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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.

Limit to evidence status or GRADE (optional)

5,762 questions in 263 reviews · Dental caries

current versions
No studies 321 · 5.6%Ungraded 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

QuestionEffectEvidenceStatus / GRADE
Early childhood caries / severe early childhood caries vs Caries-free children
Growth stunting / low linear growth (height-for-age z-score) · Children in early childhood (0-6 years) · Khanh et al. 2015 (Vietnam; pulp-involved caries)
The bi-directional relationship between growth stunting and early childhood caries: a rapid review. (2023)
MD 0.661 study · 593 participantsUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Gao,2013 [29]; model performance 5
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 01 studyUngraded
Dental fluorosis (assessed by TFI or WHO criteria) vs Individuals without dental fluorosis
Oral health-related quality of life (continuous), measured by OIDP / CPQ11-14 · Indian children and young adults
Impact of oral conditions on oral health-related quality of life among Indians- a systematic review and… (2023)
Dental fluorosis and QoL (continuous, OIDP/CPQ11-14): a significant difference between individuals with and without fluorosis on OHRQoL (Nagarajappa 2015, Shyam 2020). Two studies, 3000 individuals; not pooled.2 studies · 3000 participantsUngraded
Resin composite (RC) vs Resin-modified glass ionomer cement (RMGIC)
Secondary caries (occurrence) · Patients requiring dental restoration; deciduous (primary) teeth · 2 or more years of follow-up
Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review… (2023)
RR 1.60 [0.85, 3.00]8 studies · 438 participantsLow
Surgery plus adjuvant radiotherapy vs Chemotherapy (chemoradiotherapy)
Total mortality · Adults with oral cavity or oropharyngeal cancer · oral cavity
Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment (2023) · Cochrane
Total mortality: study reported survival significantly better with surgery and RT vs chemoradiotherapy, but no useable data; 32 participants (1 RCT, Iyer 2015 oral cavity subgroup).1 study · 32 participantsVery low
Multivariable caries prediction model vs Additional prediction model(s)
Root caries increment · Individuals of all ages · Follow-up ≥1 year, Hayes,2017 [33]; model performance 3
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR+ 1.88 [1.53, 2.29]1 studyUngraded
CPP-ACP enamel pre-treatment for remineralization of white spot lesions before bonding metallic orthodontic brackets vs No enamel pre-treatment before bonding, or treatment with another material
Shear bond strength (SBS) of metallic orthodontic brackets · Demineralized enamel of extracted permanent human teeth · Before bonding, Remineralization of WSLs (demineralized enamel)
Shear bond strength of metallic brackets bonded to enamel pretreated with CPP-ACP: a systematic review and… (2023)
MD 1.501 [-0.630, 3.632]9 studiesUngraded
Favorable socioeconomic and family environment vs Less favorable socioeconomic and family environment
Oral health-related quality of life · Adolescents aged 10-19 years
Oral-health-related quality of life in adolescents: umbrella review. (2023)
no estimate extractedNRUngraded
Growth stunting (linear growth retardation, low height-for-age) vs Children without growth stunting (normal height-for-age)
Early childhood caries (def-t/dmft caries experience) · Children in early childhood (0-6 years) · 2-year follow-up, Sokal-Gutierrez et al. 2016 (Ecuador; pre vs post intervention)
The bi-directional relationship between growth stunting and early childhood caries: a rapid review. (2023)
Pre/post ECC prevalence, dmft, and deep-caries proportion (2-year follow-up) Age 1: prevalence 53.8% to 30.3%, dmft 2.1 to 0.9; Age 2: prevalence 82% to 60%, dmft 5.3 to 3.0, deep caries 19% to 12% (pre vs post)1 study · 1575 participantsUngraded
Compomer vs Resin composite (RC)
Secondary caries (occurrence) · Patients requiring dental restoration; deciduous (primary) teeth · 1 year of follow-up, Compomer
Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review… (2023)
RR 0.41 [0.02, 8.34]2 studies · 250 participantsUngraded
P11-4 + fluoride varnish vs Control (placebo / no active therapy)
Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic…
Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. (2023)
SMD -0.96 [-1.44, -0.48]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Birpou,2019 [25]; model performance 15
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.68 [0.50, 0.93]1 studyUngraded
Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline
Development of any (cavitated or non-cavitated) carious lesion · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline) · 6 months to 3.5 years, Microbiological assessment: quantitative (culture/CFU counting)
Is Mutans Streptococci count a risk predictor of Early Childhood Caries? A systematic review and… (2023)
OR 3.82 [2.01, 7.26]6 studies · 732 participantsUngraded
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Blank control (no mouthwash; before-after comparison)
Gingival Index (GI, Loe & Silness 1963) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term)
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
WMD -0.54 [-0.96, -0.13]6 studies · 274 participantsVery low
