Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

High-frequency sugar consumption (three or more times daily) vs Low sugar intake (fewer than three times daily)

Dental caries prevalence · Nigerian individuals, including children and adults, with primary or permanent dentition

High-frequency sugar consumption was associated with 18% higher but non-significant odds of dental caries in Nigeria (OR 1.18, 95% CI 0.87 to 1.59; I2=36%; ungraded).

1 finding from 1 review

Low-power CO2 laser irradiation (LLLT, 0.5 to 2 W) vs Placebo (placebo laser or placebo agent) or no treatment

White spot lesion incidence · High caries-risk patients: fixed-orthodontic-appliance patients and children with partially erupted permanent molars

Low-power CO2 laser (LLLT) is associated with a lower incidence of new white spot lesions than placebo (OR 0.21, CI 0.15 to 0.30; ungraded, 3 RCTs, considerable heterogeneity I2=71%).

1 finding from 1 review

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Specificity for dental caries diagnosis · Children and adults with primary or permanent dentition

Specificity ranged from 83% to 100% across 13 studies; no meta-analysis or GRADE rating was reported.

1 finding from 1 review

TT+CC (homozygous) genotypes vs CT (heterozygous) genotype

Dental caries · Children (<18 years) with vs without dental caries

Over-dominant model (CC+TT vs CT) at FokI(rs10735810) showed no significant association with caries (OR 0.83); ungraded.

1 finding from 1 review

A allele vs G allele

Dental caries · Children (<18 years) with vs without dental caries

FokI(rs2228570) allelic model: A vs G was not significantly associated with dental caries (OR 1.07); ungraded.

1 finding from 1 review

Nd:YAG laser vs No anticaries intervention (untreated enamel)

Enamel acid resistance (cross-sectional microhardness) · Human enamel in pits and fissures (in situ / ex vivo)

Nd:YAG laser increased enamel acid resistance versus untreated enamel in pits and fissures (ungraded, 1 ex-vivo study, no pooled estimate).

1 finding 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 in children · Children aged 4 to 6 years whose mothers' prenatal vitamin D status was assessed

Among children aged 4-6 years, prenatal vitamin D deficiency is associated with significantly higher odds of dental caries (OR 1.44, 95% CI 1.32-1.56); ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF and ART/glass ionomer cement showed no clear difference in tooth-level caries arrestment (OR 1.22, wide CI; ungraded subgroup).

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

Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)

Pulp necrosis · Vital teeth restored with indirect restorations

Pulp necrosis incidence among treated by prosthodontists was 1.87% (subgroup analysis; not GRADE-rated).

23 findings from 1 review
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Resin infiltration 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 lesions, active caries…

Resin infiltration did not differ significantly from CPP-ACFP (SMD -0.52, 95% CI -1.16 to 0.12; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

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)

Preschool children with mutans streptococci at baseline probably have about four times higher odds of developing early childhood caries (OR 4.13; moderate certainty).

10 findings from 1 review
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P11-4 + fluoride varnish vs CPP-ACP

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…

P11-4 plus fluoride varnish was significantly better than CPP-ACP (SMD -0.78, 95% CI -1.33 to -0.24; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

ACTIVA bioactive restorative material vs Glass ionomer cement (GIC)

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 1 year in permanent teeth, the effect of ACTIVA versus GIC on secondary caries is very uncertain (RR 22.80, 95% CI 0.89-584.17; very low certainty).

1 finding from 1 review

Tooth location

Pulp necrosis · Vital teeth

One study reported a 7.1% incidence in mandibular posterior teeth.

8 findings from 1 review
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Edentulism (complete or partial missing teeth) vs Individuals without edentulism

Oral health-related quality of life · Indian elderly

One study found edentulism did not affect OHRQoL (dichotomous); ungraded.

3 findings from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).

6 findings from 1 review
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Resin infiltration vs Fluoride varnish

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 was significantly better than fluoride varnish (SMD -0.70, 95% CI -1.18 to -0.21); certainty of evidence not assessed (no GRADE).

1 finding from 1 review