Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,052 questions · 1,797 findings · 134 reviews

No studies found 10 · 0.6%GRADE not reported 1,630 · 90.7%Very low 95 · 5.3%Low 23 · 1.3%Moderate 22 · 1.2%High 17 · 0.9%

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Area under the summary ROC curve · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

The area under the summary ROC curve for AI caries detection is 0.86, indicating high overall diagnostic accuracy; ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A positive AI test raises caries probability substantially (LR+ 10.44; positive post-test probability 79%); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Log diagnostic odds ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms show strong pooled discriminative accuracy for dental caries (log DOR 4.37; DOR 70.9); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A negative AI test lowers caries probability substantially (LR- 0.17; negative post-test probability 6%); ungraded.

1 finding from 1 review

Gum chewing (sugar-free) vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.

2 findings from 1 review

Adhesive precoated (APC) flash-free brackets (minimal excess adhesive) vs Conventional brackets

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

Two studies found adhesive flash-free brackets did not clinically reduce enamel demineralization or white spot lesions versus conventional brackets, though they reduced pathogenic bacteria (ungraded).

1 finding from 1 review

ART sealant using high-viscosity glass ionomer (press-finger technique) vs No comparator

Retention of sealant (complete or partial retention) · Pits and fissures of permanent (posterior) teeth

High-viscosity glass-ionomer ART sealants showed 4-year retention of 68% (95% CI 61-75%); evidence ungraded.

6 findings from 1 review
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ART sealant using high-viscosity glass ionomer (press-finger technique) vs No comparator

Caries-free sealed pits and fissures · Pits and fissures of permanent (posterior) teeth

Pits and fissures sealed with high-viscosity glass-ionomer ART sealants remained dentine lesion-free in 100% (95% CI 99-100%) at 1-year; evidence ungraded.

6 findings from 1 review
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Probiotics vs placebo or control

Dental caries in children · Adolescents (12-18 years) without background systemic disease

In a subgroup analysis, probiotics reduced the number of caries in adolescents (MD -0.60, 95%CI -0.92 to -0.28; p-interaction=0.02); not GRADE-rated.

1 finding from 1 review

Probiotics vs placebo or control

Gingival index (GI) · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the gingival index versus control (MD 0.04, 95%CI -0.18 to 0.27; low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Lactobacillus count (CFU/mL) · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to Lactobacillus count versus control (MD -0.78 CFU/mL, 95%CI -1.65 to 0.09; very low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Salivary pH · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to salivary pH versus control (MD -0.12 pH units, 95%CI -0.72 to 0.48; very low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Dental caries in children · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably make little to no difference to the number of dental caries versus control (MD -0.24 carious pieces, 95%CI -0.72 to 0.23; low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Streptococcus mutans count · Children and/or adolescents (<18 years) without background systemic disease

Probiotics probably reduce Streptococcus mutans count versus control (MD -0.40 CFU/mL, 95%CI -0.57 to -0.24; moderate certainty).

1 finding from 1 review

Probiotics vs placebo or control

Gingival bleeding (various bleeding indices) · Children and/or adolescents (<18 years) without background systemic disease

Only one trial (Borrell 2021) reported the bleeding index, showing slightly more bleeding with probiotics (MD 0.10, 95%CI 0.02 to 0.18); not pooled or GRADE-rated.

1 finding from 1 review

Probiotics vs placebo or control

Plaque index (PI) / oral hygiene · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to the bacterial plaque index versus control (MD 0.21, 95%CI -0.55 to 0.96; very low certainty).

1 finding from 1 review

Probiotics vs placebo or control

Streptococcus viridans count (CFU/mL) · Children and/or adolescents (<18 years) without background systemic disease

Only one trial (Mishra 2014) reported S. viridans count, showing a higher count with probiotics (MD 0.40 CFU/mL, 95%CI 0.33 to 0.47); not pooled or GRADE-rated.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Self-efficacy related to oral health · school‐age children and adolescents

Theory-based educational interventions significantly improved oral health self-efficacy (SMD 1.49; low certainty), though between-study heterogeneity was very high.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health attitudes (1-7 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health attitude (SMD 9.32; low certainty); the very large effect warrants cautious interpretation.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health-related quality of life · school‐age children and adolescents

Theory-based interventions significantly improved oral health-related quality of life (SMD 7.38; low certainty), with very high heterogeneity.

1 finding from 1 review