Indirect restorations vs Follow-up duration
Pulp necrosis incidence · Vital teeth · > 5–10 years, > 5–10 years
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023)
Proportion 5.53 [3.74, 7.64]2443 participantsUngraded
Superselective neck dissection vs Selective neck dissection
Disease-free survival (new disease, progression, and mortality) · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes · 36 months
Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment (2023) · Cochrane
Disease-free survival: Pandey 2018 reported 83% (superselective) vs 91% (selective) at median 36 months, not significant (P=0.69); unable to analyse (variable follow-up); 32 participants (1 RCT).1 study · 32 participantsVery low
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Birpou,2019 [25]; model performance 8
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.60 [0.43, 0.83]1 studyUngraded
Calcium hydroxide (CH) vs Mineral trioxide aggregate (MTA)
Clinical and radiographic success (composite) · Patients with carious pulp exposure in permanent teeth undergoing pulpotomy (partial or full) · ≥6 months; follow-up range 1-2 years, Treatment performed: pulpotomy (FP/PP)
Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious… (2023)
OR 2.36 [0.47, 11.75]6 studies · 341 participantsLow
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Disney,1992 [15]; model performance 1
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.49 [0.42, 0.58]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Disney,1992 [15]; model performance 2
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR+ 3.69 [3.05, 4.45]1 studyUngraded
Calcium hydroxide (CH) vs Biodentine
Clinical and radiographic success (composite) · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy · ≥6 months follow-up
Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious… (2023)
CH vs Biodentine was investigated in 2 RCTs for the primary outcome; not pooled. Biodentine appeared to perform better than CH (and than Theracal) in the per-trial forest plots (Figure 8). Weak evidence.2 studiesUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Birpou,2019 [25]; model performance 1
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR+ 1.55 [1.13, 2.13]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Root caries increment · Individuals of all ages · Follow-up ≥1 year, Hayes,2017 [33]; model performance 2
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.35 [0.23, 0.52]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Hänsel Petersson,2010 [31]; model performance 5
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR+ 1.13 [1.03, 1.22]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Gao.2010 [17]; model performance 2
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.11 [0.08, 0.13]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Birpou,2019 [25]; model performance 12
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.58 [0.40, 0.84]1 studyUngraded
38% SDF plus KI (annual) vs CPP-ACP (casein phosphopeptide-amorphous calcium phosphate, twice daily)
Remineralization/arrest of early enamel carious lesions · Patients with early enamel carious lesions on permanent molars · 24 months, Hamdi 2022
A systematic review on the effect of silver diamine fluoride for management of dental caries in permanent… (2023)
Proportion of lesions arrested (%) 54.81 study · 45 participantsUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Sánchez-Pérez,2009 [20]; model performance 1
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.27 [0.16, 0.46]1 studyUngraded
Intervention NR
Oral health-related quality of life (impact) · Untreated fractured tooth vs no trauma
Oral-health-related quality of life in adolescents: umbrella review. (2023)
Relative risk (reporting impact) Fourfold (4x) greater risk1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Hänsel Petersson,2010 [31]; model performance 1
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR+ 1.83 [1.52, 2.19]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Hänsel Petersson,2015 [30]; model performance 2
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.55 [0.47, 0.63]1 studyUngraded
Irradiated carious dentin vs Non-irradiated carious dentin
MMP-2 activity/expression · Human carious dentin from irradiated and non-irradiated subjects
Presence of host and bacterial-derived collagenolytic proteases in carious dentin: a systematic review of ex… (2023)
no estimate extracted1 study · 36 participantsUngraded
Caries-associated bacterial biofilm vs Sound/control tissue (sound dentin, sound root, or enamel caries)
Bacterial collagenolytic enzymatic activity · Human ex vivo carious lesions / caries-associated biofilm
Presence of host and bacterial-derived collagenolytic proteases in carious dentin: a systematic review of ex… (2023)
Results are inconclusive: protein-degrading bacteria isolated from root caries biofilm were capable of degrading collagen (Prevotella, Actinobaculum, Propionibacterium predominant; proportion 7% in root caries)…2 studies · 9 participantsUngraded
Polyether impression material vs Polyvinyl siloxane impression material
Pulp necrosis incidence · Vital teeth · Polyether
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023)
Proportion 4.02 [2.47, 5.92]2985 participantsUngraded
38% SDF varnish plus oral health instruction vs oral health instruction plus water
