Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

574 questions · 721 findings · 67 reviews · Oral Health

No studies found 93 · 12.9%GRADE not reported 450 · 62.4%Very low 82 · 11.4%Low 73 · 10.1%Moderate 21 · 2.9%High 2 · 0.3%

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

Learning disability (CLD) vs No learning disability (CNLD)

Early childhood caries experience (mean dmft) · Children aged 1-18 years

In primary teeth, meta-analysis found no evidence of a difference in caries experience (dmft/deft) between children with and without learning disabilities (SMD 0.41, 95% CI -0.14 to 0.96; 8 studies; certainty not graded).

4 findings from 1 review
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Learning disability (CLD) vs No learning disability (CNLD)

Dental caries in permanent teeth · Children aged 1-18 years

Across all learning disabilities, meta-analysis found no evidence of a difference in permanent-tooth caries experience (DMFT) between children with and without learning disabilities (SMD -0.43, 95% CI -0.91 to 0.05; 16 studies; certainty not graded).

4 findings from 1 review
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Learning disability (CLD) vs No learning disability (CNLD)

Unmet dental treatment need · Children aged 1-18 years

Narrative reports from 6 studies suggested greater unmet dental treatment need in children with learning disabilities (5 of 6 studies), but no quantitative data were available (certainty not graded).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Filled primary surfaces at 3 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

Fluoride supplementation (tablets, drops, lozenges or chewing gum) showed no clear difference in filled primary surfaces at 5 years compared with placebo or no treatment; GRADE not reported.

2 findings from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Fluorosis (maxillary teeth) at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes fluorosis (maxillary teeth) at 5 years compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Caries in primary teeth: dmft (3 years) · Pregnant women (for preventing dental caries in the primary teeth of their children)

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Fluorosis (mandibular teeth) at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes fluorosis (mandibular teeth) at 5 years compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Decayed primary surfaces at 3 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

Fluoride supplementation (tablets, drops, lozenges or chewing gum) showed no clear difference in decayed primary surfaces at 3 years compared with placebo or no treatment; GRADE not reported.

2 findings from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Decayed or filled primary tooth surfaces at 3 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes decayed or filled primary tooth surfaces at 3 years compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Decayed or filled primary tooth surfaces at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes decayed or filled primary tooth surfaces at 5 years compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Adhesive/polyurethane sealant patch vs No treatment (both arms received flossing plus fluoride toothpaste)

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

Adhesive/polyurethane sealant patch showed no clear difference in caries (lesion) progression (radiographic) compared with no treatment (both arms received flossing plus fluoride toothpaste); GRADE not reported.

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

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

Micro-invasive treatment (proximal sealing or resin infiltration):… probably leads to lower caries (lesion) progression measured by pairwise reading of… compared with non-invasive measures (e.g. fluoride varnish, flossing/oral hygiene… (moderate certainty).

4 findings from 1 review
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Resin sealant (one micro-invasive treatment) vs Resin infiltration alone

Caries (lesion) progression (radiographic) · 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

Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

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

Resin infiltration led to lower caries (lesion) progression (radiographic) compared with fluoride varnish, sham/placebo, or flossing advice (non-invasive…; GRADE not reported.

1 finding from 1 review

Postbiotic products (postbiotic toothpaste; heat-killed/postbiotic oral lozenges; inactivated-bacteria tablets) vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Streptococcus mutans count · Humans at risk of dental caries (children aged 6-12 years; adults with dental caries)

Postbiotic products reduce salivary S. mutans counts in human trials, though not always significantly (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Daily for 14 days to 4 weeks · Clinical; salivary/plaque sampling
    Three RCTs reported reduced salivary S. mutans counts after postbiotic intervention; the reduction was statistically significant in Lin 2022 but non-significant in Basir 2022; no pooled estimate.
    3 studies
    GRADE not reported

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish, placebo)

Adverse effects (tooth staining and other side effects) · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF commonly causes black staining of arrested lesions; only mild, transient adverse events were reported, with no major adverse events (ungraded).

1 finding from 1 review