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%

Conventional GIC vs Amalgam or metal-reinforced GIC

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

Conventional GIC had an annual failure rate of 7.6-16.6% (2 RCTs) and failed more than amalgam in one trial; low quality of evidence (ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of LACC1 (chr13q14.11) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted LACC1 expression reached the TWAS threshold for ECC (p = 3.98e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Hall technique vs Compomer restoration or non-restorative caries treatment

Treatment failure (annual failure rate) · Children (aged 3-8 years) with 2-surface occluso-proximal dentine caries in primary molars, no pulp therapy

Preformed metal (Hall) crowns had a low reported annual failure rate (3.1%) versus compomer (14.7%) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of NRAD1 (LINC00284) (chr13q14.11) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted NRAD1 (LINC00284) expression reached the TWAS threshold for ECC (p = 1.69e-6) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs Atraumatic restorative treatment (ART)

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

SDF was not significantly better than ART at arresting caries (pooled ES 0.05, 95% CI -0.42 to 0.51; ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of TAS2R31 (chr12p13.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of TAS2R31 was suggestively associated with ECC in the TWAS (p = 1.04e-5); genetic association, ungraded.

1 finding from 1 review

Composite resin vs Compomer, glass-ionomer/RMGIC, amalgam, or glass carbomer

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

Composite resin (hybrid 0-19.5%; bulk-fill 0-16.9%) performed comparably to or better than most alternatives across 11 RCTs; evidence is of low to unclear quality (ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of TAS2R14 (chr12p13.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of TAS2R14 was significantly associated with ECC in the TWAS (p = 1.06e-6); genetic association, ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF, including SDF + fluoride varnish) vs Other standard-of-care caries treatments pooled (placebo, ART, or ART + fluoride varnish)

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

SDF had no significant effect on oral health-related quality of life versus pooled standard-of-care caries treatments (SMD -0.06, 95% CI -0.20 to 0.08; ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of IGSF5 (chr21q22.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted IGSF5 expression reached the TWAS threshold for ECC (p = 7.22e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Caries in upper primary incisors vs Reference (other primary tooth locations / caries-free)

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

Caries in upper primary incisors has the lowest tooth-specific predictive value for permanent-teeth caries (RR 1.6; single study; not GRADE-rated).

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free primary dentition

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

Early childhood caries increases the likelihood of caries in permanent teeth roughly three-fold, but the certainty of evidence is very low (OR 3.22, 95% CI 2.80 to 3.71).

1 finding from 1 review

Glass carbomer restoration (placed after drilling) vs Composite resin or RMGIC

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

Glass carbomer had very high failure rates (up to 46.2%) in a single RCT, far worse than composite resin or RMGIC; low quality of evidence (ungraded).

1 finding from 1 review