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Evidence found and GRADE certainty

348 questions · 568 findings · 47 reviews · Dental caries

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No studies found 23 · 4%GRADE not reported 485 · 85.4%Very low 27 · 4.8%Low 31 · 5.5%Moderate 2 · 0.4%High 0 · 0%

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    ECM (4 studies, 475 tooth surfaces): sensitivity ranged from 0.61 to 0.98 (0.61-0.65 in three studies; 0.98 in the most recent ECM IV study). No evidence of a difference in accuracy by device type (Chi2=0.05, df=1,…
    4 studies
    GRADE not reported

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy (sensitivity/specificity) for enamel caries, not meta-analyzed · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
    7 studies
    Very low

Other visual classification systems (unspecified or unique systems, e.g. Nyvad, Downer, Lussi, UniViSS) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Sensitivity for detection of enamel caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Sensitivity for detection of enamel caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy in previously restored teeth (secondary caries) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies) · Previously restored teeth (secondary caries)
    Only one study (Kim 2017) intentionally included restored teeth in its sample; the pre-specified secondary-caries subgroup analysis could not be performed, no summary estimate reported.
    1 study
    GRADE not reported

Electronic caries monitor (ECM) device (ECM II / ECM III / ECM IV) vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (overall test accuracy) · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review

CarieScan Pro device vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review

Other visual classification systems (unspecified or unique systems, e.g. Nyvad, Downer, Lussi, UniViSS) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection of enamel caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Visual classification: ERK (Ekstrand-Ricketts-Kidd system) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Specificity for detection of enamel caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy on surfaces with pit and fissure sealants · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

1 finding from 1 review

Visual classification: ERK (Ekstrand-Ricketts-Kidd system) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Sensitivity for detection of enamel caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence of first permanent molars (FPMs) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

After excluding the high-risk-of-bias study (Bravo 1996), fluoride varnish and fissure sealant did not differ in caries incidence of FPMs and heterogeneity fell to 0% (RR 1.05, 95% CI 0.91 to 1.22; 5 RCTs; ungraded).

3 findings from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence (proportion of enrolled children developing dentin caries, ICDAS 4-6) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

Fluoride varnish and fissure sealant did not differ significantly in the proportion of children developing caries at 2 to 3 years (RR 1.12, 95% CI 0.60 to 2.09; 2 RCTs; ungraded).

1 finding from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence of occlusal surfaces of first permanent molars · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

After excluding Bravo 1996, occlusal caries incidence slightly favored fluoride varnish but was not significant, with heterogeneity falling to 0% (RR 0.98, 95% CI 0.82 to 1.16; 3 RCTs; ungraded).

2 findings from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Increment of occlusal DMFS (decayed, missing, filled surfaces) of FPMs · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

Fluoride varnish and fissure sealant did not differ significantly in occlusal DMFS increment of FPMs (MD 0.13, 95% CI -0.09 to 0.34; 3 RCTs; ungraded).

2 findings from 1 review

Residence in weakly contaminated area (approx. 1-5 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 weakly contaminated areas, individual cross-sectional studies reported mostly higher but inconsistent DMFT/dmft in exposed vs non-exposed children; the review did not pool the data and drew no firm conclusion (ungraded).

4 findings from 1 review
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CPP-ACP vs No active treatment (control)

Enamel surface microhardness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP increased Vickers microhardness versus control (SMD 1.19, 95% CI 0.72 to 1.66; ungraded).

3 findings 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