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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.

Limit to evidence status or GRADE (optional)

5,762 questions in 263 reviews · Dental caries

current versions
No 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.

QuestionEffectEvidenceStatus / GRADE
Interdental brushing plus toothbrushing vs Toothbrushing alone
Plaque (Quigley & Hein plaque index, Turesky modification; scale 0 to 5) · 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 -0.95 [-1.34, -0.56]1 study · 62 participantsVery low
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, Low-intensity training
Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013)
Percent reduction in BBTD prevalence 271 studyUngraded
Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario
Projected mean DMFT (children below 5 years) · Alaska Native children (below age 18) · 20-year projection
Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013)
Mean DMFT, children <5 y 4.91 studyUngraded
Resin composite restorations (filling and bonding systems) containing antibacterial agents vs Composite restorations not containing antibacterial agents
Longevity of restorations (time to failure in months) · 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 studiesNo studies
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 · 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 LF, LFpen and FC. Heterogeneity I2=75%. Numeric pooled values not available in the provided…NRUngraded
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), Stainless steel crowns
Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions… (2013)
Deficient placements (%), DHAT vs dentist 3 vs 9 (DHAT vs dentist)2 studiesUngraded
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)
Sensitivity 0.876 [0.826, 0.916]8 studiesUngraded
No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) 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 0.20 [0.02, 1.72]1 study · 132 participantsModerate
Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histological examination, operative intervention, or other/visual examination)
Diagnostic accuracy (sensitivity, specificity) - not pooled · Permanent and primary teeth, 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 two included studies assessed smooth surfaces (both used LF; one permanent, one primary); no meta-analysis was possible. Both reported specificity higher than sensitivity at both thresholds.2 studiesUngraded
Fluoride varnish vs Placebo or no treatment
Caries increment in primary/deciduous teeth: decayed, (extraction indicated/missing) and filled surfaces d(e/m)fs (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 0.37 [0.24, 0.51]10 studies · 3804 participantsModerate
Interdental brushing plus toothbrushing vs Flossing plus toothbrushing
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 clinical attachment loss, a measure of progression of periodontitis. (See comment)0 studiesNo 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)
Sensitivity 0.850 [0.702, 0.943]2 studiesUngraded
ART sealant using high-viscosity glass ionomer (press-finger technique) vs None (single-arm survival proportion; no comparator)
Sealant retention (partially and fully retained) · Pits and fissures of permanent (posterior) teeth · 4 years, partially and fully retained high-viscosity glass-ionomer ART sealants in permanent dentitions, 4 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.68 [0.61, 0.75]1 studyUngraded
High-viscosity glass-ionomer ART sealants vs No comparator
Caries-free sealed pits and fissures · Permanent teeth with sealed pits and fissures · 6 years, permanent dentitions with high-viscosity glass-ionomer ART sealants, 6 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Caries-free percentage 85 [79, 91]1 studyUngraded
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Permanent posterior teeth with single-surface cavities · 2 years, single-surface permanent posterior teeth, 2 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 93 [89, 95]13 studiesUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Plaque (Turesky-modified Quigley-Hein/other plaque indices; SMD) · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease) · 1 month (mean 29 days)
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
SMD -0.23 [-0.52, 0.06]5 studies · 416 participantsVery low
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Permanent posterior teeth with multiple-surface cavities · 2 years, multiple-surface permanent posterior teeth, 2 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 41 [18, 67]1 studyUngraded
Multiple-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Primary posterior teeth with multiple-surface cavities (children) · 2 years, multiple-surface primary posterior teeth, 2 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.62 [0.51, 0.73]6 studiesUngraded
Fluoride supplements (tablets, drops, lozenges or chewing gums) vs No fluoride supplement (placebo or no treatment)
Caries increment on permanent tooth surfaces (D(M)FS) · Children and adolescents (aged 16 years or less at baseline) · 24-36 months
Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children (2011) · Cochrane
PF 0.24 [0.16, 0.33]3 studies · 1240 participantsModerate
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Permanent posterior teeth with single-surface cavities · 4 years, single-surface permanent posterior teeth, 4 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 86 [78, 93]3 studiesUngraded
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Primary posterior teeth with single-surface cavities · 1 year, single-surface primary posterior teeth, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 95 [91, 98]9 studiesUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Harms and adverse effects · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease)
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
Not estimable (5 studies). Adverse effects were assessed in five studies, but they used different outcome measures, so meta-analysis was not appropriate. The main harm identified was soft-tissue trauma to the gingival…5 studiesUngraded
ART sealant using high-viscosity glass ionomer (press-finger technique) vs None (single-arm survival proportion; no comparator)
Caries-free sealed pits and fissures · Pits and fissures of permanent (posterior) teeth · 1 year, permanent dentitions with high-viscosity glass-ionomer ART sealants, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 1.00 [0.99, 1.00]4 studiesUngraded
High-viscosity glass-ionomer ART sealants vs No comparator
Sealant retention · Permanent teeth · 1 year, partially and fully retained high-viscosity glass-ionomer ART sealants in permanent dentitions, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 75 [51, 91]3 studiesUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Gingivitis (Gingival Index, 0-3 scale; SMD) · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease) · 3 months
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
SMD -0.41 [-0.68, -0.14]6 studies · 656 participantsUngraded
ART sealant using high-viscosity glass ionomer (press-finger technique) vs None (single-arm survival proportion; no comparator)
Sealant retention (partially and fully retained) · Pits and fissures of permanent (posterior) teeth · 2 years, partially and fully retained high-viscosity glass-ionomer ART sealants in permanent dentitions, 2 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.82 [0.77, 0.86]2 studiesUngraded
Fluoride supplements (tablets, drops, lozenges or chewing gums) vs No fluoride supplement (placebo or no treatment)
Caries increment on deciduous tooth surfaces (dmfs) · Children and adolescents (aged 16 years or less at baseline) · 24-36 months
Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children (2011) · Cochrane
PF 0.73 [0.46, 0.99]1 study · 115 participantsVery low
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Primary posterior teeth with multiple-surface cavities · 2 years, multiple-surface primary posterior teeth, 2 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 62 [51, 73]6 studiesUngraded
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Permanent posterior teeth with multiple-surface cavities · 1 year, multiple-surface permanent posterior teeth, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 86 [59, 98]3 studiesUngraded
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Permanent posterior teeth with single-surface cavities · 6 years, single-surface permanent posterior teeth, 6 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 72 [67, 76]2 studiesUngraded
ART sealant using high-viscosity glass ionomer (press-finger technique) vs None (single-arm survival proportion; no comparator)
Caries-free sealed pits and fissures · Pits and fissures of permanent (posterior) teeth · 4 years, permanent dentitions with high-viscosity glass-ionomer ART sealants, 4 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.93 [0.91, 0.96]2 studiesUngraded
Multiple-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Primary posterior teeth with multiple-surface cavities (children) · 1 year, multiple-surface primary posterior teeth, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.71 [0.60, 0.80]8 studiesUngraded
ART sealant using high-viscosity glass ionomer (press-finger technique) vs None (single-arm survival proportion; no comparator)
Sealant retention (partially and fully retained) · Pits and fissures of permanent (posterior) teeth · 3 years, partially and fully retained high-viscosity glass-ionomer ART sealants in permanent dentitions, 3 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.72 [0.72, 0.86]2 studiesUngraded
Single-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Permanent posterior teeth with single-surface cavities · 2 years, single-surface permanent posterior teeth, 2 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.93 [0.89, 0.95]13 studiesUngraded
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Primary posterior teeth with multiple-surface cavities · 1 year, multiple-surface primary posterior teeth, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 71 [60, 80]8 studiesUngraded
High-viscosity glass-ionomer ART restorations vs No comparator
