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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

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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%

Radiographic caries detection vs Reference standard (often histological; also invasive opening)

Advanced proximal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled sensitivity for radiographic detection of advanced proximal lesions was 0.444 (95% CI 0.38 to 0.51).

8 findings from 1 review
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Medium income vs High income

Prevalence of fair/poor self-rated oral health · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Canada, medium versus high income differed by 8.3 percentage points in prevalence of fair/poor self-rated oral health.

4 findings from 1 review
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Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for advanced occlusal caries was 0.53 (95% CI 0.46 to 0.62) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Sensitivity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, pooled sensitivity of visual detection for all (initial and advanced) occlusal caries was 49.1% (95% CI 40 to 58) (ungraded).

3 findings from 1 review

Medium income vs High income

Prevalence of untreated decay (% DT > 0) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Australia, medium versus high income differed by 6.8 percentage points in prevalence of untreated decay.

4 findings from 1 review
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Populations in countries with a lower Human Development Index (high category, HDI <0.800) vs Populations in countries with a higher Human Development Index (very high, HDI >=0.800)

Caries experience (mean DMFT) · Adults aged 19-60 years

Pooled caries experience (DMFT) was similar in very-high-HDI and high-HDI countries, and meta-regression found no significant association between national HDI and DMFT; ungraded observational evidence with very high heterogeneity.

3 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, the negative lr of radiographic detection for all (initial and advanced) proximal caries was 0.65 (95% CI 0.57 to 0.74) (ungraded).

3 findings from 1 review

Fluoride in dentifrice vs no treatment

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between fluoride in dentifrice and no treatment at every displayed randomization year; certainty was not graded.

1 finding from 1 review

Low income vs High income

Mean number of decayed teeth (mean DT) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

Across four countries, low versus high income differed by 0.44 decayed teeth in mean number of decayed teeth (random-effects meta-analysis; I2=76.4%).

5 findings from 1 review
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Populations with low socioeconomic status (>=22.4% of the population with low SES) vs Populations with higher socioeconomic status (<22.4% of the population with low SES)

Caries experience (mean DMFT) · Adults aged 19-60 years

Populations with a higher proportion of people with low socioeconomic status had higher caries experience (pooled DMFT 15.99 vs 5.50), and meta-regression associated low SES with higher DMFT (about 10.35 more DMFT per unit; p=0.050); ungraded observational evidence.

5 findings from 1 review
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Conventional restorative treatment with compomer vs Other network treatments

Treatment success rate · Primary teeth with dentin caries lesions on occlusal surfaces

CRT with compomer ranked first for treatment success in the occlusal-surface network (low certainty).

1 finding from 1 review

Fluorides combined with CPP-ACP vs Fluorides alone (monotherapy)

Visual inspection scores · Patients with early caries lesions in permanent teeth (non-fluoridated water area)

Two trials reported visual inspection scores but could not be pooled (different criteria, missing standard deviations) and gave inconsistent findings, so no quantitative conclusion could be drawn.

1 finding from 1 review

Human Development Index (HDI) vs Not applicable

Dental caries · Adult participants in 25 meta-regression studies

The Model 1 adjusted meta-regression coefficient for quantitative HDI was -42.94101.

3 findings from 1 review

Secondary education vs University education

Mean number of decayed teeth (mean DT) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Canada, secondary versus university education differed by 0.7 decayed teeth in mean number of decayed teeth.

4 findings from 1 review
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Postnatal passive tobacco exposure (secondhand/household smoke in infancy) vs No passive tobacco exposure (non-exposed children)

Dental caries in permanent teeth · Children and adolescents with permanent dentition

Postnatal (infancy) tobacco exposure is associated with higher odds of caries in permanent dentition (pooled OR 1.30, 95% CI 1.25 to 1.34; 9 studies; no heterogeneity); certainty not graded.

1 finding from 1 review

Women who experienced preterm birth vs Women who did not experience preterm birth (term)

Dental caries · pregnant women

Women who experienced preterm birth did not have significantly higher DMFT than those who did not (mean difference 1.56, 95% CI -0.28 to 3.41; 5 studies; I2=92%); certainty of evidence not graded.

1 finding from 1 review
  • Dental caries and preterm birth: a systematic review and meta-analysis. 2018 All outcomes
    Pregnant women assessed around delivery in observational studies across multiple countries (Mexico, Malawi, India, France, Jordan, Finland, Tanzania); mostly retrospective cohort and case-control designs
    MD 1.56 [-0.28, 3.41]
    5 studies · 2963 participants
    GRADE not reported

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Positive LR for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Germany, the positive lr of radiographic detection for advanced proximal caries was 9.82 (95% CI 7.3 to 13.3) (ungraded).

3 findings from 1 review

Populations with a lower proportion of university-educated people (<33.78% with university level) vs Populations with a higher proportion of university-educated people (>=33.78% with university level)

Caries experience (mean DMFT) · Adults aged 19-60 years

The proportion of university-educated people was not associated with caries experience (DMFT); pooled DMFT was similar across subgroups and the meta-regression was non-significant; ungraded observational evidence.

5 findings from 1 review
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Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the meta-analysis tailored to Egypt, pooled specificity of radiographic detection for advanced proximal caries was 95.5% (95% CI 94 to 97) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of visual detection for all (initial and advanced) occlusal caries was 0.19 (95% CI 0.15 to 0.25) (ungraded).

3 findings from 1 review