Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

781 questions · 1,089 findings · 92 reviews · Dental caries

No studies found 77 · 7.1%GRADE not reported 781 · 71.7%Very low 86 · 7.9%Low 97 · 8.9%Moderate 38 · 3.5%High 10 · 0.9%

Silver diamine fluoride (SDF) vs placebo

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

SDF did not significantly differ from placebo for oral health-related quality of life in children (MD 0.03, 95% CI -0.16 to 0.22; ungraded).

1 finding from 1 review

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental 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

Oral-health-education-only interventions did not show a statistically significant effect on surface-level caries (dmfs SMD -0.20, 95% CI -0.43 to 0.03; 2 studies; not GRADE-rated).

1 finding from 1 review

Caries in first and second primary molars 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 the first and second primary molars is the strongest tooth-specific predictor of caries in permanent teeth (RR 3.4; single study; not GRADE-rated).

1 finding from 1 review

SDF applied biannually (every 6 months) vs Other non/minimally-invasive treatment (ART or 5% NaF varnish)

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

Biannual SDF application significantly arrested caries (pooled ES 0.39, 95% CI 0.19-0.60; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

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

SDF did not significantly differ from atraumatic restorative treatment for oral health-related quality of life (MD 0.02, 95% CI -0.32 to 0.36; ungraded).

1 finding from 1 review

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

Fluoride-releasing resin-based sealant vs Resin-based sealant

Retention of sealant (complete or partial retention) · Children with caries-free second primary molars, aged 4-8 years (dental clinic, Turkey and Spain)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-24 months
    Effect estimate not calculable; 69 (2 studies). Retention equivocal: Unal 2015 100% (fluoride resin) vs 96.0% (resin) at 12 months; Baca 2007 84.1% (fluoride resin) vs 97.7% (resin) at 12 months; at 24 months 87.8% vs…
    2 studies · 69 participants
    Very low

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

Glass ionomer-based sealant vs No sealant (control/no treatment)

Retention of sealant (complete or partial retention) · Children with caries-free primary first molars (with or without caries on other teeth), aged 1-5 years (paediatric clinic/dental school,…
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-30 months
    Chadwick 2005: one or more sealants fully/partially retained in 69 (31.2%) children at 12-30 months; Joshi 2019: at 12 months 75 (43.6%) teeth completely retained, 58 (33.7%) partially retained, 39 (22.7%) completely…
    2 studies
    GRADE not reported

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

Autopolymerised sealant vs Light polymerised sealant

Retention of sealant (complete or partial retention) · Children with sound primary molars, aged 2-4 years (municipal dental clinics or hospital paediatric clinics, Denmark)

It is very uncertain whether autopolymerised sealant changes retention of sealant (complete or partial retention) compared with light polymerised sealant (very low certainty).

1 finding from 1 review