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Evidence found and GRADE certainty

145 questions · 179 findings · 24 reviews · Oral Health

No studies found 27 · 15.1%GRADE not reported 121 · 67.6%Very low 14 · 7.8%Low 3 · 1.7%Moderate 14 · 7.8%High 0 · 0%

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

Adverse effects (tooth staining and other side effects) · Children and adolescents aged 16 years or less
1 finding from 1 review

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

Adverse effects: dental fluorosis · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride mouthrinse, gel or varnish combined with fluoride… showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride toothpaste alone; GRADE not reported.

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Fluoride mouthrinse

Caries increment on permanent tooth surfaces (D(M)FS), prevented fraction · Children and adolescents aged 16 years or less
1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Fluoride toothpaste alone

Caries increment on permanent tooth surfaces (D(M)FS), prevented fraction · Children and adolescents aged 16 years or less
1 finding from 1 review

Silver diamine fluoride (SDF) vs Chlorhexidine varnish

Primary caries prevention · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes primary caries prevention compared with chlorhexidine varnish (very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish, placebo)

Adverse effects (tooth staining and other side effects) · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF commonly causes black staining of arrested lesions; only mild, transient adverse events were reported, with no major adverse events (ungraded).

1 finding from 1 review

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

P11-4 + fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · People or specimens with white spot lesions or early caries lesions

The NMA estimated an SMD of -0.78 for P11-4 + fluoride varnish versus CPP-ACP (95% CI -1.33 to -0.28).

1 finding from 1 review

P11-4 + fluoride varnish vs Placebo or no active treatment

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…

Combined self-assembling peptide P11-4 plus fluoride varnish significantly improved white spot lesion remineralization versus control (SMD -0.96, 95% CI -1.44 to -0.48) and ranked highest of seven therapies by SUCRA (89.7%); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish 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…

P11-4 plus fluoride varnish did not differ significantly from CPP-ACFP (SMD -0.54, 95% CI -1.15 to 0.08; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

P11-4 + fluoride varnish vs Self-assembling peptide P11-4

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 did not differ significantly from P11-4 alone (SMD -0.40, 95% CI -0.97 to 0.17; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

SDF applied once (single application, no re-application) vs Other non/minimally-invasive treatment (ART or silver-fluoride varnish)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

A single (one-time) SDF application did not significantly arrest caries (pooled ES -0.09, 95% CI -0.48 to 0.29; ungraded).

1 finding from 1 review

Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Adverse effects (tooth staining/discoloration, oral soft-tissue signs, adverse symptoms such as nausea/vomiting, enamel etching) · Children and adolescents aged 16 years or less
1 finding from 1 review