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%

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

Alpha diversity (Shannon) · Children providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples

In children, caries-vs-health Shannon alpha diversity differed significantly (ungraded).

1 finding from 1 review

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

Discrimination of caries vs health (random forest ROC-AUC) · Individuals providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples; 2016 samples from 19 studies (mixed children and…

Microbiome-based random forest classifiers could not reliably discriminate caries from health across the combined cohort (best AUC approximately 0.75 in a disease-only KO subset; ungraded).

1 finding from 1 review

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

Retention of sealant (complete or partial retention) · Children with caries-free primary first molars (with or without caries on other teeth), aged 1-5 years (paediatric clinic/dental school,…
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-30 months
    Chadwick 2005: one or more sealants fully/partially retained in 69 (31.2%) children at 12-30 months; Joshi 2019: at 12 months 75 (43.6%) teeth completely retained, 58 (33.7%) partially retained, 39 (22.7%) completely…
    2 studies
    GRADE not reported

Autopolymerised sealant vs Light polymerised sealant

Retention of sealant (complete or partial retention) · Children with sound primary molars, aged 2-4 years (municipal dental clinics or hospital paediatric clinics, Denmark)

It is very uncertain whether autopolymerised sealant changes retention of sealant (complete or partial retention) compared with light polymerised sealant (very low certainty).

1 finding from 1 review

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

Retention of sealant (complete or partial retention) · 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
    12-24 months
    At 12 months, sealants on 96 (70.1%) surfaces completely retained, 25 (18.3%) partially retained, 16 (11.6%) completely lost; at 24 months, 58 (45.3%) completely retained, 29 (22.7%) partially retained, 41 (32%)…
    1 study
    GRADE not reported

Fluoride-free nano-/micro-hydroxyapatite (nHA) dentifrice vs Control (regular fluoride) dentifrice

Caries lesion initiation/progression (ICDAS score, laser fluorescence/DIAGNOdent, photographic pixels, enamel acid resistance) · Patients (children and adults, age 3-40 years) with initial enamel caries lesions (non-orthodontic and orthodontic)

No meta-analysis was possible for the 5 in vivo RCTs (high heterogeneity); narratively nHA showed generally no significant difference versus fluoridated dentifrice, and the evidence was not graded (ungraded).

1 finding from 1 review
  • Efficacy of nano-hydroxyapatite on caries prevention-a systematic review and meta-analysis. 2022 All outcomes
    Median follow-up 6 months (range 6-12 months) · In vivo (clinical); non-orthodontic and orthodontic patients
    No meta-analysis was performed for the in vivo studies owing to high heterogeneity (population, control group, outcomes, follow-up periods, risk of bias) and differing statistical designs (e.g., non-inferiority);…
    5 studies · 420 participants
    GRADE not reported

Glass ionomer-based sealant vs Resin-based sealant

Development of >=1 new carious lesion (caries incidence) · 'Healthy' children with caries-free second primary molars, aged 3-5 years (schools and kindergartens, India and China)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    6-24 months
    N/A - insufficient quantitative information available; 200 (2 studies). Comments: Due to the methods of data collection, analysis and reporting we were unable to provide any quantitative estimates. Fei 2011 narrative:…
    2 studies · 200 participants
    Very low

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

Development of >=1 new carious lesion (caries incidence) · 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
    N/A - insufficient quantitative information available; 69 (2 studies). Comments: Due to the different sealant materials, data reporting (split-mouth studies reported as parallel-group) and the very low number of tooth…
    2 studies · 69 participants
    Low

Dental caries vs Caries-free status

KEGG pathway associations · Participants in oral 16S rRNA caries microbiome studies

Phosphonate and phosphinate metabolism and glyoxylate and dicarboxylate metabolism had the lowest reported adjusted P values (0.04); no pooled effect estimate was reported.

1 finding from 1 review

Fluoride-free nano-hydroxyapatite (nHA) dentifrice/paste vs Sodium fluoride (control) toothpaste

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

Under demineralizing conditions, nHA allowed significantly more enamel demineralization than NaF (MD 1625, 95% CI 553 to 2697; very low certainty).

2 findings from 1 review

Autopolymerised sealant vs Light polymerised sealant

Development of >=1 new carious lesion (caries incidence) · Children with sound primary molars, aged 2-4 years (municipal dental clinics or hospital paediatric clinics, Denmark)

It is very uncertain whether autopolymerised sealant changes development of >=1 new carious lesion (caries incidence) compared with light polymerised sealant (very low certainty).

1 finding from 1 review

Dental caries vs Caries-free status

Beta diversity and community composition · Participants in oral 16S rRNA caries microbiome studies

Beta-diversity matrices showed statistically significant ADONIS results, while clustering by study and 16S region was also observed; no pooled effect estimate was reported.

1 finding from 1 review

Flowable resin composite vs Fluoride-releasing resin-based sealant

Retention of sealant (complete or partial retention) · Children who were regular dental attenders with caries-free first or second primary molars (public health service clinic, Brazil)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    12 months
    Effect estimate not calculable. All sealants were completely or partially retained; 40 (1 RCT). Flowable composite: 39/40 completely retained (1 partially lost) at 6 months; resin-based: 33 completely and 7 partially…
    1 study · 40 participants
    Low