Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,066 questions · 3,346 findings · 178 reviews · Dental caries

No studies found 48 · 1.4%GRADE not reported 2,789 · 83.4%Very low 208 · 6.2%Low 129 · 3.9%Moderate 136 · 4.1%High 36 · 1.1%

Higher number of lost teeth (per one additional lost tooth) vs Fewer lost teeth (continuous, per-tooth increment)

Atherosclerotic cardiovascular disease (ACVD)-related events (morbidity and mortality) · Adults (any age) with a known number of remaining teeth, followed prospectively in cohort studies

Each additional lost tooth was associated with a multivariable-adjusted HR of 1.02 (95% CI 1.01 to 1.03) for ACVD-related events (13 studies, I2=75%), statistically significant; GRADE per-analysis ratings reported in Supplementary File 7 (not available in provided sources).

3 findings from 1 review

Resin infiltration vs Fluoride varnish

Optical/esthetic improvement (DIAGNOdent reading) · Patients (mainly children) with white spot lesions (WSL)

Resin infiltration produced significantly greater optical improvement than fluoride varnish (MD 4.76, 95% CI 0.74 to 8.78; moderate certainty).

3 findings from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Percentage of bleeding on probing (BOP) · Adults undergoing orthodontic treatment

No clear difference in bleeding on probing between aligners and fixed appliances in adults at 6-12 weeks (MD -0.26, 95% CI -0.77 to 0.26; very low certainty).

1 finding from 1 review

Quantitative light-induced fluorescence (QLF) vs Histological validation (in vitro) or cavity preparation/biopsy (in vivo)

Occlusal caries detection accuracy · Human permanent posterior teeth (premolars and molars) in patients, occlusal (pit-and-fissure) surfaces

No eligible QLF studies met the meta-analysis inclusion criteria (candidate QLF studies were identified but none had acceptable index/reference tests and reporting quality).

1 finding from 1 review

Intervention not reported

Relative abundance of Veillonella spp.

The intervention showed no clear difference in relative abundance of Veillonella spp.; GRADE not reported.

1 finding from 1 review

Sealant (any type) vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)

Sealant use reduced the incidence of new white spot lesions versus no sealant (very low certainty).

1 finding from 1 review

Intervention not reported

Dental caries prevalence · General population in Ethiopia (all ages, age range 6-100 years)

Caries prevalence was highest in the Tigray region at 46.59% (95% CI 24.64 to 68.54); certainty not graded.

1 finding from 1 review

Fibre-optic transillumination (FOTI) vs Histological validation (serial sectioning, grinding, hemisection, or microradiography)

Diagnostic accuracy for occlusal caries detection at the caries detection level (D0 versus D1-D4) · Extracted human permanent posterior teeth (premolars and molars), occlusal (pit-and-fissure) surfaces

In in vitro, fibre-optic transillumination pooled sensitivity was 0.97 (95% CI -0.92 to 0.99) for occlusal caries at the caries detection level; ungraded.

4 findings from 1 review
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Intervention not reported

Dental caries prevalence · General population in Ethiopia (all ages, age range 6-100 years)

The pooled prevalence of dental caries in Ethiopia (2000-2020) was 40.98% (95% CI 31.62 to 50.34), with very high heterogeneity (I2=98.6%); certainty not graded.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Gingival inflammation-related index · Adolescents/teenagers undergoing orthodontic treatment

A single study reported lower simplified gingival index with aligners versus fixed appliances in adolescents at 1 month (MD -8.46, 95% CI -10.47 to -6.45; ungraded).

1 finding from 1 review

Visual examination (VE) vs Direct visual examination after tooth separation or bioptical cavity preparation

Diagnostic accuracy for proximal caries detection (dentin detection level) · Patients with permanent posterior teeth, proximal surfaces assessed clinically (in vivo)

Under in vivo conditions, visual examination had a pooled specificity of 0.76 (95% CI 0.11, 0.99) for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Poor / no tooth brushing habit vs Good tooth brushing habit

Dental caries · Individuals in East Africa assessed for dental caries

Poor tooth brushing was associated with significantly higher odds of dental caries (OR 1.967, 95% CI 1.205 to 3.211); certainty not graded.

1 finding from 1 review

Compomer (polyacid-modified composite, fluoride-releasing) for bonding brackets vs Compomer bonding agent without fluoride release

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

For compomer-based bonding agents, fluoride release did not significantly change WSL initiation (RR 0.71); subgroup not separately GRADE-rated.

1 finding from 1 review

Visual examination (VE) vs Histological validation of dental tissues (gold standard)

Diagnostic accuracy for proximal caries detection (dentin detection level) · Extracted permanent posterior teeth with proximal surfaces (in vitro)

Under in vitro conditions, visual examination had a summary ROC AUC of 0.85 for proximal caries detection at the dentin detection level; ungraded.

4 findings from 1 review
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Sealant/coating agent WITHOUT fluoride release applied to teeth with fixed appliances vs No sealant (control/no treatment)

Initiation of white spot lesions (WSL), visual-tactile assessment · Patients of any age (11-40 years) receiving comprehensive/fixed orthodontic treatment with fixed appliances

Among non-fluoride sealants, WSL initiation was significantly reduced versus no sealant (RR 0.69); subgroup not separately GRADE-rated.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Probing pocket depth (PPD/PD) · Adults undergoing orthodontic treatment

Aligners may reduce pocket depth compared with fixed appliances in adults at 6-12 weeks (MD -0.42 mm, 95% CI -0.71 to -0.12; very low certainty).

1 finding from 1 review