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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
5,762 questions in 263 reviews · Dental caries
current versionsNo studies 321 · 5.6%Ungraded 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Breastfeeding promotion and support (e.g. individually tailored home-based peer counselling on the importance of breastfeeding, with advice and support for healthy breastfeeding) vs Standard care dmfs index score · For interventions, pregnant and lactating women; for outcomes, children up to 6 years of age Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood… (2024) · Cochrane | dmfs was listed in the SoF table but not assessed (not reported for this comparison). | 0 studies | No studies |
Silver diamine fluoride (SDF) vs Placebo or no treatment Secondary prevention of caries · Children and adults (with or without carious lesions) · Permanent dentition (root) Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | No studies measured this outcome for root surfaces | 0 studies | No studies |
Silver diamine fluoride (SDF; 38% in most trials, 30% in three) 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) · 12 to 18 months, SDF vs NSF The role of silver diamine fluoride as dental caries preventive and arresting agent: a systematic review and… (2024) | OR 0.52 [0.43, 0.63] | 1 study · 1853 participants | Ungraded |
Intervention NR Overall success (composite of clinical and radiographic success) · Full pulpotomy, immature teeth Efficacy of pulpotomy for permanent teeth with carious pulp exposure: A systematic review and meta-analysis… (2024) | Proportion 0.844 [0.748, 0.921] | 7 studies | Ungraded |
Cranberry extract / juice and proanthocyanidin (flavonoid) fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride) pH drop / acidogenicity buffering · Streptococcus mutans (in vitro cultures and biofilms) Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus… (2024) | Cranberry PAC buffered acidogenesis: final pH 5.6 vs 5.2 control (Koo), lactic acid reduced 44% (Philip 2019) and 46% at 500 ug/mL (Philip 2019 EJOS), final pH 4.7-4.9 vs 3.7 control (Duarte), and disrupted glycolytic… | 5 studies | Ungraded |
Silver diamine fluoride (SDF) vs Placebo or no treatment Secondary prevention of caries · Children and adults (with or without carious lesions) · 24 months, Permanent dentition (coronal) Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | Peto OR 44.22 [33.12, 59.04] | 1 study · 663 participants | Very low |
Silver diamine fluoride (SDF) vs Fluoride varnish Dental pain or sensitivity · Children and adults (with or without carious lesions) · 12 months, Children Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | OR 0.36 [0.10, 1.34] | 1 study · 62 participants | Very low |
Intervention NR Correlation between teledentistry and clinical caries assessment · Studies reporting Spearman correlation (Almosa 2014, Daniel 2017, Zotti 2022) Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral… (2024) | Spearman correlation coefficient 0.76 to 0.99 (Almosa 0.76; Zotti 0.816; Daniel 0.99) | 3 studies | Ungraded |
Fluoride toothpaste less than 1000 ppm (lower concentration) vs Fluoride toothpaste 1000 ppm or more (higher concentration) Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years) Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane | OR 0.89 [0.52, 1.52] | 2 studies · 258 participants | Very low |
High intake of sweets vs Lower/less intake of sweets Dental caries · Primary school children in Ethiopia Prevalence of dental caries and associated factors among primary school children in Ethiopia: systematic… (2024) | OR 2.71 [1.968, 3.451] | 5 studies | Ungraded |
Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride) Gtf activity · Streptococcus mutans (in vitro cultures and biofilms) Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus… (2024) | GSE inhibited glucosyltransferase activity 43.9%, rising to 65.7% when combined with amine fluoride (Furiga). | 1 study | Ungraded |
Fluoride-releasing primers/adhesives (Opal Seal; Clearfil Protect Bond) vs Conventional primer/adhesive (Transbond XT) White spot lesions / enamel demineralization (photographic scoring, DIAGNOdent, micro-CT) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35) · 8 weeks to full treatment (to debonding) Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | Three non-randomized studies (Comert 2020 n=56; Oz 2019 n=35; Oz 2017 n=15) showed no consistent clinical advantage. Comert: no significant difference in photographic WSL severity or area, although DIAGNOdent favored… | 3 studies · 106 participants | Ungraded |
