Gap finder

Search review questions

Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.

Limit to evidence status or GRADE (optional)

5,762 questions in 263 reviews · Dental caries

current versions
No studies 321 · 5.6%Ungraded 4,450 · 77.2%Very low 455 · 7.9%Low 297 · 5.2%Moderate 200 · 3.5%High 39 · 0.7%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

QuestionEffectEvidenceStatus / GRADE
Intervention NR
Difference in summary sensitivity (NMA, Analysis 2) · Imaging vs Transillumination
Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022)
Sensitivity difference (95% CrI) -0.27 [-0.40, -0.12]NRUngraded
Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs No intervention or usual practice/activities
Dental caries measured by net increment in DMFS scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs) · Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer), Intervention type: oral health education
Effectiveness of primary school-based interventions in improving oral health of children in low- and… (2022)
SMD -1.05 [-2.03, -0.08]3 studiesUngraded
Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls
Recurrent oral ulcerations (WHO clinical stage 2) · Children and adolescents (<18 years) · Cross-sectional (case-control; single time point)
Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A… (2022)
OR 6.83 [1.18, 39.53]3 studies · 284 participantsUngraded
Bulk-fill composite resin with 15-second dentine etching vs Bulk-fill composite resin with 7-second dentine etching
Restoration failure · Children with carious primary teeth · 1.5 years
Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp… (2022)
Annual failure rate (%) 15 s 16.9%; 7 s 5.8%1 study · 62 participantsUngraded
Caries distribution assessment (individual, tooth and surface levels) vs None (descriptive prevalence review; subgroup analyses only)
Caries distribution (individual/tooth/surface level) · European adolescents aged 12–19 years
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
No meta-analysis possible; caries distribution reported narratively from 11 studies as skewed at individual, tooth and surface levels, changing with age at tooth and surface level (Results – Caries distribution).11 studiesUngraded
Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls
Periodontal disease (gingivitis/periodontitis) · Children and adolescents (<18 years) · Cross-sectional (case-control; single time point)
Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A… (2022)
OR 3.11 [1.62, 5.97]2 studies · 250 participantsUngraded
Combined antiretroviral therapy (post-cART) vs Pre-cART (same children, before therapy)
Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH) · After vs before cART (within-person), post-cART vs pre-cART
Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and… (2022)
OR 0.19 [0.15, 0.25]NRVery low
Intervention NR
Food purchasing · Vote counting by direction of effect; unclear association of public health harm
Association of Food and Nonalcoholic Beverage Marketing With Children and Adolescents' Eating Behaviors and… (2022)
Proportion 0.25 [0.013, 0.781]4 studiesUngraded
Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs No intervention or usual practice/activities
Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs) · Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer)
Effectiveness of primary school-based interventions in improving oral health of children in low- and… (2022)
RR 0.70 [0.53, 0.94]4 studies · 2968 participantsVery low
Socioeconomic status category vs Children without dental caries
Dental caries (association with high SES) · Children (deciduous and/or permanent dentition) in low- and middle-income countries · High SES
Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income… (2022)
OR 1.03 [0.81, 1.31]5 studies · 4340 participantsUngraded
Caries assessment at enamel threshold vs None
Caries experience · European adolescents aged 13 years · Exact age
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Mean DMFS 1.45 [1.06, 1.98]1 studyUngraded
Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs No intervention or usual practice/activities
Dental caries measured by net increment in DMFS scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs) · Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer), WHO health-promoting-schools framework
Effectiveness of primary school-based interventions in improving oral health of children in low- and… (2022)
