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Evidence found and GRADE certainty

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

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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%

Resin-based fissure sealant vs Fluoride varnish

Caries incidence of first permanent molars (FPMs) · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars

Pit and fissure sealant and fluoride varnish showed no statistically significant difference in caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of LINC02905 (C8orf49) (chr8p23.1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted LINC02905 (C8orf49) expression reached the TWAS threshold for ECC (p = 1.82e-8) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding 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 · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small-to-moderate, statistically significant reduction in caries experience at the tooth level (dmft SMD -0.34, 95% CI -0.54 to -0.13; 6 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

Silver diamine fluoride (SDF >=30%, i.e. 30% or 38%), applied annually or biannually vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

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

The pooled caries arrest rate with SDF (>=30%, applied annually/biannually) was 51.62% (622/1205 lesions arrested) at >=12 months follow-up.

1 finding from 1 review

Unfavourable oral hygiene and dietary habits (frequent sweet/sugar consumption; low toothbrushing frequency in early childhood) vs Favourable oral hygiene and dietary habits

Caries development in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Early-childhood oral hygiene and dietary habits show inconsistent associations with permanent-teeth caries, often losing significance after adjustment for past caries (2 studies; not pooled; not GRADE-rated).

1 finding from 1 review

Glass ionomer-based sealant vs Resin-based sealant

Adverse events · 'Healthy' children with caries-free second primary molars, aged 3-5 years (schools and kindergartens, India and China)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    1 study reported adverse events as some discomfort such as nausea; 1 child experienced a strong gag reflex following the glass ionomer-based sealant while 8 children reported feeling uncomfortable after the fluoride…
    1 study · 100 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 rs74470773 (3:33958083; nearest gene(s) PDCD6IP) · 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 rs74470773 near PDCD6IP showed suggestive (not genome-wide significant) association with ECC (Z = -4.589, p = 4.46e-6); genetic association, ungraded.

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of CDH17 (chr8q22.1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of CDH17 was significantly associated with ECC in the TWAS (p = 3.32e-8); genetic association, ungraded.

1 finding from 1 review

Direct composite resin restoration vs Amalgam restoration

Harms (toxicity and postoperative sensitivity) · People with permanent or adult posterior teeth requiring restoration (parallel-group trials involved children aged 6 to 12 years)
1 finding from 1 review

3-month school-based supervised daily tooth-brushing program with fluoridated toothpaste (multilevel: trained school nurses plus parental involvement) vs Pre-intervention

Visible plaque and oral-hygiene behavior · Schoolchildren aged 4-6 years in the United Arab Emirates (Dubai)

One pre-post study of a school-based supervised tooth-brushing program found visible plaque fell from 76.8% to 36.7% with positive behavior change (narrative synthesis; not GRADE-rated).

1 finding from 1 review