Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,378 questions · 2,146 findings · 145 reviews · Oral Health

No studies found 167 · 7.8%GRADE not reported 1,674 · 78%Very low 148 · 6.9%Low 113 · 5.3%Moderate 40 · 1.9%High 4 · 0.2%

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

Laser fluorescence (DIAGNOdent 2190/pen) 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. 34 datasets, 6842 tooth sites.
    32 studies
    GRADE not reported

Laser fluorescence (LF; DIAGNOdent) 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. 46 datasets, 7316 tooth sites.
    45 studies
    GRADE not reported

Red fluorescence devices (DIAGNOdent, DIAGNOdent pen, MidWest; excitation wavelength >655 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) 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

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: Medium dentine-caries prevalence (15% to 34%) (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: Histology or excavation reference standard (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: Permanent/mixed dentition (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