new root-surface carious lesions or restorations · older adults with root caries · 36 months
A systematic review on the effect of silver diamine fluoride for management of dental caries in permanent… (2023)
Preventative fraction (%) 711 study · 306 participantsUngraded
Sentinel node biopsy (neck dissection only if biopsy positive) vs Elective neck dissection
Adverse events associated with treatment · Adults with oral cavity or oropharyngeal cancer
Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment (2023) · Cochrane
Adverse events: no adverse events were reported (Garrel 2020).1 study · 279 participantsVery low
PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy
Total mortality · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3) · 3 years
Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment (2023) · Cochrane
HR 0.92 [0.65, 1.31]1 study · 564 participantsModerate
Mineral trioxide aggregate (MTA) vs Calcium hydroxide (CH)
Clinical and radiographic success · Patients with carious pulp exposure in permanent teeth · 1 to 3 years, Unadjusted; all treatment modalities and root maturities
Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious… (2023)
OR 2.94 [1.93, 4.49]10 studies · 900 participantsLow
Herbal mouthwash vs Placebo
Gingival inflammation-related index · Orthodontic patients · ≤ 3 months
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023)
GBI was significantly reduced compared to placebo [41]; GBI was significantly reduced compared to placebo [56]; BI was significantly reduced compared to placebo [40].3 studiesVery low
Elective radical (comprehensive) neck dissection vs Elective selective neck dissection
Adverse events associated with treatment · Adults with oral cavity cancer
Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment (2023) · Cochrane
Adverse events (BHNCSG 1998): flap necrosis, wound infection, fistula, vascular rupture, haematoma, seroma, chyle fistula; no complications in 45/76 modified radical ND and 54/72 supraomohyoid ND; 2 vs 1 postoperative…1 study · 148 participantsLow
Dental erosion vs No dental erosion
Oral health-related quality of life (OHRQoL) · Adolescents (10-19 years)
Oral-health-related quality of life in adolescents: umbrella review. (2023)
While dental erosion and bruxism have not been shown to impact the quality of life of adolescents [26].NRUngraded
Carious dentin before cavity sealing vs Carious dentin after cavity sealing
MMP-8 expression/activity · Human ex vivo carious dentin under sealed cavities · Before vs after sealing (Kuhn 2016: 60 days follow-up)
Presence of host and bacterial-derived collagenolytic proteases in carious dentin: a systematic review of ex… (2023)
MMP-8 may be increased in the dentin before when compared to dentin after cavity sealing; MMP-8 significantly reduced after 60 days of sealing (Kuhn et al., 2016; Chibinski et al., 2014).2 studies · 48 participantsVery low
Poor / irregular toothbrushing vs Regular toothbrushing
Oral health-related quality of life (OHRQoL) · Adolescents (10-19 years)
Oral-health-related quality of life in adolescents: umbrella review. (2023)
The systematic review reports factors that physical disability, visual impairment, mental disorders, poor diet and irregular brushing negatively impact OHRQoL [36].NRUngraded
Botulinum toxin (BoNT) injection into salivary glands vs Placebo injection
Drooling Severity and Frequency Scale (DSFS) score · Adults with Parkinson's disease and sialorrhea (drooling) · Approximately 1 month post-injection (one study ~1 week)
The effectiveness and safety of botulinum toxin injections for the treatment of sialorrhea with Parkinson's… (2023)
SMD -0.98 [-1.27, -0.70]9 studies · 224 participantsHigh
Calcium hydroxide (CH) vs Mineral trioxide aggregate (MTA)
Clinical and radiographic success (composite) · Patients with carious pulp exposure in mature permanent teeth · ≥6 months; follow-up range 1-3 years, Root maturation: mature
Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious… (2023)
OR 3.34 [1.81, 6.17]5 studies · 537 participantsModerate
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Periapical pathosis · Vital teeth restored with indirect restorations · >10 years, Follow-up >10 years
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023)
Proportion 4.05 [0.89, 9.36]2656 participantsUngraded
Fluoride varnish vs CPP-ACFP
Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic…
Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. (2023)
SMD 0.18 [-0.29, 0.64]1 studyUngraded
Mineral trioxide aggregate (MTA) vs Calcium hydroxide (CH)
Clinical and radiographic success · Patients with carious pulp exposure in permanent teeth undergoing direct pulp capping · 1 to 3 years, Direct pulp capping
Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious… (2023)
OR 3.10 [1.66, 5.79]4 studies · 559 participantsModerate
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Beck,1992 [24]; model performance 6
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR− 0.55 [0.48, 0.63]1 studyUngraded
Multivariable caries prediction model vs Additional prediction model(s)
Coronal caries increment · Individuals of all ages · Follow-up ≥1 year, Fontana,2011 [16]; model performance 9
Multivariable prediction models of caries increment: a systematic review and critical appraisal. (2023)
LR+ 2.00 [1.35, 2.95]1 studyUngraded