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Evidence found and GRADE certainty

145 questions · 179 findings · 24 reviews · Oral Health

No studies found 27 · 15.1%GRADE not reported 121 · 67.6%Very low 14 · 7.8%Low 3 · 1.7%Moderate 14 · 7.8%High 0 · 0%

Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

Pooling 10 trials, resin infiltration reduced radiographic proximal caries progression versus non-invasive measures (OR 0.23); this subgroup was not separately GRADE-rated.

1 finding from 1 review

Microinvasive techniques (mostly resin infiltration; incl. resin sealant) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal caries lesions in permanent teeth (ages 11-45)

In permanent teeth (7 trials), microinvasive techniques reduced radiographic proximal caries progression versus non-invasive measures (OR 0.18; ungraded subgroup).

1 finding from 1 review

38% silver diamine fluoride vs No treatment / other preventive agents (GIC, 5% NaF varnish)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

A second meta-analysis reported odds ratios of 2.44 to 3.63 favouring 38% SDF over fluoride varnish/water for caries arrest (ungraded).

2 findings from 1 review

Fluoride gel combined with fluoride mouthrinse vs Fluoride gel

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride gel combined with fluoride mouthrinse showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride gel alone; GRADE not reported.

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Fluoride mouthrinse

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride mouthrinse combined with fluoride toothpaste showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride mouthrinse alone; GRADE not reported.

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Fluoride toothpaste alone

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride mouthrinse combined with fluoride toothpaste showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride toothpaste alone; GRADE not reported.

1 finding from 1 review

SDF applied biannually (every 6 months) vs Other non/minimally-invasive treatment (ART or 5% NaF varnish)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

Biannual SDF application significantly arrested caries (pooled ES 0.39, 95% CI 0.19-0.60; ungraded).

1 finding from 1 review

Glass ionomer or resin-modified glass ionomer fissure sealant vs Fluoride varnish

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)
1 finding from 1 review

Resin-based fissure sealant vs Fluoride varnish

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)

It is very uncertain whether resin-based fissure sealant changes dentine caries in permanent molars (yes/no) compared with fluoride varnish (very low certainty).

1 finding from 1 review

Sealing (resin sealant, glass ionomer cement, or polyurethane tape) vs Non-invasive / control treatment

Radiographic proximal caries lesion progression · Patients with non-cavitated proximal (approximal) caries lesions (primary or permanent dentition)

Sealing probably reduces the odds of proximal lesion progression compared with placebo (OR 0.27, 95% CI 0.18 to 0.42; moderate certainty).

1 finding from 1 review

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

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…

Micro-invasive treatment (proximal sealing or resin infiltration):… probably leads to lower caries (lesion) progression measured by pairwise reading of… compared with non-invasive measures (e.g. fluoride varnish, flossing/oral hygiene… (moderate certainty).

4 findings from 1 review
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Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

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 infiltration led to lower caries (lesion) progression (radiographic) compared with fluoride varnish, sham/placebo, or flossing advice (non-invasive…; GRADE not reported.

1 finding from 1 review

38% SDF varnish plus oral health instruction vs oral health instruction plus water

new root-surface carious lesions or restorations · Older adults with root caries in permanent (mature) teeth (mean age 75 years)

SDF had a 71% preventative fraction at 36 months; no pooled estimate or GRADE rating was reported.

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

Resin infiltration vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration was significantly better than fluoride varnish (SMD -0.70, 95% CI -1.18 to -0.21); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Resin infiltration vs P11-4 + fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Resin infiltration and P11-4 plus fluoride varnish did not differ significantly (SMD 0.01, 95% CI -0.62 to 0.65; indirect evidence only); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

Self-assembling peptide P11-4 vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Self-assembling peptide P11-4 did not differ significantly from fluoride varnish (SMD -0.31, 95% CI -0.71 to 0.09); certainty of evidence not assessed (no GRADE).

1 finding from 1 review