Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,692 questions · 2,586 findings · 180 reviews · Dental caries

No studies found 194 · 7.5%GRADE not reported 1,937 · 74.9%Very low 248 · 9.6%Low 136 · 5.3%Moderate 52 · 2%High 19 · 0.7%

Glass ionomer cement (for bracket bonding) vs Resin adhesive

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

There is no clear difference in WSL initiation between glass ionomer cement and resin adhesive for bracket bonding (RR 0.72, not significant); certainty of evidence is very low.

1 finding from 1 review

Sealant (any type) vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Sealant use reduced the incidence of new white spot lesions versus no sealant (very low certainty).

1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For compomer-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.71); subgroup not separately GRADE-rated.

1 finding from 1 review

Sealant/coating agent WITHOUT fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Among non-fluoride sealants, WSL initiation was significantly reduced versus no sealant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

White spot lesions were also measured by laser fluorescence in 3 sealant-vs-no-sealant studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Fluoride-releasing compomer bonding agent did not show a statistically significant reduction in new white spot lesions versus non-fluoride compomer bonding agent (very low certainty).

1 finding from 1 review

Fluoride-releasing resin-based sealant vs Non-fluoride resin-based sealant

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For resin-based sealants, fluoride release did not significantly change WSL initiation (RR 0.71, wide CI); subgroup not separately GRADE-rated.

1 finding from 1 review

Sealant or coating agent (with or without fluoride release) applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

The additional use of a sealant probably reduces the initiation of white spot lesions during fixed orthodontic treatment compared with no sealant (RR 0.70), but the certainty of evidence is very low.

1 finding from 1 review

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

White spot lesions assessed by laser fluorescence (DIAGNOdent) · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

White spot lesions were also measured by laser fluorescence in 3 fluoride-vs-non-fluoride studies, but no meta-analysis was possible due to incompatible reporting.

1 finding from 1 review

Coating material (bonding material or sealant) WITH fluoride release vs Coating material WITHOUT fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Fluoride-releasing coating materials do not appear to reduce WSL initiation more than non-fluoride coatings (RR 0.84, not significant); certainty of evidence is very low.

1 finding from 1 review

Fluoride-releasing resin-based bonding agent vs Non-fluoride resin-based bonding agent

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For resin-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.97); subgroup not separately GRADE-rated.

1 finding from 1 review

Low birth weight (<2500 g) vs Normal birth weight (2500 g or more)

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

Adjusted analyses also showed no association between low birth weight and early childhood caries (adjusted OR 1.05, 95% CI 0.71 to 1.57); certainty not graded.

3 findings from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Filled primary surfaces at 3 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

Fluoride supplementation (tablets, drops, lozenges or chewing gum) showed no clear difference in filled primary surfaces at 5 years compared with placebo or no treatment; GRADE not reported.

2 findings from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Caries presence in primary teeth · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes children with caries in the primary teeth at 3 years compared with placebo or no treatment (very low certainty).

2 findings from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Fluorosis (maxillary teeth) at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes fluorosis (maxillary teeth) at 5 years compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Caries in primary teeth: dmft (3 years) · Pregnant women (for preventing dental caries in the primary teeth of their children)

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Fluorosis (mandibular teeth) at 5 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes fluorosis (mandibular teeth) at 5 years compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Decayed primary surfaces at 3 years · Pregnant women (for preventing dental caries in the primary teeth of their children)

Fluoride supplementation (tablets, drops, lozenges or chewing gum) showed no clear difference in decayed primary surfaces at 3 years compared with placebo or no treatment; GRADE not reported.

2 findings from 1 review