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%

MidWest (DENTSPLY; red fluorescence, red/green light and sound signal) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Analysed as a separate index test (coupled forest plot and SROC plot, Figure 22 / Figure 23; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 4 datasets, 356 tooth sites.
    4 studies
    GRADE not reported

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Multiple sites per tooth (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Smooth or secondary-caries surfaces (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Proximal surfaces (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Occlusal surfaces (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

ART using resin-modified glass ionomer cement (RM-GIC) vs Conventional treatment using RM-GIC

Secondary caries · Older adults with root caries in permanent (mature) teeth (mean age 75 years)
1 finding from 1 review

Initiation of water fluoridation (artificial or natural) vs Low/non-fluoridated water (0.4 ppm fluoride or less)

Caries development in permanent teeth · People of all ages in a community setting; the included caries studies were all in children aged 3 to 16 years

Initiation of water fluoridation (artificial or natural) may leads to lower caries in permanent teeth (change in DMFT) compared with low/non-fluoridated water (0.4 ppm fluoride or less) (low certainty).

1 finding from 1 review

Cessation of water fluoridation (fluoride removed from the water supply) vs Continued fluoridated water

Change in proportion of caries-free children (deciduous or permanent teeth) · People of all ages in a previously fluoridated community (Maupome 2001: children with generally low caries experience)

The review found no eligible studies for this question.

1 finding from 1 review

Initiation of water fluoridation (artificial or natural) vs Low/non-fluoridated water (0.4 ppm fluoride or less)

Disparities in caries across socioeconomic status (SES) · People of all ages in a community setting; the included caries studies were all in children aged 3 to 16 years
1 finding from 1 review
  • There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries levels across SES. Data from 3 observational studies (participants not…
    3 studies · 35399 participants
    Low

Initiation of water fluoridation (artificial or natural) vs Low/non-fluoridated water (0.4 ppm fluoride or less)

Change in proportion of caries-free children (permanent teeth) · People of all ages in a community setting; the included caries studies were all in children aged 3 to 16 years

Initiation of water fluoridation (artificial or natural) may leads to higher change in proportion of caries-free children (permanent teeth) compared with low/non-fluoridated water (0.4 ppm fluoride or less) (low certainty).

1 finding from 1 review

Chlorhexidine varnish (10% and 40%) vs placebo or no treatment

Caries increment in permanent teeth · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

It is very uncertain whether chlorhexidine varnish (10% and 40%) changes caries increment in permanent dentition (DMFS; higher values… compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Cessation of water fluoridation (fluoride removed from the water supply) vs Continued fluoridated water

Early childhood caries experience (mean dmft) · People of all ages in a previously fluoridated community (Maupome 2001: children with generally low caries experience)

The review found no eligible studies for this question.

1 finding from 1 review
  • No evidence to determine the effect of the cessation of water fluoridation on caries in deciduous teeth. No included study reported change in dmft following cessation.
    0 studies
    No studies found

Cessation of water fluoridation (fluoride removed from the water supply) vs Continued fluoridated water

Dental caries in permanent teeth · People of all ages in a previously fluoridated community (Maupome 2001: children with generally low caries experience)
1 finding from 1 review
  • Water fluoridation for the prevention of dental caries 2015 · Cochrane All outcomes
    Follow-up 3 years
    Insufficient evidence to determine the effect of the cessation of water fluoridation on caries. One study (Maupome 2001), at high risk of bias, over 3 years found no increase in caries in the fluoride-ended group…
    1 study · 9249 participants
    Very low

Chlorhexidine gel (0.12%) vs no treatment

Presence of new caries in the primary teeth · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

It is very uncertain whether chlorhexidine gel (0.12%) changes presence of new caries in the primary teeth compared with no treatment (very low certainty).

1 finding from 1 review

Cessation of water fluoridation (fluoride removed from the water supply) vs Continued fluoridated water

Disparities in caries across socioeconomic status (SES) · People of all ages in a previously fluoridated community (Maupome 2001: children with generally low caries experience)

The review found no eligible studies for this question.

1 finding from 1 review

Initiation of water fluoridation (artificial or natural) vs Low/non-fluoridated water (0.4 ppm fluoride or less)

Caries in deciduous teeth (change in dmft) · People of all ages in a community setting; the included caries studies were all in children aged 3 to 16 years

Initiation of water fluoridation (artificial or natural) may leads to lower caries in deciduous teeth (change in dmft) compared with low/non-fluoridated water (0.4 ppm fluoride or less) (low certainty).

1 finding from 1 review

Chlorhexidine varnish (10%) vs placebo or no treatment

Elevated mutans streptococci levels (>=4 with caries screen; high vs low) · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

It is very uncertain whether chlorhexidine varnish (10%) changes elevated mutans streptococci levels (>=4 with caries screen; high vs… compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Chlorhexidine varnish vs placebo or no treatment

Dental caries: dmfs increment (primary teeth) · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…
1 finding from 1 review

Initiation of water fluoridation (artificial or natural) vs Low/non-fluoridated water (0.4 ppm fluoride or less)

Change in proportion of caries-free children (deciduous teeth) · People of all ages in a community setting; the included caries studies were all in children aged 3 to 16 years

Initiation of water fluoridation (artificial or natural) may leads to higher change in proportion of caries-free children (deciduous teeth) compared with low/non-fluoridated water (0.4 ppm fluoride or less) (low certainty).

1 finding from 1 review