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. Every word you type has to appear somewhere in the question, and the closest matches are ranked first.

Limit to evidence status or GRADE (optional)

10,375 questions in 429 reviews · Oral Health

current versions
No studies 1,344 · 13%Ungraded 6,832 · 65.9%Very low 1,228 · 11.8%Low 613 · 5.9%Moderate 290 · 2.8%High 68 · 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
Cognitive behavioural therapy (CBT) vs Alternative (active) treatment (e.g. oral splint, medication, self-care or disease management)
Psychological distress at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer · Follow-up
Psychological therapies for temporomandibular disorders (TMDs) (2022) · Cochrane
SMD -0.32 [-0.51, -0.13]6 studies · 516 participantsLow
Pulpotomy with mineral trioxide aggregate (MTA) vs Pulpotomy with Calcium Enriched Mixture (CEM)
Clinical and radiographic success rate (>=6 months) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure · >=6 months, Pulp capping material: MTA vs CEM
Outcome of pulpotomy in permanent teeth with irreversible pulpitis: a systematic review and meta-analysis. (2022)
MTA was not significantly superior to CEM (no significant difference; Supplementary Table S5, not available).NRUngraded
Caries assessment at enamel threshold vs None
Caries prevalence · European adolescents aged 12 years · Exact age
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.69 [0.49, 0.90]13 studiesUngraded
Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs No active intervention/usual care
Gingival index (GI) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age · 3-4 months
Treatment of periodontitis for glycaemic control in people with diabetes mellitus (2022) · Cochrane
SMD -1.75 [-2.27, -1.24]12 studiesUngraded
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: Scandinavian
Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. (2022)
Prevalence 0.49 [0.32, 0.67]9 studiesUngraded
Cleft lip and/or palate (CL/P) vs No cleft lip and/or palate (non-CL/P)
Caries experience in the primary dentition (dmft/dmfs/dfs/deft/ds; pooled as standardized mean difference) · Children in the primary dentition with non-syndromic cleft lip and/or palate (CL/P) and comparable children without CL/P · Primary and mixed dentition
Caries in children with and without orofacial clefting: A systematic review and meta-analysis. (2022)
SMD 0.09 [-0.59, 0.76]5 studies · 708 participantsUngraded
Transillumination and OCT vs Reference standard (histology, operative excavation, or enhanced visual examination)
Specificity 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)
Specificity 0.82 [0.68, 0.91]64 studies · 24567 participantsLow
Cognitive behavioural therapy (CBT) vs Usual care, waiting list or no treatment (control)
Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
Psychological therapies for temporomandibular disorders (TMDs) (2022) · Cochrane
Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.1 study · 101 participantsVery low
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC)
Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · tempered CHX vs cold CPC; operator level
Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane
MD -11.5 [-18.37, -4.63]1 study · 20 participantsVery low
CD4+ T-cell count below 250 cells/mm3
HIV-related oral lesions · Children living with HIV receiving ART · CD4+ T-cell count below 250 cells/mm3
Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A… (2022)
OR 1.916 [0.613, 2.513]1 studyUngraded
Prior application of silver diamine fluoride (SDF), with or without a rinsing step vs No prior SDF application (untreated dentin control)
Immediate bond strength (MPa) · Dental adhesives/resin composite bonded to dentin (in vitro), sound or caries-affected · Immediate bond strength, Overall (all dentin conditions and rinsing protocols)
Bonding of Glass-Ionomer Cement and Adhesives to Silver Diamine Fluoride-treated Dentin: An Updated… (2022)
MD 7.12 [1.38, 12.85]11 studies · 526 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
Oral hygiene measured by mean gingival 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)
Effectiveness of primary school-based interventions in improving oral health of children in low- and… (2022)
SMD 0.12 [-0.32, 0.55]3 studies · 1573 participantsVery low
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: Libya
Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review… (2022)
MEAN 2.11 [1.178, 3.038]2 studiesUngraded