Orthodontic adhesive containing quaternary ammonium resin monomer + 40% n-ACP vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control Calcium and phosphate ion release · Human enamel specimens around orthodontic brackets (in vitro) · up to 42 days, Overall Remineralization and anti-demineralization effect of orthodontic adhesives on enamel surrounding orthodontic… (2024) | One study using an experimental quaternary ammonium resin monomer + 40% n-ACP adhesive reported a significant increase of calcium and phosphate ion release up to 42 days compared with the control group [33]. | 1 study | Ungraded |
Number of missing teeth (per additional tooth) vs One fewer missing tooth Oral cancer (OC) · Adults in case-control studies of oral cancer · Not specified, Missing teeth (per tooth) Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. (2024) | OR 0.96 [0.92, 1.01] | 2 studies | Ungraded |
Intervention NR Dental caries prevalence in children · Meta-regression adjusted estimate Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic… (2024) | Proportion 0.21 [0.16, 0.26] | NR | Ungraded |
Started toothbrushing with fluoride toothpaste before 24 months (earlier start) vs Started after 24 months (later start) Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years) Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane | OR 2.25 [1.19, 4.23] | 6 studies · 1223 participants | Very low |
Maternal smoking during pregnancy vs No maternal smoking during pregnancy Dental caries in children · Children of mothers assessed for smoking status during pregnancy (early childhood dental caries) · Exposure during pregnancy; caries assessed in early childhood, Sample size: >3000 Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and… (2024) | OR 2.18 [2.07, 2.31] | 2 studies | Ungraded |
Salivary Actinobacillus level (high) vs Not specified Salivary S. mutans level · Humans with salivary bacteria measured · Overall Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 2.39 [1.00, 5.71] | 1 study | Ungraded |
Presence of oral Candida albicans vs Absence of oral Candida albicans Early childhood caries (ECC) · Children aged ≤6 years (early childhood) · Exposure and outcome assessed concurrently (observational); children aged ≤6 years, Sample collection: oral swab RETRACTED: Investigating the association between Candida albicans and early childhood dental caries: A… (2024) | OR 9.55 [2.17, 42.01] | 2 studies | Ungraded |
Intervention NR Change in prevalence of salivary Streptococcus sobrinus · Single study (Stsepetova et al. 2019), erythritol and xylitol vs sorbitol, not pooled Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. (2024) | Narrative (no effect size) Erythritol and xylitol significantly reduced the prevalence of salivary S. sobrinus | 1 study | Ungraded |
Grape seed extract (GSE) and its proanthocyanidin fractions vs Untreated or vehicle control (some studies vs positive antimicrobial controls, e.g. chlorhexidine/fluoride) Antioxidant capacity · Streptococcus mutans (in vitro cultures and biofilms) Effect of flavonoids from grape seed and cranberry extracts on the microbiological activity of Streptococcus… (2024) | GSE had the highest Trolox-equivalent antioxidant capacity (6.99 ug/mL) among the tested agents (Furiga). | 1 study | Ungraded |
Breastfeeding for <18 months vs Breastfeeding for ≥18 months Dental caries (early childhood caries) · Preschool children (<6 years) · Cohort studies Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta-Analysis. (2024) | RR 0.41 [0.18, 0.92] | 5 studies · 2332 participants | Ungraded |
Disability (developmental, intellectual, or sensory) vs Persons without disabilities Dental caries prevalence and severity · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or… · Cross-sectional Disabilities and Disparities in Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis… (2024) | Narrative synthesis (no pooled estimate). High dental caries burden among PWDs: caries prevalence 60% to over 80% (abstract). Alkahtani 2019 (hearing-impaired adults, single-arm): caries prevalence 82.2%, treatment… | NR | Ungraded |
Opal Seal fluoride-releasing primer vs Conventional Transbond XT primer Bracket failure · Patients undergoing fixed orthodontic treatment · During orthodontic treatment Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed… (2024) | No significant differences were observed in bracket failure rates among different primers, dental arches, bracket types, or sexes. | 1 study · 56 participants | Ungraded |