SMD -0.57 [-1.56, 0.42]2 studiesUngraded
Caries assessment at enamel threshold vs None
Caries prevalence · European adolescents aged 17 years · Exact age
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.83 [0.71, 0.94]3 studiesUngraded
Pulpotomy with Biodentine vs Pulpotomy with calcium hydroxide (Ca(OH)2)
Clinical and radiographic success rate (>=6 months) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure · >=6 months, Pulp capping material: Biodentine vs calcium hydroxide
Outcome of pulpotomy in permanent teeth with irreversible pulpitis: a systematic review and meta-analysis. (2022)
Biodentine demonstrated a statistically significantly higher success rate than calcium hydroxide (indirect comparison; Supplementary Table S5, not available).NRUngraded
High-viscosity GIC atraumatic restorative treatment vs No control
Restoration survival · Children with caries in primary molars · 2 years, Multi-surface
Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. (2022)
Survival rate 599 studiesUngraded
Fluoride-releasing resin-based sealant vs No sealant (no treatment)
Mean caries increment (mean number of new cavitated occlusal lesions) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department,… · 24 months
Sealants for preventing dental caries in primary teeth (2022) · Cochrane
Mean number of new cavitated occlusal lesions 0.23 (SD 0.06) in sealed molars vs 0.29 (SD 0.06) in control molars (Wilcoxon matched-pairs signed-rank test P = 0.42)1 study · 85 participantsUngraded
Caries severity measurement (mean number of decayed, missing and filled permanent teeth, DMFT; WHO criteria) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)
Caries severity (mean DMFT) · 12-year-old children (permanent dentition) in Africa · Country: Kenya
Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review… (2022)
MEAN 0.91 [0.295, 1.525]3 studiesUngraded
Sociodemographic / socioeconomic factors (single-parent family, low parental education, family income, socioeconomic status) vs Absence of the factor / reference socioeconomic category
Caries increment in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of…
Does Early Childhood Caries Increase Caries Development among School Children and Adolescents? A Systematic… (2022)
Inconsistent findings across studies; meta-analysis could not be performed as data could not be extracted. Single-parent family and low parental education were significant in one study (Saethre-Sundli 2020); higher…3 studiesUngraded
High-viscosity glass-ionomer cement (HVGIC) restoration (conventional restorative approach) vs Compomer, composite resin, or another HVGIC
Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years · 12-36 months
Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp… (2022)
Annual failure rate (%) 2.9-25.6%3 studiesUngraded
Food and nonalcoholic beverage marketing (exposure) vs No, less, or less powerful food marketing
Food preference · Children and adolescents aged 0-19 years · Randomized trials
Association of Food and Nonalcoholic Beverage Marketing With Children and Adolescents' Eating Behaviors and… (2022)
SMD 0.38 [0.03, 0.72]8 studies · 1802 participantsVery low
Intervention NR
Difference in summary specificity (NMA, Analysis 2) · Electrical conductance vs Imaging
Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022)
Specificity difference (95% CrI) -0.16 [-0.45, 0.02]NRUngraded
Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)
Care index (CI = f/[d+m+f]) in the primary dentition · Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable children without CL/P
Caries in children with and without orofacial clefting: A systematic review and meta-analysis. (2022)
Two out of three studies for which the CI could be calculated (Nagappan 2019; Veiga 2016) showed a higher CI for non-CL/P children demonstrating a higher proportion of extraction-based treatment in CL/P children…3 studiesUngraded
Caries assessment at enamel threshold (D(M)FS>0 or D(M)FT>0, enamel lesions included) vs None (descriptive prevalence review; subgroup analyses only)
Caries prevalence · European adolescents aged 12–19 years · Age group: 12–15 years
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.73 [0.59, 0.87]24 studiesUngraded
Intervention NR
Pain during treatment · Hall Technique vs non-selective caries removal to hard dentine
Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. (2022)
Proportion with no/mild pain 89% (HT) vs 78% (control)1 studyUngraded
