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Evidence found and GRADE certainty

174 questions · 213 findings · 33 reviews

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No studies found 31 · 14.6%GRADE not reported 142 · 66.7%Very low 17 · 8%Low 8 · 3.8%Moderate 15 · 7%High 0 · 0%

Fluoride varnish vs Fluoride gel

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in varnish versus fluoride in gel across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review

Fluoride varnish vs Fluoride in rinse

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in varnish versus fluoride in rinse across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a small, statistically significant reduction in surface-level caries (dmfs SMD -0.14, 95% CI -0.26 to -0.02; 10 studies; not GRADE-rated).

1 finding from 1 review

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

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

Comprehensive interventions produced a statistically significant reduction in tooth-level caries (dmft SMD -0.47, 95% CI -0.84 to -0.10; 4 studies; not GRADE-rated), though heterogeneity was very high.

1 finding from 1 review

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

Adverse effects (tooth staining and other side effects) · Children and adolescents aged 16 years or less
1 finding from 1 review

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

Adverse effects: dental fluorosis · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride mouthrinse, gel or varnish combined with fluoride… showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride toothpaste alone; GRADE not reported.

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Access to oral healthcare (referral pathways, documentation processes, operating efficiencies, staffing, visits for oral health issues, uptake of fluoride varnish/other preventive treatment, and visits to an oral health professional) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
    19 studies
    GRADE not reported

Fluoride varnish vs No fluoride treatment

Dimensional change (size) of early enamel caries lesions · Patients (mainly children) with white spot lesions (WSL)

In one trial, professionally applied sodium fluoride varnish significantly reduced the size of early enamel caries lesions compared with no fluoride treatment; ungraded.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs Fluoride mouthrinse

Caries increment in permanent teeth · Children and adolescents aged 16 years or less
1 finding from 1 review

Fluoride varnish vs no treatment

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between fluoride in varnish and no treatment at randomization years 1954 to 1990; certainty was not graded.

1 finding from 1 review

Fluoride varnish vs placebo

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment showed a treatment-by-year interaction and differed between fluoride in varnish and placebo at randomization years 1954 to 1980; certainty was not graded.

1 finding from 1 review

Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Caries increment on permanent tooth surfaces (D(M)FS), prevented fraction · Children and adolescents aged 16 years or younger (permanent dentition)
7 findings from 1 review
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Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Caries increment on primary (deciduous) tooth surfaces (d(e/m)fs), prevented fraction · Children with primary (deciduous) teeth (younger children)
5 findings from 1 review
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Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Caries increment on permanent whole teeth (D(M)FT), prevented fraction · Children and adolescents aged 16 years or younger (permanent dentition)
7 findings from 1 review
Show 4 more findings

Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Adverse effects (tooth staining/discoloration, oral soft-tissue signs, adverse symptoms such as nausea/vomiting, enamel etching) · Children and adolescents aged 16 years or less
1 finding from 1 review