Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

310 questions · 590 findings · 34 reviews · Dental caries

No studies found 12 · 2%GRADE not reported 470 · 79.7%Very low 23 · 3.9%Low 34 · 5.8%Moderate 51 · 8.6%High 0 · 0%

Fluoride-free nano-hydroxyapatite (nHA) dentifrice/paste vs Sodium fluoride (control) toothpaste

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under demineralizing conditions, nHA allowed significantly more enamel demineralization than NaF (MD 1625, 95% CI 553 to 2697; very low certainty).

2 findings from 1 review

Atraumatic restorative treatment with GIC vs Conventional treatment

Pain during the procedure (primary analysis) · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement

The reported estimate for procedural pain with ART versus conventional treatment was inconclusive (ungraded).

1 finding 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

Analogue (conventional) radiographs vs Cone beam computed tomography (CBCT) (direct within-person / paired comparison); reference standard: histology

Diagnostic accuracy: analogue versus CBCT (within-person, not pooled) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Direct comparison analogue vs CBCT (within-person): 6 datasets from 3 studies (737 tooth sites or surfaces) provided data, but the results could not be pooled; only individual study results are shown (Figure 21). No…
    3 studies
    GRADE not reported

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)

Diagnostic accuracy: in vitro versus in vivo comparison · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • 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) · Study setting (in vitro vs in vivo)
    Pre-specified in vitro versus in vivo comparison was not completed because 49 of the 60 histology studies were in vitro; a sensitivity analysis removing the in vivo studies confirmed a minimal change to summary…
    Studies not reported
    GRADE not reported

Transillumination/OCT device used as an adjunct to a conventional visual examination vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography)

Outcome not reported · Children or adults presenting asymptomatically or suspected of having enamel caries (clinical/in vivo studies); extracted teeth of…

The review found no eligible studies for this question.

1 finding from 1 review

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy on surfaces with pit and fissure sealants · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

1 finding from 1 review
  • Imaging modalities to inform the detection and diagnosis of early 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 pit and fissure sealants: no study reported the inclusion of sealants that would allow evaluation of early caries lesions.
    0 studies
    No studies found

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)

Diagnostic accuracy on surfaces with pit and fissure sealants · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

1 finding from 1 review

Canary System (Quantum Dental Technologies; red fluorescence, scale 0-100) vs Reference standard: histology, enhanced visual examination with or without radiographs, or excavation

Outcome not reported · Children or adults presenting asymptomatically or suspected of having enamel caries (in vivo/clinical studies); extracted teeth of…

The review found no eligible studies for this question.

1 finding from 1 review

Composite resin with etch-and-rinse (total-etch) adhesion vs Composite resin with self-etch adhesion (same universal adhesive)

Treatment failure (annual failure rate) · Children with moderately deep dentine caries in primary molars, no pulp therapy

Etch-and-rinse adhesion failed more than self-etch (19.5% vs 7.0% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Participant and operator perception · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

The review found no eligible studies for this question.

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Costs (direct and indirect) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

The review found no eligible studies for this question.

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Adverse events · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…
1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Change in decayed, missing and filled (DMF/dmf) figures at surface, tooth and whole mouth level · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

The review found no eligible studies for this question.

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration) vs Conventional invasive treatment (restoration / drill and fill)

Outcome not reported · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

The review found no eligible studies for this question.

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Material deficiency (retention/adaptation loss; re-treatment) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…
1 finding from 1 review

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Enamel/dental hard-tissue changes and e-liquid cariogenic properties (demineralization, colour change, pH, sugar content, metals) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

In vitro evidence suggests e-liquids are often acidic and sugar-containing and can alter enamel/dentin colour and properties, supporting a plausible cariogenic effect, but findings are heterogeneous and not pooled (ungraded, narrative).

1 finding from 1 review