Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

439 questions · 686 findings · 68 reviews

No studies found 4 · 0.6%GRADE not reported 617 · 89.9%Very low 26 · 3.8%Low 20 · 2.9%Moderate 11 · 1.6%High 8 · 1.2%

Primary dentition DMFT score 1-3 vs No caries in primary teeth (DMFT = 0)

Caries prevalence in permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

A primary-dentition DMFT of 1-3 is associated with 1.5 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs563135 (10:115067899; nearest gene(s) TCF7L2, CASP7) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs563135 near TCF7L2, CASP7 showed suggestive (not genome-wide significant) association with ECC (Z = -4.532, p = 5.86e-6); genetic association, ungraded.

1 finding from 1 review

Enamel caries quantification (DeS/DeT within total D(M)FS/D(M)FT) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Enamel caries proportion · European adolescents aged 12–19 years

Enamel caries made up about half of total caries experience (pooled proportion 0.50, 95% CI 0.39 to 0.65; 7 studies; higher in 12–15 than 16–19-year-olds; not GRADE-rated).

3 findings from 1 review

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)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

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).

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs1044956 (7:24854765; nearest gene(s) OSBPL3, NPVF) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs1044956 near OSBPL3, NPVF showed suggestive (not genome-wide significant) association with ECC (Z = 4.551, p = 5.35e-6); genetic association, ungraded.

2 findings from 1 review

Bulk-fill composite resin with 7-second dentine etching vs Bulk-fill composite resin with 15-second dentine etching

Treatment failure (annual failure rate) · Children (aged 5-8 years) with Class-II caries in primary molars, no pulp therapy

Etching dentine for 7 s rather than 15 s lowered bulk-fill composite failure (5.8% vs 16.9% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Fluoride-free nano-/micro-hydroxyapatite (nHA) dentifrice vs Control (regular fluoride) dentifrice

Caries lesion initiation/progression (ICDAS score, laser fluorescence/DIAGNOdent, photographic pixels, enamel acid resistance) · Patients (children and adults, age 3-40 years) with initial enamel caries lesions (non-orthodontic and orthodontic)

No meta-analysis was possible for the 5 in vivo RCTs (high heterogeneity); narratively nHA showed generally no significant difference versus fluoridated dentifrice, and the evidence was not graded (ungraded).

1 finding from 1 review
  • Efficacy of nano-hydroxyapatite on caries prevention-a systematic review and meta-analysis. 2022 All outcomes
    Median follow-up 6 months (range 6-12 months) · In vivo (clinical); non-orthodontic and orthodontic patients
    No meta-analysis was performed for the in vivo studies owing to high heterogeneity (population, control group, outcomes, follow-up periods, risk of bias) and differing statistical designs (e.g., non-inferiority);…
    5 studies · 420 participants
    GRADE not reported

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Primary dentition DMFT score over 13 vs No caries in primary teeth (DMFT = 0)

Caries prevalence in permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

A primary-dentition DMFT over 13 is associated with about 15 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review

Metal-reinforced glass-ionomer cement (MRGIC) restoration vs Conventional GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Metal-reinforced GIC had a high annual failure rate (29.9%) in a single RCT; low quality of evidence (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) plus fluoride varnish vs Atraumatic restorative treatment + fluoride varnish (ART+FV)

Oral health-related quality of life · Children with dental caries

SDF plus fluoride varnish did not significantly differ from ART plus fluoride varnish for oral health-related quality of life (MD 0.16, 95% CI -0.1 to 0.42; ungraded).

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs7325099 (13:28104496; nearest gene(s) LNX2, POLR1D, RPL21) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs7325099 near LNX2, POLR1D, RPL21 showed suggestive (not genome-wide significant) association with ECC (Z = 4.485, p = 7.28e-6); genetic association, ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).

1 finding from 1 review

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

30% silver diamine fluoride vs Atraumatic restorative treatment (ART)

Patient discomfort during treatment (anxiety scale) · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

One study found no significant difference in patient discomfort between SDF and ART (p = 0.15; ungraded).

1 finding from 1 review