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%

History of toothache vs No history of toothache

Dental caries · Primary school children in Ethiopia

A history of toothache was associated with higher odds of dental caries (OR 2.99, 95% CI 2.679-3.314; ungraded).

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban / general-urban / national population

Use of alternative/indigenous mouth-cleaning implements · Adult residents of slums and non-slum urban settings of LMICs

Indigenous/alternative cleaning tools and home remedies are widely used, more so in rural/slum groups; ungraded.

1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Enamel demineralization (QLF ΔF) · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation significantly reduced enamel mineral loss versus untreated control (SMD -2.09, 95% CI -3.29 to -0.88; 4 in vitro studies; ungraded).

1 finding from 1 review

Institutionalization (living in an orphanage/institution) vs Parented children living with their families

Caries in primary teeth: dmft (3 years) · Institutionalized orphan children (roughly 3 to 18 years)

Primary-teeth caries experience (dmf) was higher in institutionalized children than parented children but not significantly so (pooled MD 0.64; very low certainty).

1 finding from 1 review

Low-power CO2 laser irradiation (LLLT, 0.5 to 2 W) vs Placebo (placebo laser or placebo agent) or no treatment

White spot lesion incidence · High caries-risk patients: fixed-orthodontic-appliance patients and children with partially erupted permanent molars

Low-power CO2 laser (LLLT) is associated with a lower incidence of new white spot lesions than placebo (OR 0.21, CI 0.15 to 0.30; ungraded, 3 RCTs, considerable heterogeneity I2=71%).

1 finding from 1 review

Nd:YAG laser vs No anticaries intervention (untreated enamel)

Enamel acid resistance (cross-sectional microhardness) · Human enamel in pits and fissures (in situ / ex vivo)

Nd:YAG laser increased enamel acid resistance versus untreated enamel in pits and fissures (ungraded, 1 ex-vivo study, no pooled estimate).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

Aesthetics · Children and adults (with or without carious lesions)
1 finding from 1 review

SDF (given at a particular frequency, concentration, or duration) vs SDF (given at a different frequency, concentration, or duration)

Adverse effects · Children and adults (with or without carious lesions)
1 finding from 1 review

Er:YAG laser irradiation of sound enamel before acid challenge vs No anticaries intervention (untreated enamel)

Calcium ions released in acidic solution · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation did not significantly change calcium ions released into acidic solution versus untreated control (SMD -0.40, 95% CI -0.96 to 0.15; 6 in vitro studies, I2=80%; ungraded).

1 finding from 1 review

Original development of CAMBRA (Caries Management by Risk Assessment) or CAT (Caries-risk Assessment Tool) multivariable models vs Not applicable

Model development with reported performance measures (per CHARMS) · Individuals of any age at risk of caries increment

No original CAMBRA or CAT model-development studies reporting performance measures according to CHARMS were found (evidence gap); these tools appeared only as validated models within other studies.

1 finding from 1 review

Outer carious dentin (by lesion depth/location) vs Inner carious dentin

MMP-8 location/depth · Human ex vivo carious dentin

MMP-8 showed no statistical difference by lesion location; the evidence is very uncertain (very low certainty).

1 finding from 1 review

Caries-associated bacterial biofilm vs Sound/control tissue (sound dentin, sound root, or enamel caries)

Bacterial collagenolytic enzymatic activity · Human ex vivo carious lesions / caries-associated biofilm

Bacterial collagenolytic enzymatic activity in caries biofilm is inconclusive across two small studies (ungraded; GRADE not feasible).

1 finding from 1 review

Outer carious dentin (by lesion depth/location) vs Inner carious dentin

MMP-2 location/depth · Human ex vivo carious dentin

No clear direction of MMP-2 presence by lesion depth/location was found; the evidence is very uncertain (very low certainty).

1 finding from 1 review

Outer carious dentin (by lesion depth/location) vs Inner carious dentin

MMP-20 location/depth (outer vs inner) · Human ex vivo carious dentin

MMP-20 probably decreases in outer compared with inner carious dentin (moderate certainty).

1 finding from 1 review