Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

377 questions · 736 findings · 60 reviews · Dental caries

No studies found 17 · 2.3%GRADE not reported 563 · 76.5%Very low 39 · 5.3%Low 47 · 6.4%Moderate 50 · 6.8%High 20 · 2.7%

1.23% APF gel vs no treatment

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel was probably more effective than no treatment for arrest or reversal of any-coronal carious lesions (RR 2.25, 95% CI 2 to 2.53; moderate certainty).

1 finding from 1 review

1.23% APF gel vs Fluoride varnish

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel may not differ from 5% NaF varnish for arrest or reversal of any-coronal carious lesions (RR 1.05, 95% CI 0.85 to 1.29; low certainty).

1 finding from 1 review

30% SDF solution (once weekly for 3 weeks) vs Fluoride varnish

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (once weekly for 3 weeks) probably did not differ from 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 0.97, 95% CI 0.8 to 1.18; moderate certainty).

3 findings from 1 review

10% CPP-ACP paste vs no treatment

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

10% CPP-ACP paste may not differ from no treatment for arrest or reversal of any-coronal carious lesions (RR 1.03, 95% CI 0.9 to 1.18; low certainty).

1 finding from 1 review

10% CPP-ACP paste vs Fluoride varnish

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

10% CPP-ACP paste was probably less effective than 5% NaF varnish for arrest or reversal of any-coronal carious lesions (RR 0.48, 95% CI 0.38 to 0.6; moderate certainty).

1 finding from 1 review

Fluoride varnish vs no treatment

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

5% NaF varnish was probably more effective than no treatment for arrest or reversal of any-coronal carious lesions (RR 2.15, 95% CI 1.8 to 2.57; moderate certainty).

1 finding from 1 review

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Primary teeth with advanced cavitated carious lesions on any coronal surface

38% SDF solution biannually compared with 12% SDF solution biannually: RR 1.29 (95% CI 1.21 to 1.38); High certainty.

1 finding from 1 review

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Proposed inhibition of S. mutans adhesion to tooth surface (mechanism; direct adherence endpoint confirmed only in Ahn 2018) · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

Postbiotics inhibit S. mutans adhesion to tooth surfaces in vitro (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    Postbiotics (mainly biosurfactants and lipoteichoic acid) interfered with S. mutans adhesion to tooth/hydroxyapatite surfaces in 5 in vitro studies; no pooled estimate.
    5 studies
    GRADE not reported

School-based supervised toothbrushing (STB) vs no intervention

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing produces a small but statistically significant reduction in tooth-surface caries (DMFS/dmfs SMD -0.22, 95% CI -0.42 to -0.01; ungraded).

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Proper surface texture or luster · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in surface texture or luster (high certainty).

1 finding from 1 review

Ion-releasing restorations (IRR): RMGIC, HVGIC, GIC, compomer/PMRC, giomer vs Composite resin (CR), including bulk-fill composite

Proper surface staining · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in surface staining (moderate certainty; downgraded for inconsistency).

1 finding from 1 review

Experimental orthodontic composite containing nano-hydroxyapatite (n-HAP) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel surface microhardness · Human enamel specimens around orthodontic brackets (in vitro)

In vitro, a nano-hydroxyapatite-containing orthodontic composite showed significant enamel remineralization versus control in a single study (ungraded).

1 finding from 1 review

Advice about a healthy diet (including breastfeeding promotion and sugar avoidance) and feeding practices (e.g. relating to bottle-feeding and sleep) for infants and young children vs usual care

dmfs index score (decayed, missing, filled primary surfaces; range 0-80) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

Advice about a healthy diet (including breastfeeding promotion and… showed no clear difference in dmfs index score (decayed, missing, filled primary surfaces; range… compared with standard care (low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Fluoride varnish

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two highly heterogeneous trials, SDF showed no significant difference versus 5% sodium fluoride varnish in surface-level caries arrestment (OR 1.46; ungraded subgroup).

1 finding from 1 review

Fixed orthodontic treatment with fixed (multibracket) appliances (exposure) vs None (single-group prevalence/incidence estimate)

Incidence of new ICLs (proportion of tooth surfaces developing new lesions) · Patients undergoing fixed orthodontic treatment with fixed (multibracket) appliances, followed for development of new ICLs

About 15% of tooth surfaces developed new ICLs during fixed orthodontic treatment (pooled 0.15, 95% CI 0.08-0.26; very low certainty; extreme heterogeneity).

1 finding from 1 review

CO2 laser (carbon dioxide) vs No anticaries intervention (untreated enamel)

Enamel surface / cross-sectional microhardness · Human / bovine enamel specimens under cariogenic challenge (in situ / ex vivo)

CO2 laser irradiation changes enamel microhardness versus untreated enamel (MD 49.55, CI 37.74 to 61.37; ungraded, 3 ex-vivo studies, I2=48%); the forest plot shows higher microhardness in laser-treated enamel, although the review text states the opposite.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, nano-silver fluoride arrested more surfaces than SDF (OR 0.52 favoring the comparator; ungraded subgroup).

1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Enamel surface microhardness · Human tooth enamel specimens, sound/intact (in vitro)

In sound enamel, Er:YAG laser irradiation significantly increased surface microhardness after acid challenge versus untreated control (SMD 2.41, 95% CI 0.70 to 4.12; 3 in vitro studies; ungraded).

1 finding from 1 review