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%

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Postoperative pain intensity in the immediate postobturation period (up to 72 hours), continuous (VAS) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

Single-visit root canal treatment showed no clear difference in postoperative pain intensity in the immediate postobturation period… compared with multiple-visit root canal treatment (two or more visits) (low certainty).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of TAS2R14 (chr12p13.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted expression of TAS2R14 was significantly associated with ECC in the TWAS (p = 1.06e-6); genetic association, ungraded.

1 finding from 1 review

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

Adverse effects of treatment · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age
1 finding from 1 review

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

Dental caries prevalence · School children (aged 4 to 15 years), primary and secondary schools in the UK and India
1 finding from 1 review
  • Milsom 2006 measured prevalence of dental caries as mean number of teeth with active caries in primary teeth (dt) and permanent teeth (DT); post-intervention changes from baseline were not significant, and the authors…
    1 study · 16684 participants
    GRADE not reported

Silver diamine fluoride (SDF, including SDF + fluoride varnish) vs Other standard-of-care caries treatments pooled (placebo, ART, or ART + fluoride varnish)

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

SDF had no significant effect on oral health-related quality of life versus pooled standard-of-care caries treatments (SMD -0.06, 95% CI -0.20 to 0.08; ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of IGSF5 (chr21q22.2) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted IGSF5 expression reached the TWAS threshold for ECC (p = 7.22e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Caries in upper primary incisors vs Reference (other primary tooth locations / caries-free)

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

Caries in upper primary incisors has the lowest tooth-specific predictive value for permanent-teeth caries (RR 1.6; single study; not GRADE-rated).

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free primary dentition

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

Early childhood caries increases the likelihood of caries in permanent teeth roughly three-fold, but the certainty of evidence is very low (OR 3.22, 95% CI 2.80 to 3.71).

1 finding from 1 review

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Pain at 1 month · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption
1 finding from 1 review

Glass ionomer-based sealant vs No sealant (control/no treatment)

Dental caries increment, DMFT/dmft (whole-tooth level) · Children with caries-free primary first molars (with or without caries on other teeth), aged 1-5 years (paediatric clinic/dental school,…
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    12 months
    Joshi 2019: dmft 8.43 (SD 5.84) with sealant vs 10.05 (SD 6.16) with no sealant at 12 months (caries threshold uncertain); Chadwick 2005: no significant difference in caries increment on occlusal surfaces, no summary…
    2 studies
    GRADE not reported

Glass carbomer restoration (placed after drilling) vs Composite resin or RMGIC

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

Glass carbomer had very high failure rates (up to 46.2%) in a single RCT, far worse than composite resin or RMGIC; low quality of evidence (ungraded).

1 finding from 1 review

SDF applied once (single application, no re-application) vs Other non/minimally-invasive treatment (ART or silver-fluoride varnish)

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

A single (one-time) SDF application did not significantly arrest caries (pooled ES -0.09, 95% CI -0.48 to 0.29; ungraded).

1 finding from 1 review

Resin-based fissure sealant vs Fluoride varnish

Caries incidence of first permanent molars (FPMs) · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars

Pit and fissure sealant and fluoride varnish showed no statistically significant difference in caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of LINC02905 (C8orf49) (chr8p23.1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted LINC02905 (C8orf49) expression reached the TWAS threshold for ECC (p = 1.82e-8) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small-to-moderate, statistically significant reduction in caries experience at the tooth level (dmft SMD -0.34, 95% CI -0.54 to -0.13; 6 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

Silver diamine fluoride (SDF >=30%, i.e. 30% or 38%), applied annually or biannually 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

The pooled caries arrest rate with SDF (>=30%, applied annually/biannually) was 51.62% (622/1205 lesions arrested) at >=12 months follow-up.

1 finding from 1 review