Chlorhexidine (CHX) vs Essential oils/herbal mouthwash
Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · pharynx level (patient level; not analysed)
Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane
Bay 1993 compared 0.12% CHX with essential oil mouthwash C (Listerine) at pharynx level (Andersen's level 2), which was considered patient level and hence was not analysed. No pooled estimate or GRADE rating.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 DMFT 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), Age 6-8 years
Effectiveness of primary school-based interventions in improving oral health of children in low- and… (2022)
SMD -0.11 [-0.17, -0.04]NRUngraded
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 · Setting: Urban
Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review… (2022)
MEAN 1.325 [0.974, 1.675]10 studiesUngraded
Scaling and root planing (SRP) plus antibiotics (amoxicillin and metronidazole) vs Supragingival scaling (plus placebo)
Adverse events due to periodontal therapy · People with periodontitis and metabolic syndrome (no CVD; primary prevention) · 12 months
Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis (2022) · Cochrane
Peto OR 0.14 [0.00, 6.90]1 study · 165 participantsVery low
Fluorescence-based devices vs Reference standard (histology, operative excavation, or enhanced visual examination)
Specificity for detecting enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies) · Analysis 1: fully within-person comparison (studies evaluating >=3 index tests)
Enamel Caries Detection and Diagnosis: An Analysis of Systematic Reviews. (2022)
Specificity 0.88 [0.78, 0.94]19 studies · 2849 participantsUngraded
Plasma rich in growth factors (PRGF) vs Alvogyl
Exposed bone (present versus absent) · Adults (>18 years) with established dry socket following permanent tooth extraction · Day 7 (also day 3)
Local interventions for the management of alveolar osteitis (dry socket) (2022) · Cochrane
PRGF versus Alvogyl (King 2018), exposed bone (% patients): day 3 PRGF 9.1% vs Alvogyl 9.1%; day 7 PRGF 0% vs Alvogyl 22.7% (P<0.05 at day 7)1 study · 44 participantsUngraded
Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)
Postoperative pain in the immediate postobturation period (up to 72 hours) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without… · Up to 72 hours postobturation
Single versus multiple visits for endodontic treatment of permanent teeth (2022) · Cochrane
RR 0.97 [0.81, 1.16]12 studies · 1329 participantsLow
Machine-learning algorithms for dental caries detection vs Different machine-learning algorithms for caries prediction
Caries detection accuracy in unrestored molars and premolars · Dental images of human beings · Duong et al., 2021; support vector machine
Uses of Different Machine Learning Algorithms for Diagnosis of Dental Caries. (2022)
Accuracy 92.371 study · 620 participantsUngraded
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 · 6 months
Zirconia Crowns for Primary Teeth: A Systematic Review and Meta-Analyses. (2022)
RR 1.00 [0.97, 1.03]2 studies · 205 participantsUngraded
Boric acid vs Water
Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level
Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane
MD -29.3 [-32.65, -25.95]1 study · 60 participantsVery low
Fluoride-containing dental care products (mainly fluoride toothpaste) vs Dietary fluoride sources (drinking water, beverages, food)
Contribution of dental care products to total daily fluoride intake (TDFI), by tap-water fluoride level · Adults using fluoride-containing dental care products (two included studies [28,47]; aged 20-35) · Habitual daily intake, Poor-fluoridated tap water (<0.3 mg/L)
Fluoride Intake Through Dental Care Products: A Systematic Review. (2022)
Mean contribution to TDFI (%) 121 studyUngraded
Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)
Tooth extraction due to endodontic problems · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without…
Single versus multiple visits for endodontic treatment of permanent teeth (2022) · Cochrane
RR 0.46 [0.09, 2.50]2 studies · 402 participantsVery low
Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)
Acute necrotising ulcerative gingivitis 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 0.00 [0.00, 0.02]NRVery low
Amalgam vs Resin-modified GIC
Restoration failure · Children with carious primary teeth · 1 year, Class II
Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp… (2022)
