Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

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%

Silver diamine fluoride (SDF) vs Not applicable (single-arm safety outcome)

Serious adverse events · Children and older adults treated with SDF for carious lesions

No serious adverse events (e.g., allergic reactions or toxicity) were reported for SDF across the reviews (ungraded).

1 finding from 1 review

1.23% APF gel vs no treatment

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel was probably more effective than no treatment for arrest or reversal of any-coronal carious lesions (RR 2.25, 95% CI 2 to 2.53; moderate certainty).

1 finding from 1 review

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

Dental caries in permanent teeth · Children aged 1-18 years

Across all learning disabilities, meta-analysis found no evidence of a difference in permanent-tooth caries experience (DMFT) between children with and without learning disabilities (SMD -0.43, 95% CI -0.91 to 0.05; 16 studies; certainty not graded).

4 findings from 1 review
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Silver diamine fluoride (SDF) vs Not applicable (single-arm safety outcome)

Adverse events: black staining of arrested lesions · Children and older adults treated with SDF for carious lesions

Black staining of arrested lesions was the main adverse event of SDF (reported by seven reviews); it was generally acceptable to patients (ungraded).

1 finding from 1 review

1.23% APF gel vs Sealant

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

1.23% APF gel may not differ from Sealant for arrest or reversal of occlusal carious lesions (RR 1.08, 95% CI 0.82 to 1.41; low certainty).

1 finding from 1 review

5,000-ppm F (1.1% NaF) toothpaste or gel vs no treatment

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)

5,000-ppm F (1.1% NaF) toothpaste or gel may be more effective than no treatment for arrest or reversal of root carious lesions (RR 2.62, 95% CI 1.49 to 4.63; low certainty).

1 finding from 1 review

1.23% APF gel vs Fluoride varnish

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel may not differ from 5% NaF varnish for arrest or reversal of any-coronal carious lesions (RR 1.05, 95% CI 0.85 to 1.29; low certainty).

1 finding from 1 review

38% silver diamine fluoride vs 38% SDF + potassium iodide solution (applied annually)

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 38% SDF + potassium iodide solution (applied annually) for arrest or reversal of root carious lesions (RR 0.8, 95% CI 0.25 to 2.61; low certainty).

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

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

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

1 finding from 1 review

30% SDF solution (once weekly for 3 weeks) vs Fluoride varnish

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

30% SDF solution (once weekly for 3 weeks) probably did not differ from 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 0.97, 95% CI 0.8 to 1.18; moderate certainty).

3 findings from 1 review

Resin infiltration 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)

Resin infiltration may be more effective than no treatment for arrest or reversal of approximal carious lesions (RR 2.11, 95% CI 1.08 to 4.13; low certainty).

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

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

Salvadora persica rinse reduced plaque more than placebo (favours Salvadora persica); certainty not GRADE-rated (Shekelle grade Ia).

1 finding from 1 review

Resin infiltration + 5% NaF varnish vs no treatment

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

Resin infiltration + 5% NaF varnish was probably more effective than no treatment for arrest or reversal of occlusal carious lesions (RR 3.2, 95% CI 2.24 to 4.56; moderate certainty).

1 finding from 1 review

Fluoride varnish vs Sealant

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

5% NaF varnish may not differ from Sealant for arrest or reversal of occlusal carious lesions (RR 0.99, 95% CI 0.86 to 1.15; low certainty).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Soft tissue pathology · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in soft tissue pathology between pulpotomy and pulpectomy (RR 3.11, 95% CI 0.54 to 17.7; ungraded).

1 finding from 1 review

Resin infiltration + 5% NaF 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)

Resin infiltration + 5% NaF varnish may not differ from Sealant for arrest or reversal of approximal carious lesions (RR 1.91, 95% CI 0.48 to 7.52; very low certainty).

1 finding from 1 review

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Prevalence and severity of oral and TMJ diseases/conditions (periodontal status and dental caries) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

1 finding from 1 review