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Evidence found and GRADE certainty

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

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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%

Fibre-optic transillumination (FOTI) vs Histological validation (in vitro) or direct visual examination after tooth separation / bioptical cavity preparation (in vivo)

detection of proximal caries · Permanent posterior teeth, proximal surfaces (in vitro extracted teeth and in vivo patients)

For fibre-optic transillumination (FOTI), studies were identified (in vitro N=4, in vivo N=3) but none had sufficiently low risk of bias and adequate reporting to be pooled; no meta-analytic estimate could be derived.

1 finding from 1 review

Oral health knowledge, attitudes and practices assessment vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Mother self-reported oral health behaviours and attitudes · Mothers and caregivers of children in the United Arab Emirates

Mothers and caregivers often had adequate knowledge/attitudes but improper oral-health practices and low dental-service use, associated with education and occupation (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Dental plaque assessment (plaque score/index) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Plaque · Children in the United Arab Emirates (Ajman, Sharjah)

Dental plaque levels were high and associated with frequent snacking and less frequent tooth brushing, and higher plaque was linked to more caries (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary Lactobacilli counts · Patients with drooling (sialorrhea) due to neurological disease

Salivary Lactobacilli counts were unchanged in two studies but significantly increased in one study one month after BoNT (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant Lactobacilli increase at 1 month; Wu 2011 and 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    No statistically significant changes in Lactobacilli CFU counts were reported by Wu et al. or by Tiigimae-Saar 2017. However, the 2018 study found that Lactobacilli CFU counts were significantly increased one month…
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary osmolality (hydration level) · Patients with drooling (sialorrhea) due to neurological disease

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary S. mutans level · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary pH · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in oral/salivary pH across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    Wu et al. did not observe significant differences in participants' oral pH before and after BoNT-A injections between the active and control groups. There were also no statistically significant differences regarding…
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Development of >=1 new carious lesion (caries incidence) · Patients with drooling (sialorrhea) due to neurological disease

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

2 findings from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary buffering capacity · Patients with drooling (sialorrhea) due to neurological disease

Salivary buffering capacity did not decrease after BoNT; one of two quasi-experimental studies reported a significant increase (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant buffering increase at 1 month; 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The quasi-experimental studies of Tiigimae-Saar found different results concerning the changes in buffering capacity. For the analysis carried out in 2017, no statistically significant change was observed. By contrast,…
    2 studies
    GRADE not reported

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 38% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.21, 95% CI 1.12 to 1.3; high certainty).

4 findings from 1 review
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30% SDF solution (applied annually) vs 30% SDF solution (once weekly for 3 weeks)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) probably did not differ from 30% SDF solution (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.13, 95% CI 0.95 to 1.34; moderate certainty).

3 findings from 1 review