Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

129 questions · 201 findings · 16 reviews

No studies found 1 · 0.5%GRADE not reported 181 · 90%Very low 7 · 3.5%Low 7 · 3.5%Moderate 5 · 2.5%High 0 · 0%

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

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs no intervention

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol significantly reduced Mutans streptococci in dental plaque compared with no treatment (SMD -0.73, 95% CI -1.09 to -0.37; 5 trials, I2=53%; not GRADE-rated).

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

Er:YAG laser irradiation of enamel after demineralisation vs No anticaries intervention (untreated enamel)

Enamel surface microhardness · Demineralised / white-spot-lesion enamel (in vitro specimens)

In demineralised enamel, Er:YAG laser irradiation did not significantly change surface microhardness versus untreated control (SMD 0.66, 95% CI -1.12 to 2.44; 2 in vitro studies; ungraded).

1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Enamel demineralization (QLF ΔF) · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation significantly reduced enamel mineral loss versus untreated control (SMD -2.09, 95% CI -3.29 to -0.88; 4 in vitro studies; ungraded).

1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Calcium ions released in acidic solution · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation did not significantly change calcium ions released into acidic solution versus untreated control (SMD -0.40, 95% CI -0.96 to 0.15; 6 in vitro studies, I2=80%; ungraded).

1 finding from 1 review

3-month school-based supervised daily tooth-brushing program with fluoridated toothpaste (multilevel: trained school nurses plus parental involvement) vs Pre-intervention

Visible plaque and oral-hygiene behavior · Schoolchildren aged 4-6 years in the United Arab Emirates (Dubai)

One pre-post study of a school-based supervised tooth-brushing program found visible plaque fell from 76.8% to 36.7% with positive behavior change (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Fluorescence camera (FC) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by setting (FC, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant setting difference for FC (RDOR 2.96, 0.36 to 24.45).

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions

Pen-type laser fluorescence on occlusal surfaces of permanent teeth (more advanced-lesion threshold): pooled DOR for LFpen lower than for LF and FC; heterogeneity I2=73%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review

Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by reference standard (LF, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant difference vs histological for LF at the advanced threshold (RDOR 0.62, 0.15 to 2.46).

2 findings from 1 review

Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions

Laser fluorescence on occlusal surfaces of permanent teeth (initial-lesion threshold): accuracy (sensitivity, specificity, DOR, PLR, NLR, sROC AUC) similar among LF, LFpen and FC; heterogeneity I2=65%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by reference standard (LFpen, initial, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant reference-standard difference for LFpen at the initial threshold (RDOR 4.41, 0.19 to 103.92).

1 finding from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Primary teeth, occlusal surfaces, with suspected caries lesions

Pen-type laser fluorescence on occlusal surfaces of primary teeth (more advanced-lesion threshold): pooled DOR intermediate for LFpen among the three methods; heterogeneity I2=31%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, approximal surfaces, with suspected caries lesions

Pen-type laser fluorescence on approximal surfaces of permanent teeth (more advanced-lesion threshold): LFpen showed similar values at both thresholds; heterogeneity I2=84%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review

Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by reference standard (LF, initial, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

LF performed significantly better with other reference standards than with histological validation at the initial threshold (RDOR 4.13, 1.24 to 13.76).

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by setting (LFpen, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant setting difference for LFpen (RDOR 0.35, 0.04 to 2.99).

2 findings from 1 review

Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by setting (LF, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

For LF on occlusal permanent teeth (advanced threshold), laboratory studies had significantly lower diagnostic accuracy than clinical studies (RDOR 0.28, 0.12 to 0.66).

2 findings from 1 review

Fluorescence camera (FC) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Primary teeth, occlusal surfaces, with suspected caries lesions

Fluorescence camera on occlusal surfaces of primary teeth (more advanced-lesion threshold): pooled DOR highest for FC among the three methods; heterogeneity I2=80%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Primary teeth, approximal surfaces, with suspected caries lesions

Pen-type laser fluorescence on approximal surfaces of primary teeth (initial-lesion threshold): only LFpen had sufficient studies to pool; heterogeneity I2=84%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review