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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Dental caries

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No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Calcium Phosphate vs Fluorine showed no significant difference in 24 h bond strength (MD 2.140, 95% CI -1.506 to 5.787; Moderate certainty).

2 findings from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Risk of fragility fractures · general population

Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 mg/L drinking-water fluoride vs null; ungraded.

5 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride up to 0.9 mg/L vs null
    RR 0.93 [0.84, 1.02]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.8 mg/L vs null
    RR 1.05 [0.82, 1.35]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Sensitivity (excluding high risk-of-bias studies): 0.8-1.5 mg/L vs null
    RR 0.93 [0.72, 1.21]
    Studies not reported
    GRADE not reported
Show 2 more findings
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Drinking-water fluoride 1.48 mg/L vs null
    RR 1.00 [0.82, 1.21]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Sensitivity (excluding high risk-of-bias studies): 1.8 mg/L vs null
    RR 0.95 [0.70, 1.29]
    Studies not reported
    GRADE not reported

Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium-based agent

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Calcium showed no significant difference in 24 h bond strength (MD 2.654, 95% CI -3.216 to 8.524; Moderate certainty).

2 findings from 1 review

Hall technique vs Atraumatic restorative treatment (ART)

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, the Hall technique had significantly higher treatment success than ART (OR 10.11; moderate certainty).

3 findings from 1 review

Hall technique vs Conventional restoration

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 12 to 24 months, the Hall technique had significantly higher treatment success than conventional restoration (OR 4.17; moderate certainty).

3 findings from 1 review

Dental treatments, care, and services (the decision context) vs No comparator

Aesthetics as a factor of choice · (Potential) patients with freedom of choice regarding dental treatments, including parents and caregivers deciding for children or…

Aesthetics was the third most frequently reported factor (N=53 articles), most prominent in Brazil and Saudi Arabia (ungraded).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Forearm fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Electronic cigarette use vs Non-smokers

Dry mouth (xerostomia) · Humans who use e-cigarettes (adolescents to adults) assessed for dental caries

Two studies reported more frequent xerostomia (dry mouth) among e-cigarette users than non-smokers, which may raise caries risk, but results were not pooled (ungraded, narrative).

1 finding from 1 review

Country-level periodontal disease prevalence (Global Burden of Disease) vs Low vs high periodontal disease prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly by country-level periodontal disease prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Country-level income (World Bank income classification) vs Higher- vs lower-income country categories

Oral health-related quality of life · people aged 60 years and older living in the community

Community-dwelling older adults in higher-income countries had better OHRQoL than those in lower-income countries (77.9, 95% CI 70.2 to 85.6 vs 66.9, 95% CI 56.7 to 77.0); the difference by income was statistically significant (ungraded).

2 findings from 1 review

Hydraulic calcium silicate cements (HCSC; MTA or Biodentine) vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Vital permanent teeth (mature or immature) with deep or extremely deep caries and asymptomatic pulp or reversible pulpitis, undergoing…

At 36-month follow-up, HCSC show higher odds of clinical and radiographic success than CaOH (OR 2.34, 95% CI 1.43 to 3.84; ungraded subgroup).

3 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs HIV-negative individuals

Caries in primary teeth: dmft (3 years) · Children and adolescents (<18 years) living with HIV (CLWH)

In cross-sectional studies, the dmft (primary dentition) index did not differ significantly between HIV+ children on ART and HIV-negative peers (MD 0.92, 95% CI -0.09 to 1.93; very low certainty).

2 findings from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 4: marginal discoloration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with marginal discoloration, surveyed dentists most often preferred replacement over repair (pooled RR 1.97; p < 0.001); ungraded.

1 finding from 1 review

Dental cavity liner (e.g. calcium hydroxide, glass ionomer, resin-modified glass ionomer, or flowable composite) placed under the restoration vs No cavity liner or a different liner material

Treatment failure · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis

The evidence is very uncertain about the effect of cavity liners on treatment failure; no significant difference between lined and unlined (or differently lined) restorations was found (very low certainty).

1 finding from 1 review