Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

63 questions · 106 findings · 8 reviews · Dental caries

No studies found 13 · 12.3%GRADE not reported 72 · 67.9%Very low 11 · 10.4%Low 10 · 9.4%Moderate 0 · 0%High 0 · 0%

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Fluoride toothpaste alone

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride mouthrinse combined with fluoride toothpaste showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride toothpaste alone; GRADE not reported.

1 finding from 1 review

Patient-used 5000 ppm F toothpaste, daily vs 1450 to 1500 ppm F toothpaste

Number of participants with new demineralised lesions (DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

Patient-used 5000 ppm F toothpaste, daily throughout treatment showed no clear difference in number of participants with new demineralised lesions (DLs) compared with 1450 ppm F (conventional) toothpaste, daily (low certainty).

1 finding from 1 review

Fluoride varnish vs Untreated lesions (single-arm before vs after proportion)

Remineralisation of early enamel caries · Patients (mainly children) with white spot lesions (WSL)

Professionally applied 5% sodium fluoride varnish remineralised about two-thirds of early enamel caries lesions in children (pooled proportion 63.6%, 95% CI 36.0% to 91.2%; 4 studies); certainty was not GRADE-rated and heterogeneity was very high (I2=96%).

1 finding from 1 review

1.23% APF gel vs Not specified

Remineralisation of early enamel caries · Children with early (incipient) enamel caries

One trial found acidulated phosphate fluoride gel did not remineralise early enamel caries; ungraded.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs Not specified

Remineralisation of early enamel caries · Children with early (incipient) enamel caries

One trial found sodium fluoride gel significantly remineralised early enamel caries; ungraded.

1 finding from 1 review

10% silver diamine fluoride (SDF) vs Glass ionomer restoration and tooth-brushing

Remineralisation of early enamel caries · Children with early enamel caries in erupting permanent first molars

One pilot study found 10% silver diamine fluoride worked about as well as glass ionomer restoration and tooth-brushing for remineralising early enamel caries; ungraded.

1 finding from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Mother microbiological presence (high-level mutans streptococci / lactobacilli) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

Oral health education/promotion (oral hygiene advice plus diet and… showed no clear difference in mother microbiological presence (high-level mutans streptococci /… compared with standard care; GRADE not reported.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Dental caries · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

The review found no eligible studies for this question.

2 findings from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Child oral health behaviours · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age
1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Caries presence in primary teeth · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

It is very uncertain whether oral health education/promotion (oral hygiene advice plus diet and… changes caries presence in primary teeth compared with standard care (very low certainty).

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

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

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

Diagnostic accuracy in previously restored teeth (secondary caries) · 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) · Restorations (secondary caries)
    Pre-specified heterogeneity investigation of teeth with previously applied restorations (secondary caries): no study intentionally included restored teeth in its sample. Studies evaluating secondary caries were…
    0 studies
    No studies found

CPP-ACP vs No active treatment (control)

Enamel surface microhardness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP increased Vickers microhardness versus control (SMD 1.19, 95% CI 0.72 to 1.66; ungraded).

3 findings from 1 review

CPP-ACP vs No active treatment (control)

Average enamel surface roughness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP markedly reduced enamel surface roughness versus control (SMD -8.21, 95% CI -10.37 to -6.04; ungraded).

1 finding from 1 review

0.9% silicon tetrafluoride (SiF4) vs Not specified

Remineralisation of white spot lesions · Patients (mainly children) with white spot lesions (WSL)

One trial found professionally applied silicon tetrafluoride did not remineralise white spot lesions; ungraded.

1 finding from 1 review

12,500 ppm F (NaF/olaflur/dectaflur) amine fluoride gel vs Placebo gel

Number of participants with more severe DLs (severity of DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

The review found no eligible studies for this question.

1 finding from 1 review

Patient-used 5000 ppm F toothpaste, daily vs 1450 to 1500 ppm F toothpaste

Number of participants with more severe DLs (severity of DLs) · Orthodontic patients of any age with fixed braces (new DLs assessed at debond)

The review found no eligible studies for this question.

1 finding from 1 review