Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

288 questions · 349 findings · 41 reviews · Dental caries

No studies found 43 · 12.3%GRADE not reported 207 · 59.3%Very low 42 · 12%Low 32 · 9.2%Moderate 22 · 6.3%High 3 · 0.9%

Herbal mouthwash vs placebo

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Reduction in frequency and severity of drooling · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin significantly reduced DSFS scores versus placebo (SMD -0.80, 95% CI -1.25 to -0.36; ungraded subgroup).

3 findings from 1 review

Resin infiltration vs Placebo or no active treatment

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 lesions, active caries…

Resin infiltration significantly improved remineralization versus control (SMD -0.94, 95% CI -1.46 to -0.43), ranking second of seven therapies by SUCRA (88.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Fluoride varnish vs Placebo varnish, resin sealant, or standard care (oral hygiene instructions)

Prevalence of white spot lesions (WSL) at debonding, subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances

Fluoride varnish applied regularly during fixed orthodontic treatment may reduce the prevalence of white spot lesions at debonding (pooled RR 0.64, 95% CI 0.42 to 0.98), but the certainty of evidence is very low.

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs placebo injection

Adverse events (participants with >=1 adverse event) · Adults with Parkinson's disease and sialorrhea (drooling)

Type A botulinum toxin showed a borderline, non-significant increase in adverse events versus placebo (RD 0.10, 95% CI 0.00 to 0.21; ungraded subgroup).

3 findings from 1 review

P11-4 + fluoride varnish vs Placebo or no active treatment

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 lesions, active caries…

Combined self-assembling peptide P11-4 plus fluoride varnish significantly improved white spot lesion remineralization versus control (SMD -0.96, 95% CI -1.44 to -0.48) and ranked highest of seven therapies by SUCRA (89.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Herbal mouthwash vs placebo

Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced gingival inflammation-related indices versus placebo, but certainty is very low.

1 finding from 1 review

Chlorhexidine mouthwash vs placebo

Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.

1 finding from 1 review

Fluoride varnish vs Placebo varnish, resin sealant, or standard care (oral hygiene instructions)

White spot lesion clinical score (mean values), subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances

In a pooled analysis of two placebo-controlled trials, fluoride varnish also reduced white spot lesion clinical scores (pooled SMD -0.44, 95% CI -0.64 to -0.24); this secondary outcome was not separately GRADE-rated.

1 finding from 1 review

Fluoride varnish vs Placebo or no active treatment

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 lesions, active caries…

Fluoride varnish (gold standard) did not differ significantly from control (SMD -0.25, 95% CI -0.51 to 0.02); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Chlorhexidine mouthwash vs Placebo mouthwash

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash probably reduces the Gingival Index versus placebo in the short term (WMD -0.45, 95% CI -0.70 to -0.20; low certainty).

1 finding from 1 review

CPP-ACP vs Placebo or no active treatment

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 lesions, active caries…

CPP-ACP did not differ significantly from control (SMD -0.18, 95% CI -0.49 to 0.14); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

CPP-ACFP vs Placebo or no active treatment

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 lesions, active caries…

CPP-ACFP versus control gave SMD -0.42 (95% CI -0.84 to 0.00); the review classed CPP-ACFP as statistically significant versus control although the reported CI upper limit is at the null (0.00); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Atraumatic restorative treatment vs placebo

Oral health-related quality of life · Children with dental caries

ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).

3 findings from 1 review

Silver diamine fluoride (SDF) vs placebo

Oral health-related quality of life · Children with dental caries

SDF did not significantly differ from placebo for oral health-related quality of life in children (MD 0.03, 95% CI -0.16 to 0.22; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF, including SDF + fluoride varnish) vs Other standard-of-care caries treatments pooled (placebo, ART, or ART + fluoride varnish)

Oral health-related quality of life · Children with dental caries

SDF had no significant effect on oral health-related quality of life versus pooled standard-of-care caries treatments (SMD -0.06, 95% CI -0.20 to 0.08; ungraded).

1 finding from 1 review

Chemotherapy vs Placebo

Outcome not reported · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

The review found no eligible studies for this question.

1 finding from 1 review

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Adverse events (any type) and safety of sealant · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review

Sealing (resin sealant, glass ionomer cement, or polyurethane tape) vs Non-invasive / control treatment

Radiographic proximal caries lesion progression · Patients with non-cavitated proximal (approximal) caries lesions (primary or permanent dentition)

Sealing probably reduces the odds of proximal lesion progression compared with placebo (OR 0.27, 95% CI 0.18 to 0.42; moderate certainty).

1 finding from 1 review

Any of the interventions (CR, SE, SW, sealing with sealant materials, Hall Technique, or NRCC) vs Each other, placebo, or no treatment

Subjective evaluation of the treatments by participants · Children and/or adults with permanent or primary teeth, vital (sensitive) pulps, and cavitated or dentine carious lesions conventionally…

The review found no eligible studies for this question.

1 finding from 1 review