Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,745 questions · 4,389 findings · 203 reviews · Oral Health

No studies found 39 · 0.9%GRADE not reported 3,844 · 87.6%Very low 198 · 4.5%Low 137 · 3.1%Moderate 134 · 3.1%High 37 · 0.8%

Flowable bulk-fill composite resin vs Light-cured compomer (polyacid-modified composite resin)

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; both arms had 0% failure.

1 finding from 1 review

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

Oral hairy leukoplakia (WHO clinical stage 3) · Children or adolescents

No difference in oral hairy leukoplakia between groups (pooled OR 1.00, 95% CI 0.06 to 16.19); lesion essentially absent in both.

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

Imaging (analog or digital radiographs) vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection of enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies)

In the fully within-person analysis, radiographic imaging had a summary sensitivity of 0.48 (95% CrI 0.35, 0.62); ungraded.

2 findings from 1 review

Atraumatic restorative treatment with GIC vs Conventional treatment

Pain during the procedure (primary analysis) · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement

The reported estimate for procedural pain with ART versus conventional treatment was inconclusive (ungraded).

1 finding from 1 review

30% silver diamine fluoride vs Atraumatic restorative treatment (ART)

Patient discomfort during treatment (anxiety scale) · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

One study found no significant difference in patient discomfort between SDF and ART (p = 0.15; ungraded).

1 finding from 1 review

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

Angular cheilitis (WHO clinical stage 2) · Children or adolescents

No significant difference in angular cheilitis prevalence between CLWH and healthy controls (pooled OR 1.95, 95% CI 0.16 to 23.65).

1 finding from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs Single-surface ART with high-viscosity GIC

Restoration failure · Children (2-9 years) with caries in posterior primary teeth

Multi-surface ART restorations had a high reported mean annual failure rate (17%; ungraded).

1 finding from 1 review

Transillumination and OCT vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection of enamel caries · Asymptomatic children or adults suspected of enamel caries (clinical studies); extracted teeth (in vitro studies)

Transillumination and OCT had a summary sensitivity of 0.76 (95% CrI 0.63, 0.86) for detecting enamel caries; low certainty.

1 finding from 1 review

Good brushing habits (>=2 daily tooth brushing) vs Not applicable (single-group prevalence)

Good brushing habits prevalence (among children with caries) · Children with dental caries (deciduous and/or permanent dentition) in low- and middle-income countries

About 57% of children with caries in LMICs had good brushing habits (pooled prevalence 0.569, 95% CI 0.354 to 0.771; 7 studies; very high heterogeneity; not GRADE-rated).

1 finding from 1 review

Conventional GIC vs Amalgam or metal-reinforced GIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Conventional GIC had an annual failure rate of 7.6-16.6% (2 RCTs) and failed more than amalgam in one trial; low quality of evidence (ungraded).

1 finding from 1 review

Class-I (single-surface) cavity restoration vs Class-II (proximal/multi-surface) cavity restoration

Treatment failure (annual failure rate) by cavity class · Children with carious primary teeth restored in Class-I versus Class-II cavities, no pulp therapy

Class-II restorations failed more than Class-I (annual failure 5-28.9% vs 1.2-14.7% in ART studies); low quality of evidence (ungraded).

1 finding from 1 review

Genetically predicted gene expression (TWAS; S-PrediXcan with GTEx v8 cis-eQTL across 49 tissues; cross-tissue S-MultiXcan) vs ECC-unaffected children (association of genetically predicted expression)

Early childhood caries (ECC) - association with genetically predicted expression of LACC1 (chr13q14.11) · Children up to age 5-6 years (European / European non-Hispanic ancestry); 843 ECC-affected vs 2124 unaffected across 5 cohorts (N=2974)

Genetically predicted LACC1 expression reached the TWAS threshold for ECC (p = 3.98e-5) but was flagged as a possible false positive (LD misspecification) and not further considered; ungraded.

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with mineral trioxide aggregate (MTA)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure

Biodentine had a significantly higher pulpotomy success rate than MTA (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Hall technique vs Compomer restoration or non-restorative caries treatment

Treatment failure (annual failure rate) · Children (aged 3-8 years) with 2-surface occluso-proximal dentine caries in primary molars, no pulp therapy

Preformed metal (Hall) crowns had a low reported annual failure rate (3.1%) versus compomer (14.7%) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review