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%

Laser enamel preparation vs Air abrasion

Any planned outcome (sealant retention, caries, etc.) · Patients with premolars/molars requiring pit-and-fissure sealants

No eligible studies compared laser preparation with air abrasion for fissure sealant placement (evidence gap).

1 finding from 1 review

Intervention not reported

Mean DMFT/dmft (caries severity) · Children (<12 years) and adolescents (12-18 years) with type 1 diabetes

The pooled mean DMFT/dmft (caries severity) was 5.7 (SD 3.6) across 5 studies; certainty not graded.

1 finding from 1 review

Laser enamel preparation (with or without acid-etching) vs Acid-etching (phosphoric acid)

Adverse events · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

No adverse events were reported in any included study (ungraded, narrative).

1 finding from 1 review

1.23% APF gel vs Resin infiltration + 5% NaF varnish

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 be less effective than Resin infiltration + 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.67, 95% CI 0.45 to 0.99; low certainty).

1 finding from 1 review

38% SDF + potassium iodide solution (applied annually) 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 + potassium iodide 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 0.9, 95% CI 0.22 to 3.62; very low certainty).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Radiographic failure · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in radiographic failure between pulpotomy and pulpectomy in the main analysis (RR 0.79, 95% CI 0.25 to 2.42), with considerable heterogeneity (I2=76%; ungraded).

2 findings from 1 review

CPP-ACP vs Pre-treatment (baseline, same group)

Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients (mainly children) with white spot lesions (WSL)

Compared with baseline, CPP-ACP significantly improved white spot lesions on QLF (SMD -0.43, 95% CI -0.79 to -0.07; ungraded).

1 finding from 1 review

1.23% APF gel vs Sealants plus fluoride varnish (with or without restorations)

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 be less effective than Sealant + 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.64, 95% CI 0.44 to 0.92; low certainty).

1 finding from 1 review

0.2% NaF mouthrinse + supervised toothbrushing vs 1.23% APF gel

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

0.2% NaF mouthrinse + supervised toothbrushing may not differ from 1.23% APF gel for arrest or reversal of occlusal carious lesions (RR 0.91, 95% CI 0.68 to 1.22; low certainty).

1 finding from 1 review

Resin infiltration + 5% NaF 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)

Resin infiltration + 5% NaF varnish was probably more effective than Sealant for arrest or reversal of occlusal carious lesions (RR 1.61, 95% CI 1.16 to 2.24; moderate certainty).

1 finding from 1 review

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Dental erosive wear · Children and adolescents with juvenile idiopathic arthritis (JIA)

No eligible studies reported dental erosive wear, so its association with JIA could not be assessed (evidence gap).

1 finding from 1 review

Fluoride varnish vs Sealants plus fluoride varnish (with or without restorations)

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 was probably less effective than Sealant + 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.59, 95% CI 0.45 to 0.76; moderate certainty).

1 finding from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Triple antibiotic paste (TAP)

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 3-arm RCT found no difference in pulpotomy success between MTA and triple antibiotic paste (both 100%; not pooled; ungraded).

1 finding from 1 review

1% chlorhexidine + 1% thymol varnish 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)

1% chlorhexidine + 1% thymol varnish may not differ from no treatment for arrest or reversal of root carious lesions (RR 1.67, 95% CI 0.44 to 6.31; very low certainty).

1 finding from 1 review

Resin infiltration + 5% NaF varnish 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 + 5% NaF varnish may be more effective than no treatment for arrest or reversal of approximal carious lesions (RR 4.59, 95% CI 1.01 to 20.88; 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 Finland

The single Finnish study showed lower DMFT/S with OHPP (OR 0.48, 95% CI 0.41 to 0.56; ungraded, single study).

1 finding from 1 review

Sealant + 5% NaF 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)

Sealant + 5% NaF varnish was probably more effective than Sealant for arrest or reversal of occlusal carious lesions (RR 1.69, 95% CI 1.26 to 2.27; moderate certainty).

1 finding from 1 review

Er:YAG laser preparation combined with acid-etching vs Acid-etching (phosphoric acid)

Development of >=1 new carious lesion (caries incidence) · Children (high caries risk) with permanent molars requiring pit-and-fissure sealants

Caries incidence was 10% with laser-plus-acid versus 22% with acid-etching at 18 months, a non-significant difference (ungraded, single study).

1 finding from 1 review