Silver diamine fluoride (SDF) vs Fluoride varnish Primary caries prevention · Children and adults (with or without carious lesions) · 36 months, Permanent dentition (root) Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | MD -0.20 [-0.91, 0.51] | 1 study · 100 participants | Very low |
Prenatal vitamin D deficiency (maternal 25(OH)D measured at gestational weeks 24 to 38) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D) Dental caries in children · Infants and children (aged about 2 to 8 years) whose mothers' vitamin D status was assessed during pregnancy · Maternal 25(OH)D measured at gestational weeks 24 to 38, Gestational-age subgroup: weeks 24 to 38 Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic… (2024) | OR 1.30 [1.15, 1.45] | 4 studies | Ungraded |
Presence of oral Candida albicans vs Absence of oral Candida albicans Early childhood caries (ECC) · Children aged ≤6 years (early childhood) · Exposure and outcome assessed concurrently (observational); children aged ≤6 years, Study design: case-control RETRACTED: Investigating the association between Candida albicans and early childhood dental caries: A… (2024) | OR 5.30 [1.72, 16.31] | 2 studies · 708 participants | Ungraded |
Mineral trioxide aggregate (MTA) vs Calcium hydroxide (CH) Overall success (composite of clinical and radiographic success) · Permanent teeth with carious pulp exposure · >=12 months, Mature teeth Efficacy of pulpotomy for permanent teeth with carious pulp exposure: A systematic review and meta-analysis… (2024) | OR 2.63 [1.14, 6.03] | NR | Ungraded |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Mixed-type caries (crown and root) · Adults · Mixed-type caries Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 3.40 [3.10, 3.73] | 1 study | Ungraded |
Silver diamine fluoride (SDF; 38% in most trials, 30% in three) vs Nano-silver fluoride (NSF; with or without green tea extract) Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition) · 3 weeks to 12 months, SDF vs NSF The role of silver diamine fluoride as dental caries preventive and arresting agent: a systematic review and… (2024) | OR 0.39 [0.26, 0.60] | 2 studies · 384 participants | Ungraded |
Silver diamine fluoride (SDF) vs Placebo or no treatment Caries arrest · Children and adults (with or without carious lesions) · 24 to 36 months, Primary dentition Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | MD 0.86 [0.39, 1.33] | 2 studies · 841 participants | Low |
Intervention NR Serum vitamin D (25(OH)D): ECC vs caries-free · Region: North America (Fig 4) The Association Between Vitamin D and Early Childhood Caries: A Systematic Review and Meta-Analysis. (2024) | Mean difference -13.10 [-16.97, -9.23] | 4 studies | Ungraded |
Not applicable (single-group prevalence) vs Not applicable (single-group prevalence) Early childhood caries (ECC) prevalence (%, dmft>0) · Children younger than 71 months (under 6 years) · GNI >$40000 A systematic review and meta-analysis on early-childhood-caries global data. (2024) | Prevalence 47 [32, 62] | 14 studies | Ungraded |
AA+AG genotypes vs GG genotype Dental caries · Children (<18 years) with vs without dental caries · Dominant model (AA+AG vs GG) Association of vitamin D receptor gene polymorphisms with caries risk in children: a systematic review and… (2024) | OR 1.07 [0.59, 1.96] | 3 studies · 855 participants | Ungraded |
Extraction of the mandibular permanent first molar vs None (single-group prevalence) Rotation of the mandibular second premolar · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar) · Until eruption of the permanent second molar (median follow-up 4.0 years), Mandible Spontaneous space closure after extraction of permanent first molars in children and adolescents: a… (2024) | Prevalence 60.0 [10.7, 95.0] | 2 studies · 105 participants | Ungraded |
Cesarean section delivery vs Vaginal delivery Early childhood caries (ECC) · Children aged <6 years · Time period: 2017 and before RETRACTED: The association between mode of childbirth delivery and early childhood caries: A comprehensive… (2024) | OR 1.10 [0.80, 1.52] | 11 studies | Ungraded |
Silver diamine fluoride (SDF) vs Placebo or no treatment Primary caries prevention · Children and adults (with or without carious lesions) · 36 months, Primary dentition Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | MD -1.14 [-1.58, -0.70] | 1 study · 373 participants | Very low |
Intervention NR Overall success (composite of clinical and radiographic success) · Full pulpotomy, mature teeth Efficacy of pulpotomy for permanent teeth with carious pulp exposure: A systematic review and meta-analysis… (2024) | Proportion 0.846 [0.739, 0.930] | 9 studies | Ungraded |