Annual failure rate (%) amalgam 28.0%; RMGIC 16.9%1 study · 120 participantsUngraded
Visual or visual-tactile classification (e.g., ICDAS, ERK) vs Reference standard (histology, operative excavation, or enhanced visual examination)
Specificity 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)
Specificity 0.81 [0.73, 0.87]64 studies · 24567 participantsLow
Alvogyl vs SaliCept (acemannan hydrogel)
Pain (VAS) · Adults (>18 years) with established dry socket following permanent tooth extraction
Local interventions for the management of alveolar osteitis (dry socket) (2022) · Cochrane
Alvogyl versus SaliCept (acemannan hydrogel) (Kaya 2011): data not usable (medians presented with error bars). Text reports differences in clinical signs and symptoms between control and all 3 treatment groups…1 studyUngraded
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
Dental extraction protocol with plasma rich in growth factors (PRGF) inserted into the postextraction alveolus vs Standard dental extraction protocol without PRGF
Rate of complications and side effects of the intervention · People with cancer treated with intravenous bisphosphonates undergoing dental extractions (at risk of MRONJ) · 24 to 60 months
Interventions for managing medication‐related osteonecrosis of the jaw (2022) · Cochrane
No intraoperative complications were observed in either of the groups.1 study · 176 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), 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
Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs No active intervention/usual care
HbA1c (glycated haemoglobin), change · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age · 3-4 months
Treatment of periodontitis for glycaemic control in people with diabetes mellitus (2022) · Cochrane
MD -0.43 [-0.59, -0.28]30 studies · 2443 participantsModerate
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
Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart
Change in probing pocket depth (PPD) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive… · 6 to 8 months (SoF); similar at 3 to 4 months
Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults (2022) · Cochrane
MD 0.03 [-0.14, 0.20]5 studies · 148 participantsLow
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
Neocone vs Alvogyl
Time to complete resolution of pain (days) · Adults (>18 years) with established dry socket following permanent tooth extraction · Complete resolution of pain
Local interventions for the management of alveolar osteitis (dry socket) (2022) · Cochrane
MD -1.62 [-1.86, -1.38]1 study · 78 participantsUngraded
Any preprocedural mouth rinse vs Placebo, no rinsing or control
Adverse events such as transient discolouration, altered taste, allergic reaction, hypersensitivity · Dental patients undergoing aerosol-generating procedures (AGPs)
Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane
SoF tables state 'Not reported'; no included study reported adverse events.0 studiesNo studies
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
Alvogyl vs Zinc oxide eugenol
Time to complete resolution of pain (days) · Adults (>18 years) with established dry socket following permanent tooth extraction · Complete resolution of pain
Local interventions for the management of alveolar osteitis (dry socket) (2022) · Cochrane
MD -2.17 [-2.37, -1.97]1 study · 78 participantsUngraded
Any preprocedural mouth rinse vs Placebo, no rinsing or control
Incidence of infection of dental healthcare providers · Dental patients undergoing aerosol-generating procedures (AGPs)
Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane
Primary outcome. Not measured by any of the 17 included studies (SoF tables state 'Not reported'); remained a total evidence gap from the protocol.0 studiesNo studies
Scaling and root planing (SRP) plus antibiotics (amoxicillin and metronidazole) vs Supragingival scaling (plus placebo)
All cardiovascular events · People with periodontitis and metabolic syndrome (no CVD; primary prevention) · 12 months
Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis (2022) · Cochrane
Peto OR 7.77 [1.07, 56.1]1 study · 165 participantsVery low
Teriparatide 20 microg daily in addition to standard care vs Placebo in addition to standard care
Healing of MRONJ (resolution of lesions) · People with established (manifest) MRONJ · 52 weeks
Interventions for managing medication‐related osteonecrosis of the jaw (2022) · Cochrane
RR 0.96 [0.31, 2.95]1 study · 33 participantsLow
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