Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

Flavonoids (e.g., quercetin, proanthocyanidin) vs Mesoporous silica (SiO2)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Silica showed no significant difference in 24 h bond strength (MD 3.764, 95% CI -5.241 to 12.769; Moderate certainty).

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 7: non-stable (mobile) restoration · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with non-stable (mobile) restoration, surveyed dentists most often preferred replacement over repair (pooled RR 24.22; p < 0.001); ungraded.

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 7: non-stable (mobile) restoration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with non-stable (mobile) restoration, surveyed dentists most often preferred replacement over repair (pooled RR 12.17; p < 0.001); ungraded.

1 finding from 1 review

Hall technique vs Partial caries removal (PCR)

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, the Hall technique had significantly higher treatment success than partial caries removal (OR 13.49; moderate certainty).

1 finding from 1 review

Anorexia nervosa (as exposure; diagnosed by DSM-III/III-R/IV/V) vs Healthy controls

Caries experience · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population

Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).

1 finding from 1 review

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

Adequate periodontal tissue · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

Uncertain whether IRR and CR differ in periodontal tissue outcomes (low certainty; downgraded for very serious inconsistency).

1 finding from 1 review

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

Microinvasive techniques probably reduce radiographic progression of non-cavitated proximal caries lesions compared with non-invasive measures (moderate certainty).

1 finding from 1 review

Prenatal vitamin D level ≤50 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a lower odds ratio at maternal prenatal vitamin D ≤50 nmol/L than at ≤35 nmol/L, without a numeric value in the available sources.

1 finding from 1 review

ADGRL2 gene (aggregate gene-based signal, MAGMA) vs Genome-wide gene background (FDR threshold)

Dental caries (self-reported history) · Japanese adults (present-study direct-to-consumer genetic testing cohort); self-reported disease cases vs controls

Gene-based analysis found ADGRL2 significantly associated with dental caries (FDR q<0.05); ungraded.

1 finding from 1 review
  • Genome-wide association meta-analysis identifies two novel loci associated with dental caries. 2024 All outcomes
    Lifelong (germline genotype) · Population-based genetic association study (Japanese direct-to-consumer genetic testing cohort) · MAGMA gene-based test (present study)
    Gene-based association analysis (MAGMA): ADGRL2 was the only gene associated with dental caries at false-discovery-rate q<0.05 (no effect size reported).
    1 study · 45525 participants
    GRADE not reported

Acidic bacillary pH on teeth vs Non-acidic bacillary pH

Dental caries · Primary school children in Ethiopia

Acidic bacillary pH on the teeth was associated with higher odds of dental caries (OR 2.42, 95% CI 1.494-3.335; ungraded).

1 finding from 1 review

Stevia (high-intensity/non-nutritive sweetener) in a daily snack vs Baseline (within-group change); white sugar snack is a parallel arm with no between-group effect size reported

Change in Mutans streptococci (MS) and Lactobacilli in saliva · Schoolchildren (6-9 years), high caries risk

The single stevia trial (Cocco 2019) reported a significant reduction in salivary Mutans streptococci and lactobacilli, but gave no effect size and was not GRADE-rated.

1 finding from 1 review
  • Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. 2024 All outcomes
    42 days · Schoolchildren in Italy, high caries risk; sweetener delivered as a daily snack · Single study (Cocco 2019); not pooled
    Cocco 2019 (the only high-intensity sweetener trial): the stevia snack showed a significant decrease in MS (P < .01) and in lactobacilli (P = .03) versus baseline, whereas the white-sugar snack showed no significant…
    1 study · 271 participants
    GRADE not reported

Disability (developmental, intellectual, or sensory) vs Persons without disabilities

Oral health-related quality of life · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or multiple disabilities)…

Persons with disabilities in Saudi Arabia report poorer overall oral health-related quality of life and greater oral-health impact than those without disabilities, synthesized narratively without a pooled estimate (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

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

In one trial, SDF greatly increased individual-level caries arrestment versus ART/glass ionomer cement (OR 18.03); this subgroup was not separately GRADE-rated.

1 finding from 1 review

Poor / no tooth brushing habit vs Good tooth brushing habit

Dental caries · Primary school children in Ethiopia

A poor tooth-cleaning habit was associated with higher odds of dental caries (OR 3.90, 95% CI 2.761-5.045; ungraded).

1 finding from 1 review

Child has a disability (special needs) vs Parents/caregivers of children without disabilities

Parental concern / caregiver stress indices (parental perception and parenting stress about the child's oral health) · Parents/caregivers of children with disabilities (special needs; autism spectrum disorder or unspecified disability) in Saudi Arabia

Parents of children with disabilities in Saudi Arabia report significantly greater concern/stress about their child's oral health than parents of children without disabilities (pooled SMD 0.43, 95% CI 0.23 to 0.63; I2=0%; 3 studies); not GRADE-rated.

1 finding from 1 review

Dental caries vs Caries-free controls

Periodontitis (prevalence) · adults

Using adjusted ORs, caries remained associated with higher periodontitis odds (OR 1.57).

3 findings from 1 review