Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

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

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%

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Specificity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled specificity (0.90) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%).

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Area under the summary ROC curve · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

The area under the summary ROC curve for AI caries detection is 0.86, indicating high overall diagnostic accuracy; ungraded.

1 finding from 1 review

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Enamel/dental hard-tissue changes and e-liquid cariogenic properties (demineralization, colour change, pH, sugar content, metals) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

In vitro evidence suggests e-liquids are often acidic and sugar-containing and can alter enamel/dentin colour and properties, supporting a plausible cariogenic effect, but findings are heterogeneous and not pooled (ungraded, narrative).

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A positive AI test raises caries probability substantially (LR+ 10.44; positive post-test probability 79%); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Log diagnostic odds ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms show strong pooled discriminative accuracy for dental caries (log DOR 4.37; DOR 70.9); ungraded.

1 finding from 1 review

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A negative AI test lowers caries probability substantially (LR- 0.17; negative post-test probability 6%); ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Control (placebo/no treatment or other topical fluoride agents)

Prevention of new caries (caries development/increment) · Preschool children (primary dentition) at risk of new caries

Limited evidence from two trials suggests SDF may help prevent new caries, but preventive efficacy was not meta-analyzed and remains uncertain (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the individual (patient) level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-arrestment proportion at the individual level, but the reported difference was not statistically significant.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the tooth level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-free proportion at the tooth level, but the reported difference was not statistically significant.

1 finding from 1 review

38% SDF (indirect pulp capping under resin composite) vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries prevention in young permanent first molars · Children with deep occlusal caries in young permanent first molars (indirect pulp capping)

SDF and RMGIC did not differ significantly for secondary caries prevention in young permanent molars (no events; p>0.05; ungraded).

1 finding from 1 review

38% SDF plus potassium iodide (KI) (indirect pulp capping) vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries prevention in young permanent first molars · Children with deep occlusal caries in young permanent first molars (indirect pulp capping)

SDF+KI and RMGIC did not differ significantly for secondary caries prevention (p>0.05; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs Glass ionomer cement (GIC) plus fluoride varnish

Caries prevention (preventive fraction, SDF vs GIC+5% fluoride varnish) · intellectually disabled individuals with caries in permanent posterior teeth

SDF had a 45% preventative fraction versus glass ionomer cement plus fluoride varnish; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% silver diamine fluoride vs Atraumatic restorative treatment (ART)

restoration and caries status · children with caries in permanent molars

The review reported SDF was beneficial for arresting caries; no effect estimate or GRADE rating was reported.

1 finding from 1 review

Sodium fluoride (NaF) varnish, applied every 3 months, plus OHI vs inactive control

Root carious lesions prevention · Older adults with root caries (community-dwelling or residential elders)

In elders, sodium fluoride varnish gave a 64% prevented fraction for root caries vs water, lower than SDF (71%) (p<0.01; ungraded).

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

Autopolymerised sealant vs Light polymerised sealant

Development of >=1 new carious lesion (caries incidence) · Children with sound primary molars, aged 2-4 years (municipal dental clinics or hospital paediatric clinics, Denmark)

It is very uncertain whether autopolymerised sealant changes development of >=1 new carious lesion (caries incidence) compared with light polymerised sealant (very low certainty).

1 finding from 1 review