Caries assessment at dentine threshold (cavitation into dentine) vs None (descriptive prevalence review; subgroup analyses only)
Caries prevalence · European adolescents aged 12–19 years · Region: non-Scandinavian
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.57 [0.32, 0.81]6 studiesUngraded
Intervention NR
Difference in summary sensitivity (NMA, Analysis 2) · Imaging vs Visual
Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022)
Sensitivity difference (95% CrI) -0.34 [-0.42, -0.23]NRUngraded
Fluorescence-based devices vs Reference standard (histology, operative excavation, or enhanced visual examination)
Sensitivity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 2: network meta-analysis (all studies evaluating >=2 index tests)
Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022)
Sensitivity 0.76 [0.68, 0.82]64 studies · 24567 participantsLow
Fluoride-containing dental care products, primarily toothpaste vs Dietary fluoride sources in extremely fluoridated areas
Contribution to total daily fluoride intake · Adults · Extreme fluoride in water (>1.5 mg/L)
Fluoride Intake Through Dental Care Products: A Systematic Review. (2022)
Mean percentage contribution 31 studyUngraded
Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)
Parotid hypertrophy prevalence · Children and adolescents (<18 years) living with HIV (CLWH)
Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and… (2022)
OR 0.01 [0.00, 0.05]NRVery low
Baby-led weaning (BLW) vs Other models of complementary feeding (traditional CF)
Overweight/obesity risk · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western… · Follow-up interval 18-78 months, BLW; observational studies
Complementary Feeding Caregivers' Practices and Growth, Risk of Overweight/Obesity, and Other… (2022)
OR 0.37 [0.25, 0.55]3 studies · 969 participantsVery low
Good brushing habits (>=2 daily tooth brushing) vs Children without dental caries
Dental caries (association with good/>=2 daily brushing) · Children (deciduous and/or permanent dentition) in low- and middle-income countries
Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income… (2022)
OR 0.65 [0.46, 0.92]7 studies · 5446 participantsUngraded
Single-surface ART with high-viscosity GIC vs Multi-surface ART with high-viscosity GIC
Mean annual restoration failure rate · Children (2-9 years) with caries in posterior primary teeth · First 3 years, Single-surface
Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. (2022)
Mean annual failure rate (%) 4.7% (van 't Hof 2006) to 5% (de Amorim 2018)NRUngraded
Prefabricated zirconia crowns (e.g., NuSmile, Zirkiz, Kinder Krown) vs Other crowns/restorations (stainless steel crowns, pre-veneered SSC, resin composite strip crowns, glass-fiber composite crowns)
Recurrent caries (crowns free of recurrent caries) · Children with primary (deciduous) teeth requiring full-coverage crown restoration · 12 months
Zirconia Crowns for Primary Teeth: A Systematic Review and Meta-Analyses. (2022)
RR 1.03 [0.96, 1.10]2 studies · 203 participantsUngraded
Placebo vs Silver diamine fluoride
Oral health-related quality of life · Children with dental caries · Direct estimate
Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. (2022)
MD 0.03 [-0.16, 0.22]2 studies · 440 participantsUngraded
Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)
Dental development and maturation · Children and adolescents (<18 years) living with HIV (CLWH)
Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and… (2022)
One study (Trigueiro 2010) reported that dental age exceeded chronological age by 5.35 to 14.36 months (SE 3.03 to 15.86) in children on NRTI/PI/NNRTI regimens versus -0.67 months in those without medication; the…1 studyVery low
Maternal education attainment vs Children without dental caries
Dental caries (association with secondary/higher maternal education) · Children (deciduous and/or permanent dentition) in low- and middle-income countries · Secondary and higher education
Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income… (2022)
OR 0.96 [0.64, 1.44]7 studies · 6529 participantsUngraded
Not applicable vs Not applicable
Mean DMFT score · Children aged 12 years (plus or minus one year) in Africa · Overall, publication-period analysis
Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review… (2022)
Mean DMFT 1.0900 [0.9143, 1.2657]NRUngraded
Fluoride-containing dental care products, primarily toothpaste vs Dietary fluoride sources in low-fluoridated areas
