Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · All outcomes

No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

Glass ionomer cement vs Resin composite restoration

Secondary caries · Patients requiring dental restoration; permanent teeth

Over 2 or more years in permanent teeth, GIC probably reduces secondary caries versus resin composite (RR 0.50, 95% CI 0.28-0.91; moderate certainty).

2 findings from 1 review

Malocclusion vs No malocclusion

Poor oral health-related quality of life (OHRQoL) · Adolescents (10-19 years)

Malocclusions probably have a negative effect on OHRQoL in adolescents, after adjustment for confounders (moderate certainty).

1 finding from 1 review

Amalgam (AAG) vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

Over 2 or more years in deciduous teeth, amalgam probably had a higher risk of secondary caries than RMGIC (RR 2.46, 95% CI 1.42-4.27; moderate certainty).

1 finding from 1 review

Herbal mouthwash vs Blank control

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced several plaque-related indices, but certainty is very low.

1 finding from 1 review

Giomer (GIONOMER) vs Resin-modified glass ionomer cement (RMGIC)

Secondary caries · Patients requiring dental restoration; deciduous (primary) teeth

Over 2 or more years in deciduous teeth, the difference in secondary caries between giomer and RMGIC is uncertain (RR 1.66, 95% CI 0.49-5.61; low certainty).

1 finding from 1 review

Gum chewing (sugar-free) vs No chewing gum

Salivary flow rate (unstimulated) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

In elderly and medically compromised people with xerostomia, chewing sugar-free gum daily for two or more weeks produces a small but statistically significant increase in unstimulated whole salivary flow rate versus no gum (SMD 0.44, 95% CI 0.22 to 0.66); certainty of evidence was not formally graded.

1 finding from 1 review

Biodentine vs Mineral trioxide aggregate (MTA)

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy

MTA and Biodentine performed comparably for clinical and radiographic success (5 RCTs, not pooled; ungraded).

1 finding from 1 review

CPP-ACP 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-ACP did not differ significantly from control (SMD -0.18, 95% CI -0.49 to 0.14); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Mineral trioxide aggregate (MTA) vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in mature permanent teeth

MTA increases clinical and radiographic success versus CH in mature teeth (moderate certainty).

1 finding from 1 review

Gum chewing (sugar-free) vs No chewing gum

Dry mouth (xerostomia) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

Gum chewing was linked with improved self-reported xerostomia / dry mouth in most studies (12 of 17 positive, 5 no effect); heterogeneous instruments precluded meta-analysis.

1 finding from 1 review

Chlorhexidine mouthwash vs Blank control

Total bacteria (colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce total bacteria colony counts versus blank control in the short term, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

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

Herbal mouthwash vs Blank control

Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced some gingival inflammation-related indices, but certainty is very low.

1 finding from 1 review

Herbal mouthwash vs Blank control

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash showed mixed effects on Mutans streptococci, with very low-certainty evidence.

1 finding from 1 review

Mutans streptococci detected in plaque or saliva at baseline vs No mutans streptococci detected in plaque or saliva at baseline

Development of any (cavitated or non-cavitated) carious lesion · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Across the sample-based sensitivity analysis, mutans streptococci at baseline were associated with higher odds of developing caries.

1 finding from 1 review

Resin infiltration vs Baseline before resin infiltration

Lightness change · Patients with post-orthodontic white spot lesions and permanent dentition

Knosel (2019) reported a statistically significant lightness-change effect.

3 findings from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Salivary immunoglobulin A (SIgA) concentration · Children and adolescents (<18 years) living with HIV (CLWH)

Evidence on salivary IgA in CLWH on versus off ART was divergent and inconclusive (very low certainty).

1 finding from 1 review