Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,954 questions · 2,335 findings · 149 reviews · All outcomes

No studies found 436 · 18.7%GRADE not reported 1,370 · 58.7%Very low 254 · 10.9%Low 173 · 7.4%Moderate 80 · 3.4%High 22 · 0.9%

Bulk-fill composite resin with 7-second dentine etching vs Bulk-fill composite resin with 15-second dentine etching

Treatment failure (annual failure rate) · Children (aged 5-8 years) with Class-II caries in primary molars, no pulp therapy

Etching dentine for 7 s rather than 15 s lowered bulk-fill composite failure (5.8% vs 16.9% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Fluoride-free nano-/micro-hydroxyapatite (nHA) dentifrice vs Control (regular fluoride) dentifrice

Caries lesion initiation/progression (ICDAS score, laser fluorescence/DIAGNOdent, photographic pixels, enamel acid resistance) · Patients (children and adults, age 3-40 years) with initial enamel caries lesions (non-orthodontic and orthodontic)

No meta-analysis was possible for the 5 in vivo RCTs (high heterogeneity); narratively nHA showed generally no significant difference versus fluoridated dentifrice, and the evidence was not graded (ungraded).

1 finding from 1 review
  • Efficacy of nano-hydroxyapatite on caries prevention-a systematic review and meta-analysis. 2022 All outcomes
    Median follow-up 6 months (range 6-12 months) · In vivo (clinical); non-orthodontic and orthodontic patients
    No meta-analysis was performed for the in vivo studies owing to high heterogeneity (population, control group, outcomes, follow-up periods, risk of bias) and differing statistical designs (e.g., non-inferiority);…
    5 studies · 420 participants
    GRADE not reported

Hypnosis vs relaxation

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hypnosis showed no clear difference in pain intensity compared with relaxation; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion
    Not pooled (clinical heterogeneity). Abrahamsen 2011: MD -1.00 (95% CI -2.27 to 0.27), n=38 (hypnosis 19, relaxation 19); Stam 1984: MD not reported, n=27 (hypnosis 12, relaxation 15).
    2 studies · 65 participants
    GRADE not reported

Habit reversal vs waiting list control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Habit reversal treatment led to lower pain intensity compared with waiting-list control; GRADE not reported.

1 finding from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Treatment failure (annual failure rate) · Children (aged 3-5.5 years) with early childhood caries in anterior primary teeth (>=2 carious surfaces), no pulp therapy

Zirconia crowns failed less than composite strip crowns (3.3% vs 15% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Percentage of bleeding on probing (BOP) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower bleeding on probing (BOP) compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Glass ionomer-based sealant vs Resin-based sealant

Development of >=1 new carious lesion (caries incidence) · 'Healthy' children with caries-free second primary molars, aged 3-5 years (schools and kindergartens, India and China)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-24 months
    N/A - insufficient quantitative information available; 200 (2 studies). Comments: Due to the methods of data collection, analysis and reporting we were unable to provide any quantitative estimates. Fei 2011 narrative:…
    2 studies · 200 participants
    Very low

Primary dentition DMFT score over 13 vs No caries in primary teeth (DMFT = 0)

Caries prevalence in permanent dentition · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

A primary-dentition DMFT over 13 is associated with about 15 times higher risk of caries in permanent teeth (single study; not GRADE-rated).

1 finding from 1 review

Education vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review

Metal-reinforced glass-ionomer cement (MRGIC) restoration vs Conventional GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Metal-reinforced GIC had a high annual failure rate (29.9%) in a single RCT; low quality of evidence (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) plus fluoride varnish vs Atraumatic restorative treatment + fluoride varnish (ART+FV)

Oral health-related quality of life · Children with dental caries

SDF plus fluoride varnish did not significantly differ from ART plus fluoride varnish for oral health-related quality of life (MD 0.16, 95% CI -0.1 to 0.42; ungraded).

1 finding from 1 review

Fluoride-releasing resin-based sealant vs Resin-based sealant

Development of >=1 new carious lesion (caries incidence) · Children with caries-free second primary molars, aged 4-8 years (dental clinic, Turkey and Spain)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-24 months
    N/A - insufficient quantitative information available; 69 (2 studies). Comments: Due to the different sealant materials, data reporting (split-mouth studies reported as parallel-group) and the very low number of tooth…
    2 studies · 69 participants
    Low

Traditional screening (referral card given if the inspecting dentist judges the child needs to see a dentist) vs No screening

Malocclusion or orthodontic treatment needs measured by any validated index · School children (aged 4 to 15 years), primary and secondary schools in the UK and India

The review found no eligible studies for this question.

1 finding from 1 review

Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)

Early childhood caries (ECC) - association at lead SNP rs7325099 (13:28104496; nearest gene(s) LNX2, POLR1D, RPL21) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

The common variant rs7325099 near LNX2, POLR1D, RPL21 showed suggestive (not genome-wide significant) association with ECC (Z = 4.485, p = 7.28e-6); genetic association, ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).

1 finding from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain disability at treatment completion compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

Traditional screening (referral card given if the inspecting dentist judges the child needs to see a dentist) vs No screening

Proportion of children with other untreated oral health needs · School children (aged 4 to 15 years), primary and secondary schools in the UK and India

The review found no eligible studies for this question.

1 finding from 1 review