What do systematic reviews say?

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs None (descriptive prevalence meta-analysis)

In permanent dentition, the pooled prevalence of dental caries was 57.2% (95% CI 26.3 to 85.3); ungraded.

• Prevalence of dental caries in Pakistan: a systematic review and meta-analysis. 2021 All outcomes

  Pakistan (school-, community-, and hospital/clinic-based cross-sectional surveys) · Dentition: permanent
  Prevalence 57.184 [26.288, 85.251]
  Studies not reported
  GRADE not reported
• Prevalence of dental caries in Pakistan: a systematic review and meta-analysis. 2021 All outcomes

  Pakistan (school-, community-, and hospital/clinic-based cross-sectional surveys) · Dentition: mixed
  Prevalence 61.183 [43.796, 73.274]
  Studies not reported
  GRADE not reported
• Prevalence of dental caries in Pakistan: a systematic review and meta-analysis. 2021 All outcomes

  Pakistan (school-, community-, and hospital/clinic-based cross-sectional surveys) · City: Islamabad and Rawalpindi (combined)
  Prevalence 57.377 [32.642, 80.287]
  4 studies
  GRADE not reported

Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

It is very uncertain whether sealing using sealant materials changes failure of therapy compared with selective carious tissue removal (selective excavation, SE) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  18-24 months · Cavitated lesions, primary dentition
  OR 3.11 [0.11, 85.52]
  2 studies · 82 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Stepwise carious tissue removal (SW)

Non-selective carious tissue removal and conventional restoration (CR) probably leads to higher failure of therapy compared with stepwise carious tissue removal (SW) (moderate certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  6-60 months · Deep lesions, permanent dentition
  OR 2.06 [1.34, 3.17]
  3 studies · 398 participants
  Moderate
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12 months · Deep lesions, primary dentition
  OR 2.43 [0.65, 9.12]
  1 study · 63 participants
  Very low

Selective carious tissue removal (selective excavation, SE) vs Hall Technique (sealing with a preformed metal crown)

It is very uncertain whether selective carious tissue removal (selective excavation, SE) changes failure of therapy compared with hall Technique (sealing with a preformed metal crown) (very low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  24-36 months · Deep lesions, primary dentition
  OR 1.95 [0.57, 6.63]
  1 study · 72 participants
  Very low
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  24 months · Cavitated but not deep lesions, primary dentition
  OR 8.94 [0.57, 139.67]
  2 studies · 586 participants
  Very low

Non-selective carious tissue removal and conventional restoration (CR) vs Hall Technique (sealing with a preformed metal crown)

Non-selective carious tissue removal and conventional restoration (CR) may leads to higher failure of therapy compared with hall Technique (sealing with a preformed metal crown) (low certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  30-60 months · Cavitated (not deep) lesions, primary dentition
  OR 8.35 [3.73, 18.68]
  2 studies · 249 participants
  Low

Not applicable (single-group prevalence) vs Not applicable

Fixed-effect pooled dental caries prevalence was 57.0% (95% CI 56.4% to 57.6%).

• Prevalence of dental caries in Pakistan: a systematic review and meta-analysis. 2021 All outcomes

  2009 to 2020 · Pakistan · Fixed-effects model
  Prevalence 56.999 [56.415, 57.581]
  30 studies · 27878 participants
  GRADE not reported

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Periodontitis prevalence is significantly higher in systemic sclerosis patients than controls (OR 7.01); certainty ungraded.

• Oral manifestations of patients with systemic sclerosis: a meta-analysis for case-controlled studies. 2021 All outcomes

  Hospital/clinic-based case-control studies from Asia, America and Europe
  OR 7.007 [3.529, 13.915]
  3 studies
  GRADE not reported

Intervention not reported

Caries prevalence was lowest in Addis Ababa at 34.20% (95% CI 8.42 to 59.97); certainty not graded.

• Dental caries and associated factors in Ethiopia: systematic review and meta-analysis. 2021 All outcomes

  Community-, school-, and hospital/clinic-based populations across regions of Ethiopia · Addis Ababa
  Prevalence 0.3420 [0.0842, 0.5997]
  2 studies
  GRADE not reported

Intervention not reported

Caries prevalence was highest in Eritrea at 65.2% (95% CI 49.2 to 81.1); certainty not graded.

