented fraction) · Children and adolescents aged 16 years or less · At least 1 year Fluoride varnishes for preventing dental caries in children and adolescents (2013) · Cochrane | PF 0.44 [0.11, 0.76] | 5 studies | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing 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. 2 studies reported adverse outcomes in terms of problems with the use of the assigned interdental cleaning aids. We were unable to pool data. (See comment) Three further studies reported that no adverse… | 5 studies | 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, 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 0.96 [0.12, 7.77] | NR | 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) | Specificity 0.821 [0.739, 0.885] | 8 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 Significant Caries (SiC) index · Alaska Native children (below age 18) · 20-year projection, 12-year-olds Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Significant Caries (SiC) index, 12-year-olds 3.3 | 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) Frequency of toothbrushing · Children aged 4 to 12 years attending primary school Primary school‐based behavioural interventions for preventing caries (2013) · Cochrane | Worthington 2001 reported children's brushing frequency: almost all children (99%) at baseline reported twice daily brushing, and this level was maintained across all groups throughout the intervention (in baseline… | 1 study | Ungraded |
Fluoride varnish vs Placebo or no treatment Caries increment in permanent teeth: decayed, (missing) and filled tooth surfaces D(M)FS (prevented fraction) · Children and adolescents aged 16 years or less · At least 1 year Fluoride varnishes for preventing dental caries in children and adolescents (2013) · Cochrane | PF 0.43 [0.30, 0.57] | 13 studies · 6478 participants | Moderate |
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) · 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 similar among the three methods (very low inconsistency). Heterogeneity I2=0%. Numeric pooled values not… | NR | 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) · 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 lowest for LF among the three methods. Heterogeneity I2=23%. Numeric pooled values not available in the… | NR | Ungraded |
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) | Specificity 0.815 [0.713, 0.892] | 2 studies | Ungraded |
Laser fluorescence (LF) vs Reference standard Initial caries lesion detection · Primary teeth with occlusal surfaces · Initial caries lesion threshold, LF, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Specificity 0.838 [0.810, 0.864] | 14 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, 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 higher pooled DOR at the more advanced threshold. Heterogeneity I2=89%. Numeric pooled values not… | NR | Ungraded |
Intervention NR Risk of caries occurrence · 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) 0.12 (SD 0.08) | 22 studies | Ungraded |
PDHA program vs Baseline pre-intervention scenario School-based oral health promotion services · Alaska children · 20 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percentage receiving services >90% | 1 study | Ungraded |
Laser fluorescence (LF) vs Reference standard Initial caries lesion detection · Primary teeth with occlusal surfaces · Initial caries lesion threshold, LF, occlusal, primary teeth Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Sensitivity 0.622 [0.592, 0.651] | 14 studies | Ungraded |
PDHA program vs Baseline pre-intervention scenario Significant caries index · Alaska children · 20 years, Children Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in SiC index 50 | 1 study | 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) | Specificity 0.718 [0.637, 0.791] | 5 studies | Ungraded |
DHAT-delivered dental care vs Dentist-delivered dental care Amalgam preparation deficiency · Alaska dental health aide therapists Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Number of deficient DHAT amalgam preparations 2 | 2 studies | Ungraded |
Quantitative light-induced fluorescence (QLF) vs Reference standard (histological examination, operative intervention, or other/visual examination) Diagnostic accuracy (sensitivity, specificity, DOR) - not pooled · Permanent teeth (occlusal and smooth surfaces), with suspected caries lesions · Initial and more advanced caries lesions thresholds Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of… (2013) | Only three articles using QLF were included (all permanent teeth); no meta-analysis could be performed. Individual studies reported high sensitivity or high specificity depending on threshold and surface. | 3 studies | Ungraded |
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing Plaque (plaque 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 -2.14 [-5.25, 0.97] | 2 studies · 107 participants | Very 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, PDHA + robust prevention model Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Caries-free children 5-18 y (%) >50 | 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 · 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 |
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) · 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 FC among the higher values, exceeding LFpen. Heterogeneity I2=17%. Numeric pooled values not… | NR | Ungraded |
PDHA program vs Baseline pre-intervention scenario Significant caries index · Alaska children aged 12 years · 20 years, Age 12 years Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Percent reduction in SiC index 70 | 1 study | Ungraded |
Interdental brushing plus toothbrushing vs Toothbrushing alone Periodontitis (clinical attachment loss) · 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 periodontitis 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 proportion of caries-free children (5-18 years) · Alaska Native children (below age 18) · 20-year projection, PDHA or PDHA + intensive staffing model Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Caries-free children 5-18 y (%) 8 | 1 study | Ungraded |
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), Composite restorations Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | Deficient restorations (%), DHAT vs dentist 15 vs 12 (DHAT vs dentist) | 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) | Sensitivity 0.749 [0.715, 0.781] | 9 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 · 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 similar among LF, LFpen and FC. Heterogeneity I2=54%. Numeric pooled values not available in the provided… | NR | 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) | Sensitivity 0.750 [0.641, 0.840] | 2 studies | Ungraded |
Chlorhexidine and xylitol chewing gum vs Placebo intervention Infant dental caries · Pregnant Alaska Native women and their infants · Trial discontinued Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013) | no estimate extracted | 1 study | Ungraded |
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) | Specificity 0.816 [0.793, 0.837] | 13 studies | Ungraded |