Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

336 questions · 427 findings · 28 reviews · Dental caries

No studies found 48 · 11.2%GRADE not reported 284 · 66.5%Very low 46 · 10.8%Low 25 · 5.9%Moderate 24 · 5.6%High 0 · 0%

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Dental caries: dmfs increment (primary teeth) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmfs increment ranged from -1.0 to 1.0 across 7 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free children (primary dentition, d3) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual decline in the percentage of caries-free children ranged from 3.8% to 12.2% across 6 studies (descriptive range, no pooled estimate; ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries incidence rate (first D3 lesion) per person-year at risk (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the pooled caries incidence rate was 0.11 per person-year at risk (95% CI 0.09 to 0.13; random-effects meta-analysis of 15 studies), i.e., about 11 of every 100 caries-free persons develop dentine caries each year (ungraded).

1 finding from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per person-year at risk · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    Incidence rate (per person-year at risk) 0.11 [0.09, 0.13]
    15 studies · 10768 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in dmft (primary dentition) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmft increment ranged from -0.3 to 0.3 across 4 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Farzanegan 2021 = Transbond XT + 1% chitosan + 1% TiO2 (co-intervention); Mollabashi 2022 = TiO2-only composite (1 wt%) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel demineralization / white spot lesion prevention (DIAGNOdent, enamel mineral content) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

Two small RCTs gave inconsistent results for TiO2-modified adhesives/composites on enamel demineralization (one favorable on DIAGNOdent, one no difference in mineral content); ungraded.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

When usual mechanical plaque control continued, Salvadora persica and chlorhexidine did not differ significantly for plaque; not GRADE-rated.

8 findings from 1 review
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Salvadora persica (miswak) mouthrinse vs Chlorhexidine 0.2% mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica was less effective than 0.2% chlorhexidine at reducing plaque (favours chlorhexidine); not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced plaque more than placebo (favours Salvadora persica); certainty not GRADE-rated (Shekelle grade Ia).

1 finding from 1 review

Single full-coverage metal-ceramic crown over composite core and post vs Direct adhesive composite restoration with post (conventional filling, no crown)

Cost of the intervention · People with a permanent tooth that has undergone endodontic (root canal) treatment

The review found no eligible studies for this question.

1 finding from 1 review

Resin composite restorations containing antibacterial agents vs Non-antibacterial containing composite restorations

Costs (direct costs of interventions) · Adults and adolescents in any age group with restorations in the permanent dentition and children with restorations in the primary dentition

The review found no eligible studies for this question.

1 finding from 1 review

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Adverse events · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…
1 finding from 1 review
  • Ozone therapy for the treatment of dental caries 2004 · Cochrane All outcomes
    To 6 months
    Baysan 2003 stated that no adverse events were reported to 6 months; no information was provided by Abu-Naba'a 2003 or Abu-Naba'a 2003pilot.
    1 study
    GRADE not reported

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Patient satisfaction · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…
1 finding from 1 review
  • Abu-Naba'a 2003 reported participants' state of anxiety, comparing ozone treatment with traditional dental interventions (injection, drilling, filling); because no participant was randomised between ozone and drilling…
    1 study
    GRADE not reported

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Further conventional dental treatment (filling and drilling) (binary yes/no) · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…

The review found no eligible studies for this question.

1 finding from 1 review
  • Data were not provided by any study on the number of lesions requiring restorations to 6 months or later; no data on any further conventional treatment or other dental interventions.
    Studies not reported
    No studies found

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Costs · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…

The review found no eligible studies for this question.

1 finding from 1 review

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Pain (assessed by the patient) · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…

The review found no eligible studies for this question.

1 finding from 1 review

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Caries progression/regression (clinical severity index, log(e) ECM and log(e) DIAGNOdent scores) · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…
1 finding from 1 review
  • Ozone therapy for the treatment of dental caries 2004 · Cochrane All outcomes
    6 and 12 months
    No consistent trend of benefit or harm following ozone was seen across the outcome measures in any of the three studies; analyses were conducted at the lesion level (not independent of the person), so data were not…
    3 studies · 137 participants
    GRADE not reported

Fluoride-releasing resin-based sealant vs Non-invasive measures (fluoride varnish; no intervention)

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

Pooling 2 trials, resin-based sealants reduced radiographic proximal caries progression versus non-invasive measures (OR 0.24; ungraded subgroup).

1 finding from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing produces a small but statistically significant reduction in tooth-surface caries (DMFS/dmfs SMD -0.22, 95% CI -0.42 to -0.01; ungraded).

1 finding from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Dental caries increment, DMFT/dmft (whole-tooth level) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing has no statistically significant effect on whole-tooth caries (DMFT/dmft SMD 0.05, 95% CI -0.27 to 0.37; ungraded).

1 finding from 1 review

Microinvasive technique (proximal sealing) vs no intervention

Radiographic proximal caries lesion progression · Children with lesions in both primary and permanent teeth (ages 8-10)

In one trial including both primary and permanent teeth, proximal sealing reduced radiographic caries progression versus no intervention (OR 0.16; ungraded subgroup).

1 finding from 1 review