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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · Oral Health

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No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

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)

Adverse events and periodontal/secondary outcomes (gingival bleeding, gingival bleeding index, visible plaque index) · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

Only three trials reported secondary/adverse outcomes; no adverse events were attributed to microinvasive treatment and periodontal findings were mixed and not pooled (ungraded).

1 finding from 1 review

Partial pulpotomy (PP) with calcium hydroxide vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Partial pulpotomy with calcium hydroxide had a pooled success rate of 34.3%.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Risk of fragility fractures · Females aged over 50 years

In females over 50, fragility-fracture risk rose steeply from ~0.5 mg/L: RR 0.98 at 0.25, 1.00 at 0.45, and 1.26 (95% CI 1.10-1.46) at 1.0 mg/L drinking-water fluoride vs null; ungraded.

3 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females over 50 years: drinking-water fluoride 0.45 mg/L vs null
    RR 1.00 [0.80, 1.24]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females over 50 years: drinking-water fluoride 0.25 mg/L vs null
    RR 0.98 [0.83, 1.14]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females over 50 years: drinking-water fluoride 1.0 mg/L vs null
    RR 1.26 [1.10, 1.46]
    Studies not reported
    GRADE not reported

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative post-test probability · Dental images or diagnostic tests for dental caries detection

The negative post-test probability was 6%; certainty was not graded.

1 finding from 1 review

Intervention not reported

Amalgam: Preference for replacement over repair - Scenario 2: loss of dental hard substance adjacent to the restoration

The intervention led to higher amalgam: Preference for replacement over repair - Scenario 2: loss…; GRADE not reported.

1 finding from 1 review

Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Hydroxyapatite (e.g., nano-HAp)

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

In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Peptide vs HAp showed no significant difference in 24 h bond strength (MD -0.288, 95% CI -7.988 to 7.411; Very Low certainty).

2 findings from 1 review

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

Adequate marginal or tooth integrity · Children receiving dental restorations (aged 4-11 years; primary teeth; Class I/II/V cavities)

No significant difference between IRR and CR in marginal or tooth integrity (high certainty).

1 finding from 1 review

Hydroxyapatite (e.g., nano-HAp) vs HEMA/EGDMA-based desensitizer

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, HAp vs HEMA showed no significant difference in 24 h bond strength (MD -4.815, 95% CI -10.709 to 1.079; Moderate certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health behaviour (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health behavior (SMD 2.58; low certainty), with very high heterogeneity.

1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Reference standard (bitewing radiography, ADA classification, ICDAS II)

Occlusal caries detection: sensitivity · Patients (in vivo); permanent and primary teeth, occlusal surfaces

In vivo, QLF pooled sensitivity for occlusal caries detection was 0.86 (4 studies; ungraded).

2 findings from 1 review

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

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

No significant difference between IRR and CR in color or translucency (moderate certainty; downgraded for inconsistency).

1 finding from 1 review

Dental caries vs Caries-free status

Relative abundance of S. mutans in saliva · Systemically healthy individuals (children and adults, aged 40 months to 50 years) assessed for dental caries

The relative abundance of S. mutans in saliva is significantly higher in caries-active than caries-free individuals (pooled SMD 1.48, 95% CI 0.45 to 2.50), but heterogeneity is very high (I2=90%); ungraded.

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Serum IgG antibody response (immunogenicity) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines elicited increased serum IgG antibody responses across the animal studies (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review