What do systematic reviews say?

OHI + 38% SDF (applied every 12 months) vs oral health instruction plus water

SDF had a 28% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

• A systematic review on the effect of silver diamine fluoride for management of dental caries in permanent teeth. 2023 All outcomes

  24 months · Hong Kong
  Preventative fraction (%) 28
  1 study · 266 participants
  GRADE not reported

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Oral-health-education-only interventions did not show a statistically significant effect on surface-level caries (dmfs SMD -0.20, 95% CI -0.43 to 0.03; 2 studies; not GRADE-rated).

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Oral health education only (vs comprehensive intervention)
  SMD -0.20 [-0.43, 0.03]
  2 studies
  GRADE not reported

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Comprehensive interventions produced a small, statistically significant reduction in surface-level caries (dmfs SMD -0.14, 95% CI -0.26 to -0.02; 10 studies; not GRADE-rated).

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
  SMD -0.14 [-0.26, -0.02]
  10 studies
  GRADE not reported

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Behaviour change interventions delivered by non-dental health workers produced a small, statistically significant reduction in caries experience at the surface level (dmfs SMD -0.15, 95% CI -0.25 to -0.04; 12 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.)
  SMD -0.15 [-0.25, -0.04]
  12 studies
  GRADE not reported

Intervention not reported

• Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. 2022 All outcomes

  38% SDF vs comparators (NaF/no treatment)
  Mean arrested caries surfaces (count) 2.5-4.5 (38% SDF) vs 1.3-1.8 (comparators)
  2 studies
  GRADE not reported

Arginine butyrate plus standard care alone vs usual care

• Interventions for treating leg ulcers in people with sickle cell disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 23 participants
  Very low

Propionyl‐L‐carnitine vs placebo

• Interventions for treating leg ulcers in people with sickle cell disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 15 participants
  Very low

Isoxsuprine vs placebo

• Interventions for treating leg ulcers in people with sickle cell disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 40 participants
  Very low

Solcoseryl vs antiseptic agent

• Interventions for treating leg ulcers in people with sickle cell disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 35 participants
  Very low

Duoderm® (hydroactive dressing) vs antiseptic agent

• Interventions for treating leg ulcers in people with sickle cell disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 35 participants
  Very low

Aqueous oxygen peroxide vs placebo (saline solution or sterile water)

• Wound cleansing for treating venous leg ulcers 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 61 participants
  Very low

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)

The review found no eligible studies for this question.

• 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) · Pit and fissure sealants
  Pre-specified heterogeneity investigation of surfaces with previously applied pit and fissure sealants: no studies reported the inclusion of sealants.
  0 studies
  No studies found

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in dental caries: number of tooth surfaces with any caries (ICDAS 1-6) compared with clinical examination with 6-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD -0.60 [-2.54, 1.34]
  1 study · 271 participants
  Moderate

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

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).

• Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a Systematic… 2020 All outcomes

  2 to 3 years · Sensitivity analysis excluding Bravo 1996 (high risk of bias)
  RR 0.98 [0.82, 1.16]
  3 studies
  GRADE not reported
• Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a Systematic… 2020 All outcomes

  2 to 3 years
  RR 1.33 [0.83, 2.11]
  4 studies · 6551 participants
  GRADE not reported

Topical antimicrobial agent vs alternative antimicrobial agent

• Topical treatment for facial burns 2020 · Cochrane Headline outcomes only
  no estimate extracted
  142 participants
  Low

Skin substitute vs topical antimicrobial agent

• Topical treatment for facial burns 2020 · Cochrane Headline outcomes only
  no estimate extracted
  34 participants
  Low

Miscellaneous treatment vs miscellaneous treatments

• Topical treatment for facial burns 2020 · Cochrane Headline outcomes only
  no estimate extracted
  2011 participants
  GRADE not reported

Topical antimicrobial agent vs topical non‐antimicrobial agent

The review found no eligible studies for this question.

• Topical treatment for facial burns 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

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

Evidence on other dental-caries measures was inconsistent: some indices (decayed surfaces/teeth, root caries, white spots) were higher in vegetarians while some studies found lower caries in vegetarian children (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 dental caries using 11 definitions; four (DMFT) were meta-analysed (see O2). Narrative findings were inconsistent: DMFS results were mixed; decayed surfaces and decayed teeth and percentages of…
  Studies not reported
  GRADE not reported

Resin-based fissure sealant (visible-light-polymerized) vs Fluoride varnish

It is very uncertain whether resin-based fissure sealant (visible-light-polymerized) changes incidence of dentinal carious lesion on treated occlusal surfaces of… compared with fluoride varnish (very low certainty).

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

  9 years
  RR 0.48 [0.29, 0.79]
  1 study · 75 participants
  Very low
• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes

  4 years
  RR 0.42 [0.21, 0.84]
  1 study · 75 participants
  Very low