Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

336 questions · 427 findings · 28 reviews · Dental caries

No studies found 48 · 11.2%GRADE not reported 284 · 66.5%Very low 46 · 10.8%Low 25 · 5.9%Moderate 24 · 5.6%High 0 · 0%

Gamified mobile health app vs Nongamified intervention

Regular use rate · Children or adolescents

One RCT reported a 72.4% regular-use rate with a gamified mobile health app versus 48.3% with a nongamified intervention; no GRADE assessment was reported.

1 finding from 1 review

Consumption of xylitol chewing gum by women (mothers) vs no intervention

Change in Mutans streptococci (MS) count in saliva · healthy people

Xylitol significantly reduced Mutans streptococci in saliva compared with no intervention (SMD -1.47, 95% CI -1.94 to -0.99; 3 trials), though heterogeneity was very high (I2=98%); not GRADE-rated.

1 finding from 1 review

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

Demineralised lesion depth · Human tooth enamel specimens, sound/intact (in vitro)

Er:YAG laser irradiation significantly reduced demineralised lesion depth versus untreated control (SMD -0.55, 95% CI -0.97 to -0.12; 3 in vitro studies, I2=62%; ungraded).

1 finding from 1 review

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

Enamel surface microhardness · Human tooth enamel specimens, sound/intact (in vitro)

In sound enamel, Er:YAG laser irradiation significantly increased surface microhardness after acid challenge versus untreated control (SMD 2.41, 95% CI 0.70 to 4.12; 3 in vitro studies; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the individual (patient) level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-arrestment proportion at the individual level, but the reported difference was not statistically significant.

1 finding from 1 review

Xylitol (low-intensity sweetener/sugar alcohol) in food products (chewing gum, milk, candy, or tablets) vs no intervention

Change in Mutans streptococci (MS) count in dental plaque · healthy people

Xylitol significantly reduced Mutans streptococci in dental plaque compared with no treatment (SMD -0.73, 95% CI -1.09 to -0.37; 5 trials, I2=53%; not GRADE-rated).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the tooth level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-free proportion at the tooth level, but the reported difference was not statistically significant.

1 finding from 1 review

Er:YAG laser irradiation of enamel after demineralisation vs No anticaries intervention (untreated enamel)

Enamel surface microhardness · Demineralised / white-spot-lesion enamel (in vitro specimens)

In demineralised enamel, Er:YAG laser irradiation did not significantly change surface microhardness versus untreated control (SMD 0.66, 95% CI -1.12 to 2.44; 2 in vitro studies; 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

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

3-month school-based supervised daily tooth-brushing program with fluoridated toothpaste (multilevel: trained school nurses plus parental involvement) vs Pre-intervention

Visible plaque and oral-hygiene behavior · Schoolchildren aged 4-6 years in the United Arab Emirates (Dubai)

One pre-post study of a school-based supervised tooth-brushing program found visible plaque fell from 76.8% to 36.7% with positive behavior change (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Chlorhexidine mouthrinse vs Placebo or no intervention (including routine care)

Outcome not reported · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

The review found no eligible studies for this question.

1 finding from 1 review

Chlorhexidine spray vs Placebo or no intervention (including routine care)

Outcome not reported · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

The review found no eligible studies for this question.

1 finding from 1 review

Chlorhexidine toothpaste vs Placebo or no intervention (including routine care)

Outcome not reported · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

The review found no eligible studies for this question.

1 finding from 1 review

Chlorhexidine chewing gum vs Placebo or no intervention (including routine care)

Outcome not reported · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

The review found no eligible studies for this question.

1 finding from 1 review

Fluorescence camera (FC) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by setting (FC, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant setting difference for FC (RDOR 2.96, 0.36 to 24.45).

2 findings from 1 review

Laser fluorescence (DIAGNOdent 2190/pen) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (pooled sensitivity, specificity, diagnostic odds ratio, summary-ROC AUC) · Permanent teeth, occlusal surfaces, with suspected caries lesions

Pen-type laser fluorescence on occlusal surfaces of permanent teeth (more advanced-lesion threshold): pooled DOR for LFpen lower than for LF and FC; heterogeneity I2=73%. Diagnostic accuracy was not formally graded (GRADE not used).

2 findings from 1 review

Laser fluorescence (LF; DIAGNOdent) vs Reference standard (histology, excavation, or enhanced visual examination)

Relative DOR by reference standard (LF, advanced, occlusal permanent) · Permanent teeth, occlusal surfaces, with suspected caries lesions

No significant difference vs histological for LF at the advanced threshold (RDOR 0.62, 0.15 to 2.46).

2 findings from 1 review