Contribution to total daily fluoride intake · Children · Low fluoride in water (0.3-0.51 mg/L)
Fluoride Intake Through Dental Care Products: A Systematic Review. (2022)
Mean percentage contribution 397 studiesUngraded
BLW vs Other models of complementary feeding (traditional CF)
Infant weight-length gain (achievement of adequate weight) · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western… · Measured at 18-78 months of age, observational studies
Complementary Feeding Caregivers' Practices and Growth, Risk of Overweight/Obesity, and Other… (2022)
OR 1.36 [0.18, 10.51]3 studiesUngraded
Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)
Oral hygiene status · Children and adolescents (<18 years) living with HIV (CLWH)
Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and… (2022)
OR 0.73 [0.13, 4.26]0 studiesUngraded
Dental caries assessment (WHO/clinical diagnostic criteria; caries = DMFT>0) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)
Caries prevalence · 12-year-old children (permanent dentition) in Africa · Country: Nigeria
Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review… (2022)
Prevalence 0.13 [0.106, 0.163]2 studiesUngraded
Intervention NR
Oral Candida carriage and salivary yeast concentration
Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and… (2022)
no estimate extracted1 studyUngraded
Caries assessment at enamel threshold (D(M)FS>0 or D(M)FT>0, enamel lesions included) vs None (descriptive prevalence review; subgroup analyses only)
Caries prevalence · European adolescents aged 12–19 years · Examination type: partial-mouth
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.81 [0.70, 0.91]5 studiesUngraded
Placebo vs Silver diamine fluoride
Oral health-related quality of life · Children with dental caries · Network estimate
Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. (2022)
MD 0.03 [-0.16, 0.22]2 studies · 440 participantsUngraded
Common genetic variants genome-wide (GWAS; ~3.9 million SNPs with MAF > 5%) vs ECC-unaffected children (per-allele case-control association)
Early childhood caries (ECC) - association at lead SNP rs8091366 (18:24715618; nearest gene(s) CHST9, KCTD1) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5… · Cross-sectional (ECC ascertained at the last dental exam before age 6), rs8091366 (18:24715618); effect/non-effect allele A/G; MAF 0.52; direction across 5 cohorts +++++
Association of Early Childhood Caries with Bitter Taste Receptors: A Meta-Analysis of Genome-Wide… (2022)
Z-score (Stouffer's combined Z, 5 cohorts) 4.4765 studies · 2974 participantsUngraded
Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs No intervention or usual practice/activities
Dental caries measured by net increment in DMFS scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs) · Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer), Non-WHO-framework interventions
Effectiveness of primary school-based interventions in improving oral health of children in low- and… (2022)
SMD -1.88 [-3.15, -0.60]NRUngraded
Silver diamine fluoride (SDF) vs Placebo
Oral health-related quality of life (OHRQoL; C-ECOHIS) · Children with dental caries (ages ~2-13 years in the pooled trials) · Post-treatment
Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. (2022)
MD 0.03 [-0.16, 0.22]2 studies · 440 participantsUngraded
Food and nonalcoholic beverage marketing (exposure) vs No, less, or less powerful food marketing
Dental caries · Children and adolescents aged 0-19 years · Nonrandomized studies
Association of Food and Nonalcoholic Beverage Marketing With Children and Adolescents' Eating Behaviors and… (2022)
Vote counting: 1 of 2 studies (50%; 95% CI, 9%-90.5%) showed an association of public health harm; 1 moderate-quality study found a clear association with caries and 1 high-quality study found no association.2 studiesVery low
Caries assessment at enamel threshold (D(M)FS>0 or D(M)FT>0, enamel lesions included) vs None (descriptive prevalence review; subgroup analyses only)
Caries prevalence · European adolescents aged 12–19 years · Examination type: full-mouth
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.74 [0.57, 0.90]17 studiesUngraded
HVGIC Fuji IX Gold Label vs HVGIC Vitro Molar and Maxxion R
Restoration failure · Children with carious primary teeth · 2 years, ART; Class I
Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp… (2022)
Annual failure rate (%) Fuji IX 14.7%; Vitro Molar 31.8%; Maxxion R 37.1%1 study · 150 participantsUngraded