Clinical care quality · Alaska dental health aide therapists
Four newly trained DHATs met stated clinical care standards in a qualitative evaluation, without a GRADE rating.
1 finding from 1 review
Relative DOR by reference standard (LFpen, initial, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions
No significant reference-standard difference for LFpen at the initial threshold (RDOR 4.41, 0.19 to 103.92).
1 finding from 1 review
Intervention not reported
Caries occurrence on sealed teeth
The intervention showed no clear difference in caries occurrence on sealed teeth; GRADE not reported.
1 finding from 1 review
RR 1.81 [0.39, 8.37]
3 studies
GRADE not reported
Intervention not reported
Risk of loss of complete retention
1 finding from 1 review
Initial caries lesion detection · Primary teeth with approximal surfaces
Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=84%; no GRADE rating was reported.
2 findings from 1 review
Sensitivity 0.354 [0.324, 0.385]
5 studies
GRADE not reported
Specificity 0.870 [0.843, 0.895]
5 studies
GRADE not reported
Clinic-based dental care utilization · Alaska children
The PDHA program was projected to increase clinic-based dental care utilization from 75% to 90%, without a GRADE rating.
1 finding from 1 review
Projected receipt of school-based prevention services · Alaska Native children (below age 18)
A simulation projected that over 90% of children would receive school-based prevention services under the PDHA model, up from 53% (certainty not graded).
1 finding from 1 review
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Primary teeth, occlusal surfaces, with suspected caries lesions
Pen-type laser fluorescence on occlusal surfaces of primary teeth (more advanced-lesion threshold): pooled DOR intermediate for LFpen among the three methods; heterogeneity I2=31%. Diagnostic accuracy was not formally graded (GRADE not used).
2 findings from 1 review
Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity. 2013 All outcomesMore advanced (dentine/cavitated) caries lesions threshold · Laboratory (in vitro) and clinical (in vivo)
Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); pooled DOR intermediate for LFpen among the three methods. Heterogeneity I2=31%. Numeric pooled values not available…
Studies not reported
GRADE not reported
Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 7); accuracy similar among the three methods. Heterogeneity I2=0%. Numeric pooled values not available in the provided…
Studies not reported
GRADE not reported
Amalgam restoration deficiency · Alaska dental health aide therapists
Amalgam restoration deficiency was 12% for DHATs versus 22% for dentists, without a GRADE rating.
1 finding from 1 review
Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, approximal surfaces, with suspected caries lesions
Pen-type laser fluorescence on approximal surfaces of permanent teeth (more advanced-lesion threshold): LFpen showed similar values at both thresholds; heterogeneity I2=84%. Diagnostic accuracy was not formally graded (GRADE not used).
2 findings from 1 review
Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity. 2013 All outcomesMore advanced (dentine/cavitated) caries lesions threshold · Laboratory (in vitro) and clinical (in vivo)
Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); LFpen showed similar values at both thresholds. Heterogeneity I2=84%. Numeric pooled values not available in the…
Studies not reported
GRADE not reported
Pooled sensitivity, specificity, DOR, PLR, NLR and summary-ROC AUC reported qualitatively (Figure 8); only LFpen had sufficient studies to pool; similar values at both thresholds. Heterogeneity I2=93%. Numeric pooled…
Studies not reported
GRADE not reported
Caregiver satisfaction · Caregivers of Alaska Native children aged 6 to 17 years
More than 90% of caregivers reported being usually or always satisfied with DHAT care, without a GRADE rating.
1 finding from 1 review
More advanced caries lesion detection · Primary teeth with occlusal surfaces
Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=31%; no GRADE rating was reported.
2 findings from 1 review
Initial caries lesion detection · Permanent teeth with occlusal surfaces
Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=65%; no GRADE rating was reported.
2 findings from 1 review
Sensitivity 0.779 [0.763, 0.794]
27 studies
GRADE not reported
Specificity 0.712 [0.690, 0.734]
27 studies
GRADE not reported
Relative DOR by reference standard (LF, initial, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions
LF performed significantly better with other reference standards than with histological validation at the initial threshold (RDOR 4.13, 1.24 to 13.76).
2 findings from 1 review
Retention-to-caries risk ratio (RCR) · Patients with fissure-sealed permanent molar teeth
In the sensitivity analysis, the difference in retention-to-caries risk ratio between resin- and glass-ionomer cement-based sealants was not statistically significant (p = 0.069; ungraded).
2 findings from 1 review
Mean RCR (retention-to-caries risk ratio); t-test of difference Resin vs GIC difference not statistically significant (p=0.069); sensitivity-analysis mean RCRs not reported
14 studies
GRADE not reported
Mean RCR (retention-to-caries risk ratio); t-test of difference Resin mean RCR 9.64 (SD 24.58) vs GIC 13.68 (SD 13.72); p=0.017
62 studies
GRADE not reported
Composite restoration deficiency · Alaska dental health aide therapists
Composite restoration deficiency was 15% for DHATs versus 12% for dentists, without a GRADE rating.
1 finding from 1 review
More advanced caries lesion detection · Primary teeth with occlusal surfaces
Pooled specificity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=80%; no GRADE rating was reported.
2 findings from 1 review
Specificity 0.898 [0.867, 0.924]
2 studies
GRADE not reported
Sensitivity 0.850 [0.702, 0.943]
2 studies
GRADE not reported
Initial caries lesion detection · Primary teeth with occlusal surfaces
Pooled sensitivity was reported, but the numerical estimate is not stated in the supplied text or attached figures; I²=0%; no GRADE rating was reported.
2 findings from 1 review
Sensitivity 0.719 [0.677, 0.757]
5 studies
GRADE not reported
Specificity 0.718 [0.637, 0.791]
5 studies
GRADE not reported
Relative DOR by setting (LFpen, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions
No significant setting difference for LFpen (RDOR 0.35, 0.04 to 2.99).
2 findings from 1 review
Association between loss of complete retention risk and caries occurrence risk · Patients with fissure-sealed permanent molar teeth
Loss of complete retention was not directly associated with caries occurrence for glass-ionomer cement-based sealants in the main analysis (regression slope 0.81, 95% CI -0.07 to 1.68; ungraded).
2 findings from 1 review
Regression slope (ln caries risk on ln retention-loss risk) 0.81 [-0.07, 1.68]
22 studies · 3768 participants
GRADE not reported
Regression slope (ln caries risk on ln retention-loss risk) 1.44 [0.71, 2.18]
14 studies · 2307 participants
GRADE not reported