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%

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review

38% silver diamine fluoride vs placebo

Root carious lesions prevention · Older adults with root carious lesions (exposed root surfaces)

38% silver diamine fluoride reduced root-caries increment (DMFRS/DFRS) versus placebo, MD −0.33 (95% CI −0.39 to −0.28) (ungraded).

3 findings from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

MTA and calcium hydroxide had similar clinical and radiographic pulpotomy success at 6 months (RR 1.00, 95% CI 0.94 to 1.06; 2 RCTs; ungraded).

2 findings from 1 review

Learning disability (CLD) vs No learning disability (CNLD)

Care index (CI), permanent teeth · Children aged 1-18 years

The care index (met dental care need) for permanent teeth could not be meta-analyzed because no study reported variance; it was lower or equal in children with learning disabilities in 5 of 8 studies (certainty not graded).

1 finding from 1 review

Fluoride varnish vs Resin infiltration alone

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

5% NaF varnish may not differ from Resin infiltration for arrest or reversal of approximal carious lesions (RR 1.09, 95% CI 0.32 to 3.65; very low certainty).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Japan

The single Japanese study yielded a degenerate estimate of OR 0.00 (95% CI 0.00 to 0.00; ungraded, single study).

1 finding from 1 review

12% SDF solution (applied annually) 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)

12% SDF solution (applied annually) did not differ from 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 0.94, 95% CI 0.87 to 1.02; high certainty).

4 findings from 1 review
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10% CPP-ACP cream (+ 900-ppm NaF mouthrinse + 1,000-ppm NaF dentifrice) vs Placebo cream (+ 900-ppm NaF mouthrinse + 1,000-ppm NaF dentifrice)

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

10% CPP-ACP cream (+ 900-ppm NaF mouthrinse + 1,000-ppm NaF dentifrice) may not differ from Placebo cream (+ 900-ppm NaF mouthrinse + 1,000-ppm NaF dentifrice) for arrest or reversal of facial/lingual carious lesions (RR 1.28, 95% CI 0.97 to 1.68; low certainty).

3 findings from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Calcium-enriched mixture (CEM)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found no difference in pulpotomy success between MTA and calcium-enriched mixture (both 100% at 6 and 12 months; not pooled; ungraded).

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Chlorhexidine 0.2% mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica was less effective than 0.2% chlorhexidine at reducing plaque (favours chlorhexidine); not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Lactobacillus count (CFU/mL) · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Lactobacillus counts more than placebo (favours Salvadora persica); not GRADE-rated.

1 finding from 1 review

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 5-7 years (early school-age)

In early school-age children (5-7 y) from heavily contaminated areas, individual studies gave conflicting DMFT/dmft differences (some favouring exposed, some non-exposed); the review did not pool them (ungraded).

4 findings from 1 review
Show 1 more finding

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Fluoride varnish vs Resin infiltration + 5% NaF varnish

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

5% NaF varnish may not differ from Resin infiltration + 5% NaF varnish for arrest or reversal of approximal carious lesions (RR 0.5, 95% CI 0.18 to 1.37; very low certainty).

1 finding from 1 review

Learning disability (CLD) vs No learning disability (CNLD)

Restorative index (RI), permanent teeth · Children aged 1-18 years

The restorative index for permanent teeth could not be meta-analyzed (no variance data); it was lower or equal in children with learning disabilities in 4 of 9 studies, and the pattern suggested more extraction- than restoration-based care in CLD (certainty not graded).

1 finding from 1 review

Triple antibiotic paste (TAP) vs Abscess remedy (AR)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found higher pulpotomy success with triple antibiotic paste than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs 5,000-ppm F (1.1% NaF) toothpaste or gel

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 5,000-ppm F (1.1% NaF) toothpaste or gel for arrest or reversal of root carious lesions (RR 0.72, 95% CI 0.18 to 2.95; very low certainty).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pathological periapical radiolucency · Children with carious vital pulp exposure in primary incisors

Two trials reported periapical radiolucency but results were not pooled owing to considerable heterogeneity.

1 finding from 1 review

Fluoride varnish vs 5,000-ppm F (1.1% NaF) toothpaste or gel

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

5% NaF varnish may not differ from 5,000-ppm F (1.1% NaF) toothpaste or gel for arrest or reversal of root carious lesions (RR 1.13, 95% CI 0.1 to 13.12; very low certainty).

1 finding from 1 review

Fluoride varnish vs Sealant

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

5% NaF varnish may not differ from Sealant for arrest or reversal of approximal carious lesions (RR 0.95, 95% CI 0.38 to 2.41; very low certainty).

1 finding from 1 review