Restoration survival · Primary posterior teeth with single-surface cavities · 3 years, single-surface primary posterior teeth, 3 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Survival percentage 66 [13, 99]2 studiesUngraded
Fluoride supplements (tablets, drops, lozenges or chewing gums) vs Topical fluoride (fluoride rinse, varnish or toothpaste)
Fluorosis (adverse effect; % of children with fluorotic teeth) · Children and adolescents (aged 16 years or less at baseline)
Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children (2011) · Cochrane
Summary of findings 2 lists fluorosis (% of children with fluorotic teeth) as 'See comment / Not estimable / Not estimated'; no included study reported fluorosis for the fluoride supplements versus topical fluoride…NRNo studies
Fluoride supplements (tablets, drops, lozenges or chewing gums) vs Topical fluoride (fluoride rinse, varnish or toothpaste)
Caries increment on permanent tooth surfaces (DMFS) · Children and adolescents (aged 16 years or less at baseline) · 96 months
Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children (2011) · Cochrane
PF 0.21 [0.04, 0.38]1 studyUngraded
Single-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Permanent posterior teeth with single-surface cavities · 6 years, single-surface permanent posterior teeth, 6 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.72 [0.67, 0.76]2 studiesUngraded
Multiple-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Permanent posterior teeth with multiple-surface cavities · 1 year, multiple-surface permanent posterior teeth, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.86 [0.59, 0.98]3 studiesUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Economic and resource cost of flossing · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease)
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
Not reported. No included study measured the economic or resource cost of flossing; the review notes it may be important to measure in future trials.0 studiesNo studies
ART sealant using high-viscosity glass ionomer (press-finger technique) vs None (single-arm survival proportion; no comparator)
Sealant retention (partially and fully retained) · Pits and fissures of permanent (posterior) teeth · 1 year, partially and fully retained high-viscosity glass-ionomer ART sealants in permanent dentitions, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.75 [0.51, 0.91]3 studiesUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Gingivitis (Loe-Silness/bleeding indices; SMD) · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease) · 1 month
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
SMD -0.36 [-0.66, -0.05]7 studies · 489 participantsVery low
Fluoride supplements (tablets, drops, lozenges or chewing gums) vs No fluoride supplement (placebo or no treatment)
Caries increment on permanent tooth surfaces (DMFS) · Children and adolescents (aged 16 years or less at baseline) · 55 months
Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children (2011) · Cochrane
PF 0.25 [0.12, 0.38]1 studyUngraded
Multiple-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Permanent posterior teeth with multiple-surface cavities · 5 years, multiple-surface permanent posterior teeth, 5 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.77 [0.56, 0.92]1 studyUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Interproximal caries · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease)
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
Not estimable (0 studies). See comment: No included study assessed caries as an outcome.0 studiesNo studies
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Plaque (0-5 scale; SMD) · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease) · 6 months
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
SMD -0.06 [-0.23, 0.12]3 studies · 487 participantsUngraded
Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone (with or without a negative-control/placebo rinse)
Clinical attachment loss · Dentate adults aged 16 years or older (excluding orthodontic patients and those with severe periodontal disease)
Flossing for the management of periodontal diseases and dental caries in adults (2011) · Cochrane
Not estimable (0 studies). SoF comment reads (verbatim) 'No included study assessed calculus as an outcome' (apparent copy-paste typo in the clinical attachment loss row; no study assessed clinical attachment loss).0 studiesNo studies
Single-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Permanent posterior teeth with single-surface cavities · 1 year, single-surface permanent posterior teeth, 1 year
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.96 [0.94, 0.97]15 studiesUngraded
Single-surface ART restoration using high-viscosity glass ionomer vs None (single-arm survival proportion; no comparator)
Restoration survival · Permanent posterior teeth with single-surface cavities · 5 years, single-surface permanent posterior teeth, 5 years
Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. (2011)
Proportion 0.80 [0.76, 0.83]3 studiesUngraded