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Evidence found and GRADE certainty

558 questions · 704 findings · 64 reviews · Dental caries

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No studies found 91 · 12.9%GRADE not reported 441 · 62.6%Very low 76 · 10.8%Low 73 · 10.4%Moderate 21 · 3%High 2 · 0.3%

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Dental caries prevalence · Children or adolescents

In permanent dentition, CLWH on ART had higher caries prevalence than healthy controls (OR 2.49, 95% CI 1.86 to 3.32; single study).

3 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Dental caries (by severity) · Children or adolescents

One study reported higher median caries severity among CLWH under 12 years; no meta-analytic estimate was pooled.

1 finding from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: sensitivity from 0.61 to 0.98 ... CarieScan Pro: sensitivity from 0.55 to 0.91'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites…
    7 studies
    Very low

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
    7 studies
    Very low

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, nano-silver fluoride arrested more surfaces than SDF (OR 0.52 favoring the comparator; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, nano-silver fluoride achieved higher individual-level caries arrestment than SDF (OR 0.39 favoring the comparator; ungraded subgroup).

1 finding from 1 review

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

Dental caries prevalence · Institutionalized orphan children (roughly 3 to 18 years)

Institutionalized orphan children may be at higher risk of dental caries than parented children (pooled RR 1.19), but the estimate is imprecise and not statistically significant (very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF and nano-silver fluoride showed no significant difference in tooth-level caries arrestment (OR 1.47; ungraded subgroup).

1 finding from 1 review

Cessation of water fluoridation (fluoride removed from the water supply) vs Continued fluoridated water

Change in proportion of caries-free children (deciduous or permanent teeth) · People of all ages in a previously fluoridated community (Maupome 2001: children with generally low caries experience)

The review found no eligible studies for this question.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Number of detected salivary bacterial genera · Young children with early childhood caries and caries-free controls

Fewer salivary bacterial genera were reported in the caries-affected group, without a comparative effect estimate or CI.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Relative abundance of dominant salivary microbial community (7 genera) · Young children with early childhood caries and caries-free controls

The reported multi-genus community had similar relative abundance in caries-affected and caries-free children, without a comparative effect estimate or CI.

1 finding from 1 review

Early childhood caries (ECC) vs Caries-free controls

Streptococcus mutans and Veillonella spp. levels · Young children with early childhood caries and caries-free controls

Veillonella spp. levels were reported as substantially greater in caries subjects, but the review gave no numerical effect estimate or CI.

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children with permanent dentition (>12 years)

In children with permanent dentition, vitamin D deficiency was associated with a 28% higher caries risk (RR 1.28; ungraded).

1 finding from 1 review

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children with deciduous dentition (<6 years)

In children with deciduous dentition, vitamin D deficiency was associated with a 68% higher caries risk (RR 1.68; ungraded).

1 finding from 1 review

Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) vs Normal vitamin D level (serum 25(OH)D ≥ 50 nmol/L)

Dental caries · Children (mixed dentition; baseline about 8 years)

In children with mixed dentition, vitamin D deficiency was associated with an 8% higher caries risk (RR 1.08; ungraded).

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Proportion of children not remaining caries-free · Children with primary (deciduous) teeth (younger children)

Fluoride gel (topically applied; operator- or self-applied; any… showed no clear difference in proportion of children not remaining caries-free compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Resin sealant (with or without flossing advice) vs Flossing advice (non-invasive control)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Resin sealant (with or without flossing advice) led to lower caries (lesion) progression (radiographic) compared with flossing advice (non-invasive control); GRADE not reported.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Relative abundance of Veillonella spp. · Children under 6 years with severe early childhood caries and caries-free controls

Veillonella spp. mean relative abundance was lower in the S-ECC group; no comparative effect estimate or CI was reported.

1 finding from 1 review

Severe early childhood caries vs Caries-free controls

Relative abundance of S. mutans in saliva · Children under 6 years with severe early childhood caries and caries-free controls

S. mutans median relative abundance was higher in the S-ECC group, without a comparative effect estimate or CI.

1 finding from 1 review