What do systematic reviews say?

Xylitol-only sugar-free chewing gum vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Xylitol-only sugar-free gum significantly reduced Streptococcus mutans load versus pooled controls (SMD -0.46, 95% CI -0.64 to -0.28; 12 trials, I2 43%); certainty not formally graded.

• A systematic review and meta-analysis of the role of sugar-free chewing gum on Streptococcus mutans. 2021 All outcomes

  Final/end-of-study time point (follow-up 2 weeks to 18 months) · Schools, kindergartens, universities and community settings; adults and children; multiple countries · Overall (vs all controls)
  SMD -0.46 [-0.64, -0.28]
  12 studies · 1295 participants
  GRADE not reported

Non-selective carious tissue removal and conventional restoration (CR) vs Non-restorative cavity control (NRCC)

It is very uncertain whether non-selective carious tissue removal and conventional restoration (CR) changes failure of therapy compared with non-restorative cavity control (NRCC) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  30 months · Cavitated lesions, primary dentition
  OR 1.16 [0.5, 2.71]
  1 study · 102 participants
  Very low

Intervention not reported

Caries prevalence was lowest in Tanzania at 30.7% (95% CI 21.5 to 39.9); certainty not graded.

• Prevalence of Dental Caries and Associated Factors in East Africa, 2000-2020: Systematic Review and Meta-Analysis. 2021 All outcomes

  Community- and school-based populations, East Africa · Tanzania
  Prevalence 0.307 [0.215, 0.399]
  Studies not reported
  GRADE not reported

Sealing using sealant materials vs Non-selective carious tissue removal and conventional restoration (CR)

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with non-selective carious tissue removal and conventional restoration (CR) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  48 months · Cavitated lesions, permanent dentition
  OR 5.0 [0.51, 49.27]
  1 study · 41 participants
  Very low

Sealing using sealant materials vs no treatment

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with no treatment (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12 months · Non-cavitated lesions, permanent dentition
  OR 0.05 [0.0, 2.71]
  2 studies · 103 participants
  Very low

Resin-based fissure sealant vs Fluoride varnish

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  Five studies (Bravo 2005; Chestnutt 2017; Kalnina 2016; Liu 2012; Tagliaferro 2011) considered adverse events; participants detected and reported no adverse events.
  5 studies
  GRADE not reported

Resin-based fissure sealant vs Fluoride varnish

The review found no eligible studies for this question.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  None of the studies measured time taken to apply pit and fissure sealant or fluoride varnish (resin sealant versus fluoride varnish comparison).
  0 studies
  No studies found

Resin-modified glass ionomer fissure sealant vs Fluoride varnish

Resin-modified glass ionomer fissure sealant showed no clear difference in progression of dentinal carious lesions into enamel or dentine compared with fluoride varnish; GRADE not reported.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes

  1 year
  OR 0.18 [0.01, 4.27]
  1 study · 21 participants
  GRADE not reported

Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Among adults and excluding the outlier study, vegetarian diet was associated with higher odds of dental erosion with no heterogeneity (OR 2.56, 95% CI 1.77 to 3.71; ungraded).

• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings · Adults only, excluding Linkosalo & Markkanen 1985
  OR 2.56 [1.77, 3.71]
  4 studies
  GRADE not reported
• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings · Sensitivity analysis excluding Linkosalo & Markkanen 1985 (outlier)
  OR 1.97 [1.19, 3.27]
  5 studies
  GRADE not reported
• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
  OR 2.40 [1.24, 4.66]
  6 studies
  GRADE not reported

Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Beyond dental erosion, vegetarians tended to have a higher prevalence of other NCCL and tooth wear than nonvegetarians, reported narratively (ungraded).

• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
  Eleven studies reported on NCCL using six definitions (presence of NCCL, presence of dental erosion, presence and severity of tooth wear, dental abrasion, cervical buccal defects); the six reporting presence of dental…
  Studies not reported
  GRADE not reported

Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Evidence on the number of natural teeth was conflicting and could not be pooled (ungraded).

• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
  Seven studies reported on the number of teeth with conflicting findings; meta-analysis was not possible due to inconsistent outcome definitions. One study found vegetarians had significantly more teeth; two found no…
  7 studies
  GRADE not reported

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

The review found no eligible studies for this question.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  The study (Splieth 2001) did not measure the number of visits to the dentist for repair of sealant or fluoride varnish application.
  0 studies
  No studies found

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

The review found no eligible studies for this question.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  The study (Splieth 2001) did not report progression of dentinal carious lesions into enamel or dentine.
  0 studies
  No studies found

Vegetarian diet (any diet excluding all meat, poultry and fish) vs Nonvegetarian diet

Among adults, the lower DMFT score in vegetarians was smaller and not statistically significant (mean difference -0.09, 95% CI -0.32 to 0.13; ungraded).

• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings · Adults only
  MD -0.09 [-0.32, 0.13]
  3 studies
  GRADE not reported
• Vegetarian diet and its possible influence on dental health: A systematic literature review. 2020 All outcomes

  Multiple countries (mostly India; also Finland and other European countries, Brazil, Trinidad and Tobago); community and clinical settings
  MD -0.15 [-0.29, -0.02]
  4 studies
  GRADE not reported

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  Splieth 2001: total time for sealing and resealing two teeth averaged 29 minutes over 2 years (about 17 minutes initial sealants); each fluoride varnish application under 3 minutes (total 9 minutes).
  1 study
  GRADE not reported

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes

  2 years
  Splieth 2001: whole-mouth mean DMFS increased from 0.2 to 0.6 after 1 year and to 1.1 after 2 years; most caries on occlusal surfaces of first permanent molars (50.9%).
  1 study · 92 participants
  GRADE not reported

Summary of findings for combination antimicrobial susceptibility testing vs conventional treatment (separate testing)

The review found no eligible studies for this question.

• Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings for combination antimicrobial susceptibility testing vs conventional treatment (separate testing)

• Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 82 participants
  Moderate

Summary of findings for combination antimicrobial susceptibility testing vs conventional treatment (separate testing)

The review found no eligible studies for this question.

• Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings for combination antimicrobial susceptibility testing vs conventional treatment (separate testing)

The review found no eligible studies for this question.

• Combination antimicrobial susceptibility testing for acute exacerbations in chronic infection of Pseudomonas… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found