• Prevalence of Dental Caries and Associated Factors in East Africa, 2000-2020: Systematic Review and Meta-Analysis. 2021 All outcomes

  Community- and school-based populations, East Africa · Eritrea
  Prevalence 0.652 [0.492, 0.811]
  Studies not reported
  GRADE not reported

Intervention not reported

Caries prevalence in the Amhara region was 40.44% (95% CI 24.67 to 56.21); certainty not graded.

• Dental caries and associated factors in Ethiopia: systematic review and meta-analysis. 2021 All outcomes

  Community-, school-, and hospital/clinic-based populations across regions of Ethiopia · Amhara
  Prevalence 0.4044 [0.2467, 0.5621]
  6 studies
  GRADE not reported

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

The review found no eligible studies for this question.

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
  None of the studies reported adverse effects.
  0 studies
  No studies found

Systemic sclerosis (SSc / scleroderma) vs SSc-free individuals (controls)

Systemic sclerosis patients have a significantly higher number of decayed teeth than controls (SMD 0.19); certainty ungraded.

• Oral manifestations of patients with systemic sclerosis: a meta-analysis for case-controlled studies. 2021 All outcomes

  Hospital/clinic-based case-control studies from Asia, America and Europe
  SMD 0.186 [0.007, 0.365]
  3 studies
  GRADE not reported

Intervention not reported

Caries prevalence in other regions (Oromia, Harar, SNNPR) was 42.90% (95% CI 24.68 to 61.12); certainty not graded.

• Dental caries and associated factors in Ethiopia: systematic review and meta-analysis. 2021 All outcomes

  Community-, school-, and hospital/clinic-based populations across regions of Ethiopia · Others (Oromia, Harar town, SNNPR)
  Prevalence 0.4290 [0.2468, 0.6112]
  3 studies
  GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Stepwise carious tissue removal (SW)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Permanent and primary dentition
  Cost-effectiveness reported narratively: SE found more cost-effective than SW in permanent (Labib 2019) and primary teeth (Elhennawy 2021); not GRADE-rated.
  2 studies
  GRADE not reported

Intervention not reported

Caries prevalence in Sudan was 57.8% (95% CI 36.0 to 79.7); certainty not graded.

• Prevalence of Dental Caries and Associated Factors in East Africa, 2000-2020: Systematic Review and Meta-Analysis. 2021 All outcomes

  Community- and school-based populations, East Africa · Sudan
  Prevalence 0.578 [0.360, 0.797]
  Studies not reported
  GRADE not reported

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

The review found no eligible studies for this question.

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes
  We found no studies reporting subjective evaluation of the treatments by participants.
  0 studies
  No studies found

Sealing using sealant materials vs Selective carious tissue removal (selective excavation, SE)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Cavitated lesions, primary dentition
  Lesion progression reported narratively: Dias 2018 1/27 sealed vs 1/21 SE at 24 months; Hesse 2014 0/17 sealed vs 0/17 SE at 18 months; not pooled and not GRADE-rated.
  2 studies
  GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Stepwise carious tissue removal (SW)

Selective carious tissue removal (selective excavation, SE) probably leads to higher failure of therapy compared with stepwise carious tissue removal (SW) (moderate certainty).

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-60 months · Deep lesions, permanent dentition
  OR 2.25 [1.33, 3.82]
  3 studies · 371 participants
  Moderate
• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  12-24 months · Deep lesions, primary dentition
  OR 2.05 [0.49, 8.62]
  2 studies · 126 participants
  Very low

Intervention not reported

Caries prevalence was highest in the Tigray region at 46.59% (95% CI 24.64 to 68.54); certainty not graded.

• Dental caries and associated factors in Ethiopia: systematic review and meta-analysis. 2021 All outcomes

  Community-, school-, and hospital/clinic-based populations across regions of Ethiopia · Tigray
  Prevalence 0.4659 [0.2464, 0.6854]
  2 studies
  GRADE not reported

Non-selective carious tissue removal and conventional restoration (CR) vs Hall Technique (sealing with a preformed metal crown)

• Interventions for treating cavitated or dentine carious lesions 2021 · Cochrane All outcomes

  Primary dentition
  Cost-effectiveness reported narratively: HT found more cost-effective than CR in primary teeth (Innes 2011; Santamaria 2018); not GRADE-rated.
  2 studies
  GRADE not reported