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%

CPP-ACFP 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…

CPP-ACFP versus control gave SMD -0.42 (95% CI -0.84 to 0.00); the review classed CPP-ACFP as statistically significant versus control although the reported CI upper limit is at the null (0.00); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Self-assembling peptide P11-4 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…

Self-assembling peptide P11-4 did not differ significantly from CPP-ACFP (SMD -0.13, 95% CI -0.68 to 0.42); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin-modified glass-ionomer cement (RMGIC) restoration vs Amalgam, compomer, composite resin, or glass carbomer

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

RMGIC had an annual failure rate of 1.9-16.9% (4 RCTs), lower than amalgam and similar to compomer/composite; low quality of evidence (ungraded).

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction

Caries detection accuracy on intraoral images · Dental images of human beings

The review reported 93.3% accuracy for caries detection on intraoral images in Kühnisch et al. (Ungraded).

1 finding from 1 review

Caries experience measurement (mean D(M)FS, enamel lesions included) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Dental caries · European adolescents aged 12–19 years

Mean caries experience (DMFS) in subgroup 'Examination type: full-mouth' was 6.56 (95% CI 4.55 to 9.47; 12 studies).

11 findings from 1 review
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Consumption of xylitol chewing gum by women (mothers) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Xylitol sugar-free gum significantly reduced plaque quantity versus no-gum/control (SMD -0.743, 95% CI -1.148 to -0.338), with high heterogeneity (I2 = 86.0%; ungraded).

1 finding from 1 review

Amalgam restoration vs Composite resin, compomer, conventional glass-ionomer cement, or resin-modified GIC (head-to-head RCT comparators)

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Amalgam restorations in primary teeth showed a wide annual failure rate (1-28%) across 4 RCTs; the evidence is of low quality (high risk of bias; ungraded).

1 finding from 1 review

Caries distribution assessment (individual, tooth and surface levels) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Caries distribution (individual/tooth/surface level) · European adolescents aged 12–19 years

Caries distribution was skewed at individual, tooth and surface levels and too heterogeneous to meta-analyze (narrative synthesis of 11 studies; not GRADE-rated).

1 finding from 1 review

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

High-viscosity GIC had a wide annual failure rate (2.9-25.6%) and was outperformed by compomer/composite in some trials (3 RCTs); low quality of evidence (ungraded).

1 finding from 1 review

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction

detection of proximal caries · Dental images of human beings

The review reported 85.6% accuracy for proximal caries in Casalegno et al. (Ungraded).

2 findings from 1 review

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction

Occlusal caries detection accuracy · Dental images of human beings

The review reported 66.7% accuracy for the worst class in Moutselos et al. (Ungraded).

4 findings from 1 review
Show 1 more finding

Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction

Dental caries detection accuracy · Dental images of human beings

The review reported 70% accuracy for dental caries detection in Mayank et al. (Ungraded).

3 findings from 1 review

Gum chewing (sugar-free) vs No chewing gum

Plaque · Adults and children (predominantly adults; one study in children), with natural dentition

Sugar-free chewing gum significantly reduced plaque quantity versus no-gum/control (SMD -0.778, 95% CI -1.167 to -0.390), with high heterogeneity (I2 = 86.6%) and no GRADE rating (ungraded).

2 findings from 1 review

Enamel caries quantification (DeS/DeT within total D(M)FS/D(M)FT) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Enamel caries proportion · European adolescents aged 12–19 years

Enamel caries made up about half of total caries experience (pooled proportion 0.50, 95% CI 0.39 to 0.65; 7 studies; higher in 12–15 than 16–19-year-olds; not GRADE-rated).

3 findings from 1 review

Metal-reinforced glass-ionomer cement (MRGIC) restoration vs Conventional GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Metal-reinforced GIC had a high annual failure rate (29.9%) in a single RCT; low quality of evidence (ungraded).

1 finding from 1 review

Compomer (C) vs Amalgam, RMGIC, HVGIC, composite resin, bulk-fill composite resin, another compomer, or alternative caries management

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Compomer had an annual failure rate of 0-14.7% (7 RCTs), comparable to amalgam/RMGIC/composite and better than high-viscosity GIC; low quality of evidence (ungraded).

1 finding from 1 review

38% silver diamine fluoride vs No treatment / other preventive agents (GIC, 5% NaF varnish)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

A second meta-analysis reported odds ratios of 2.44 to 3.63 favouring 38% SDF over fluoride varnish/water for caries arrest (ungraded).

2 findings from 1 review

Conventional GIC vs Amalgam or metal-reinforced GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Conventional GIC had an annual failure rate of 7.6-16.6% (2 RCTs) and failed more than amalgam in one trial; low quality of evidence (ungraded).

1 finding from 1 review

Composite resin vs Compomer, glass-ionomer/RMGIC, amalgam, or glass carbomer

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Composite resin (hybrid 0-19.5%; bulk-fill 0-16.9%) performed comparably to or better than most alternatives across 11 RCTs; evidence is of low to unclear quality (ungraded).

1 finding from 1 review

Resin infiltration vs Pre-treatment baseline before infiltration (T0); pooled as a within-arm before/after change

Lightness/brightness change of white spot lesion (luminosity L*, T0 to T1) · Patients with post-orthodontic white spot lesions and permanent dentition

ICON resin infiltration showed no statistically significant change in lightness/brightness of post-orthodontic white spot lesions at 6 months (pooled Cohen's d/SMD -0.001, 95% CI -0.23 to 0.23; 3 studies, 330 teeth; I2=97%); not GRADE-rated.

1 finding from 1 review