Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,052 questions · 1,797 findings · 134 reviews

No studies found 10 · 0.6%GRADE not reported 1,630 · 90.7%Very low 95 · 5.3%Low 23 · 1.3%Moderate 22 · 1.2%High 17 · 0.9%

Prenatal vitamin D level ≤50 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a lower odds ratio at maternal prenatal vitamin D ≤50 nmol/L than at ≤35 nmol/L, without a numeric value in the available sources.

1 finding from 1 review

Prenatal vitamin D level ≤35 nmol/L vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported a slightly higher odds ratio at maternal prenatal vitamin D ≤35 nmol/L than at ≤50 nmol/L, without a numeric value in the available sources.

1 finding from 1 review

Preterm birth (<37 weeks gestation) vs Full-term birth (37 weeks or more gestation)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

In children aged 3 years or younger, preterm birth was not associated with early childhood caries (OR 0.90, 95% CI 0.59 to 1.37); certainty not graded.

2 findings from 1 review

Prenatal vitamin D deficiency (low maternal 25(OH)D during pregnancy) vs Adequate prenatal vitamin D (sufficient maternal 25(OH)D)

Dental caries · Children aged 2 to 8 years

The review reported an OR of 1.32 when prenatal vitamin D was measured at 6 to 38 gestational weeks.

2 findings from 1 review

Multivariable caries prediction model vs Additional prediction model(s)

Coronal caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

168 findings from 1 review
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Multivariable caries prediction model vs Additional prediction model(s)

Root caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

22 findings from 1 review
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Multivariable caries prediction model vs Additional prediction model(s)

Coronal and/or root caries increment · Individuals of all ages

The review reported this model performance without meta-analysis.

2 findings from 1 review

Laser enamel preparation (with or without acid-etching) vs Acid-etching (phosphoric acid)

Adverse events · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

No adverse events were reported in any included study (ungraded, narrative).

1 finding from 1 review

Laser enamel preparation alone (Er,Cr:YSGG or CO2 laser) vs Acid-etching (phosphoric acid)

Development of >=1 new carious lesion (caries incidence) · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

In the single study reporting it, caries incidence was 0% in both the laser-alone and acid-etching groups (ungraded, single study).

1 finding from 1 review

Laser enamel preparation alone (Er,Cr:YSGG or CO2 laser) vs Acid-etching (phosphoric acid)

Acceptability · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

Both laser and acid-etching preparation were well accepted by patients (VAS, P = 1.000; ungraded, single study).

1 finding from 1 review

Laser enamel preparation alone (Er,Cr:YSGG or CO2 laser) vs Acid-etching (phosphoric acid)

Clinical (chair-side) time · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

Laser conditioning was reported to take less chair-side time than acid-etching in the studies that measured it, but times were not pooled (ungraded, narrative).

1 finding from 1 review

Laser enamel preparation alone (Er,Cr:YSGG or CO2 laser) vs Acid-etching (phosphoric acid)

Sealant retention rate (completely retained) · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

At 18 months, laser preparation alone did not differ significantly from acid-etching for sealant retention (OR 0.82, 95% CI 0.23 to 2.85; ungraded, single study, high risk of bias).

6 findings from 1 review
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CPP-ACP enamel pre-treatment for prevention 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 · Extracted permanent human teeth (enamel); sound or demineralized

CPP-ACP enamel pre-treatment before bonding did not significantly affect the shear bond strength of metallic orthodontic brackets (MD 1.163 MPa, 95% CI -0.321 to 2.648; ungraded).

1 finding from 1 review

CPP-ACP enamel pre-treatment for prevention 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 · Sound enamel of extracted permanent human teeth

When used to prevent white spot lesions on sound enamel, CPP-ACP pre-treatment did not significantly affect shear bond strength (MD 1.009, 95% CI -0.723 to 2.740; ungraded).

1 finding from 1 review

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

When used to remineralize white spot lesions on demineralized enamel, CPP-ACP pre-treatment did not significantly affect shear bond strength (MD 1.501, 95% CI -0.630 to 3.632; ungraded).

1 finding from 1 review

Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded.

2 findings from 1 review

Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years)

Early childhood caries (ECC) · Healthy children under 6 years of age (6 months to 6 years); preschool children

In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded.

2 findings 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