Silver diamine fluoride (SDF) vs Fluoride varnish Secondary prevention of caries · Children and adults (with or without carious lesions) · Permanent dentition (root) Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | No studies reported data in this dentition type | 0 studies | No studies |
Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs Standard care Adverse events for mother or child · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes,… Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood… (2024) · Cochrane | One trial (Harrison 2012) reported observing no adverse events; other trials provided no information on adverse events. | 1 study | Ungraded |
Orthodontic adhesive/composite containing nano-calcium fluoride (n-CaF2), alone or with DMAHDM vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control Enamel remineralization extent · Human enamel specimens around orthodontic brackets (in vitro) · pH cycling 30 days, Overall Remineralization and anti-demineralization effect of orthodontic adhesives on enamel surrounding orthodontic… (2024) | A study using an orthodontic adhesive containing nano-calcium fluoride showed statistically significant remineralization compared with control orthodontic adhesives [35]. | 1 study | Ungraded |
Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight) Dental caries / early childhood caries (ECC) · Children (approx. 4-18 years) Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… (2024) | OR 1.44 [1.16, 1.78] | 16 studies | Ungraded |
Higher BMI (continuous / per-unit increment) vs Lower BMI (continuous reference / per 1 kg/m2 decrement) Dental caries in children · Children (approx. 4-18 years) · Continuous BMI, direct pooling (studies reporting BMI as a continuous variable) Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… (2024) | OR 1.01 [0.99, 1.03] | 4 studies | Ungraded |
Highest BMI category (overweight/obese) vs Lowest BMI category (normal weight/underweight) Dental caries / early childhood caries (ECC) · Children (approx. 4-18 years) · Study design: case-control Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and… (2024) | OR 1.31 [0.77, 2.22] | 4 studies | Ungraded |
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) · After cariogenic acid challenge / pH cycling, sound enamel Effect of Er:YAG Laser Irradiation on Preventing Enamel Caries: A Systematic Review and Meta-Analysis. (2024) | SMD 2.41 [0.70, 4.12] | 3 studies | Ungraded |
CC+CA genotypes vs AA genotype Dental caries · Children (<18 years) with vs without dental caries · Dominant model (CC+CA vs AA) Association of vitamin D receptor gene polymorphisms with caries risk in children: a systematic review and… (2024) | OR 0.91 [0.55, 1.50] | 3 studies · 1327 participants | Ungraded |
Brushed less than twice per day vs Brushed twice or more per day Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years) Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane | OR 0.88 [0.71, 1.08] | 3 studies · 2037 participants | Very low |
Silver diamine fluoride (SDF) plus fluoride varnish vs Sealants plus fluoride varnish (with or without restorations) Adverse effects · Children and adults (with or without carious lesions) · Study period (24 months), Children Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults (2024) · Cochrane | Ruff 2022 reported that there were no adverse events during the study period; adverse events were not defined by the study authors. Assumed data available for 1398 participants. | 1 study · 1398 participants | Very low |
Male sex vs Female sex Spontaneous space closure · Children and adolescents after extraction of a mandibular permanent first molar (before eruption of the second molar) · Until eruption of the permanent second molar (median follow-up 4.0 years), Mandible Spontaneous space closure after extraction of permanent first molars in children and adolescents: a… (2024) | OR 1.38 [0.37, 5.14] | 2 studies | Ungraded |
Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual/clinical dental examination (reference standard) Specificity · Children and adults with primary or permanent dentition undergoing dental caries assessment · Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo), Overall (studies reporting specificity; narrative synthesis) Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral… (2024) | Specificity ranged from 83% to 100% across studies (reported in 13 of 19 studies). No pooled estimate; meta-analysis not performed. | 13 studies | Ungraded |