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%

Fluoride varnish vs Placebo varnish, resin sealant, or standard care (oral hygiene instructions)

White spot lesion clinical score (mean values), subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances

In a pooled analysis of two placebo-controlled trials, fluoride varnish also reduced white spot lesion clinical scores (pooled SMD -0.44, 95% CI -0.64 to -0.24); this secondary outcome was not separately GRADE-rated.

1 finding from 1 review

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

MMP-9 location/depth · Human ex vivo carious dentin

No clear direction of MMP-9 expression by lesion depth/location was found; the evidence is very uncertain (very low certainty).

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-based fissure sealant vs Fluoride varnish

DMFS (decayed, missing, filled surfaces) increment, occlusal surfaces · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars

Pit and fissure sealant and fluoride varnish showed no statistically significant difference in DMFS increment at 24 months (SMD -0.13, 95% CI -0.67 to 0.40; I2=92%; not GRADE-rated).

1 finding from 1 review

Nano-hydroxyapatite (nHA) dentifrice/paste (fluoride-free or fluoridated) vs nHA-free / fluoride-free (negative) control

Mineral loss (transversal microradiography) · Enamel/dentin specimens with initial caries lesions (or sound surfaces) in intraoral (in situ) appliances worn by patients

Under remineralizing conditions, nHA produced significantly more remineralization than the negative control (MD 350, 95% CI 179 to 521; very low certainty).

2 findings from 1 review

Fluoride-releasing resin-based sealant vs No sealant (control/no treatment)

Development of >=1 new carious lesion (caries incidence) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department, dental hospital, France)
2 findings from 1 review

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Alpha diversity (Chao1, Observed, Shannon) · Adults providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples

In adults, caries-vs-health alpha diversity differed for the Shannon index but not Chao1/Observed (ungraded).

1 finding from 1 review

Glass ionomer-based sealant vs No sealant (control/no treatment)

Development of >=1 new carious lesion (caries incidence) · Children with caries-free primary first molars (with or without caries on other teeth), aged 1-5 years (paediatric clinic/dental school,…

Glass ionomer-based sealant may leads to lower development of >=1 new carious lesion (caries incidence) compared with no sealant (low certainty).

2 findings from 1 review

Fluoride-releasing resin-based sealant vs No sealant (control/no treatment)

Mean caries increment (mean number of new cavitated occlusal lesions) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department, dental hospital, France)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    24 months
    Mean number of new cavitated occlusal lesions 0.23 (SD 0.06) in sealed molars vs 0.29 (SD 0.06) in control molars (Wilcoxon matched-pairs signed-rank test P = 0.42)
    1 study · 85 participants
    GRADE not reported

Not applicable (single-group prevalence) vs Not applicable

Caries experience (mean DMFT) · Children aged 12 years (plus or minus one year) in Africa

The pooled mean DMFT score was 1.0900 (95% CI 0.9143 to 1.2657); GRADE was not reported.

2 findings from 1 review

Fluoride-releasing resin-based sealant vs Resin-based sealant

Retention of sealant (complete or partial retention) · Children with caries-free second primary molars, aged 4-8 years (dental clinic, Turkey and Spain)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-24 months
    Effect estimate not calculable; 69 (2 studies). Retention equivocal: Unal 2015 100% (fluoride resin) vs 96.0% (resin) at 12 months; Baca 2007 84.1% (fluoride resin) vs 97.7% (resin) at 12 months; at 24 months 87.8% vs…
    2 studies · 69 participants
    Very low

Dental caries vs Caries-free status

Alpha diversity (Observed, Chao1, Shannon, and Simpson) · Participants in oral 16S rRNA caries microbiome studies

Across the combined sample set, alpha-diversity metrics were significantly higher in caries than in health, but no pooled effect estimate was reported.

1 finding from 1 review