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Evidence found and GRADE certainty

1,338 questions · 2,104 findings · 136 reviews · Dental caries

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No studies found 159 · 7.6%GRADE not reported 1,657 · 78.8%Very low 138 · 6.6%Low 111 · 5.3%Moderate 36 · 1.7%High 3 · 0.1%

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

Early childhood caries (ECC) vs Caries-free controls

Relative abundance of Veillonella spp. · Young children with early childhood caries and caries-free controls

Veillonella spp. mean relative abundance was higher in ECC children, without a comparative effect estimate or CI.

4 findings from 2 reviews · compare the 2 reviews
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Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-6 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-6 levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 11.60 pg/mL, 95% CI 6.27 to 16.94; 11 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

Salivary IL-8 level (pg/mL) · Children and young adults (3-25 years)

Salivary IL-8 levels are higher in children and young adults with active dental caries than in controls but the difference is not statistically significant (SMD 57.20 pg/mL, 95% CI -18.60 to 133.00; 7 studies); ungraded.

1 finding from 1 review

Moderate-severe active dental caries (exposure) vs Caries-free or mild dental caries (control)

TNF-α level · Children and young adults (3-25 years)

Salivary TNF-α levels are significantly higher in children and young adults with active dental caries than in caries-free or mild-caries controls (SMD 14.81 pg/mL, 95% CI 4.76 to 24.86; 7 studies); ungraded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Intra-examiner reliability ranged from kappa 0.52 to 1.00 across 6 studies; certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Overall diagnostic accuracy (agreement) · Children and adults with primary or permanent dentition undergoing dental caries assessment

Where reported (about 5 studies, Table 2), overall diagnostic accuracy was high (about 93% to 97.6%); no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Specificity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the specificity of teledentistry caries diagnosis ranged from 83% to 100%; no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Positive predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Positive predictive value was reported in 10 studies and varied widely across studies (about 42% to 99%); no pooled estimate and certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Sensitivity · Children and adults with primary or permanent dentition undergoing dental caries assessment

Across 13 studies, the sensitivity of teledentistry (photographic) caries diagnosis versus visual examination ranged from 48% to 98.3%; the review pooled no estimate and did not grade certainty.

1 finding from 1 review
  • Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
    Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting sensitivity; narrative synthesis)
    Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
    13 studies
    GRADE not reported

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Inter-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Inter-examiner reliability ranged from kappa 0.44 to 0.91 across 13 studies (moderate to almost perfect agreement); certainty not graded.

1 finding from 1 review

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Negative predictive value · Children and adults with primary or permanent dentition undergoing dental caries assessment

Negative predictive value was reported in 10 studies and ranged widely across studies (about 31% to 99.5%); no pooled estimate and certainty not graded.

1 finding from 1 review

Caries experience vs Adolescents without dental caries

Negative oral-health impact on daily performance (OIDP or Child-OIDP) · Adolescents (10-19 years)

For experience (history) of dental caries, adolescents had a significantly worse oral-health impact: PR 1.72 (95% CI 1.23 to 2.43) from 6 studies (I2=97%); ungraded, and not statistically different from the presence subgroup (p=0.19).

1 finding from 1 review
  • Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis. 2025 All outcomes
    Cross-sectional (concurrent exposure and outcome); oral impacts recalled over the prior 6 months · School-based (17/20 studies), plus household and secondary-data surveys; low-, middle- and high-income countries (Brazil, Thailand, Tanzania, Saudi Arabia, Sri Lanka, Zambia, Iran, Serbia, Nepal, India, South Africa, China) · Caries-definition subgroup: experience of dental caries
    PR 1.72 [1.23, 2.43]
    6 studies
    GRADE not reported

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction

Post-Streptococcus mutans prediction accuracy · Dental images of human beings

The review reported 99% accuracy for post-Streptococcus mutans prediction in Javed et al. (Ungraded).

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs None (descriptive prevalence; random-effects pooled proportion)

Dental caries prevalence · Children (deciduous and/or permanent dentition) in low- and middle-income countries

About 39% of children in LMICs had dental caries (pooled prevalence 0.387, 95% CI 0.284 to 0.495; 11 studies; very high heterogeneity I2=99%; not GRADE-rated).

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)

Development of >=1 new carious lesion (caries incidence) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

In preclinical animal models, anticaries vaccines significantly reduced dental caries risk (pooled RR 0.53, 95% CI 0.46 to 0.62; random-effects), but the evidence is ungraded and limited to short-term animal studies.

1 finding from 1 review

Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries prevalence · 12-year-old children (permanent dentition) in Africa

Pooled caries prevalence in Uganda was 0.27 (95% CI 0.126 to 0.418; 3 article(s); not GRADE-rated).

23 findings from 1 review
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Simple childhood caries prediction models with at least two predictors vs No competing model

Dental caries discrimination (area under the curve) · Children or adolescents

The Luo (2021) model had an AUC of 0.77 (95% CI 0.76 to 0.77).

6 findings from 1 review
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Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in the United Kingdom

In UK studies, OHPPs were associated with lower DMFT/S (OR 0.04, 95% CI 0.00 to 0.58; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review