Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

174 questions · 213 findings · 33 reviews

No studies found 31 · 14.6%GRADE not reported 142 · 66.7%Very low 17 · 8%Low 8 · 3.8%Moderate 15 · 7%High 0 · 0%

Fluoride-releasing resin-based sealant vs Non-invasive measures (fluoride varnish; no intervention)

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 2 trials, resin-based sealants reduced radiographic proximal caries progression versus non-invasive measures (OR 0.24; ungraded subgroup).

1 finding from 1 review

Microinvasive techniques (resin infiltration or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Radiographic proximal caries lesion progression · Children with non-cavitated proximal caries lesions in primary teeth (ages 3-9)

In primary teeth (5 trials), microinvasive techniques reduced radiographic proximal caries progression versus non-invasive measures (OR 0.38; ungraded subgroup).

1 finding from 1 review

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Adverse events and periodontal/secondary outcomes (gingival bleeding, gingival bleeding index, visible plaque index) · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

Only three trials reported secondary/adverse outcomes; no adverse events were attributed to microinvasive treatment and periodontal findings were mixed and not pooled (ungraded).

1 finding from 1 review

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) 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)

Microinvasive techniques probably reduce radiographic progression of non-cavitated proximal caries lesions compared with non-invasive measures (moderate certainty).

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

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-based fissure sealant vs Fluoride varnish

Caries incidence of first permanent molars (FPMs) · 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 caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated).

1 finding from 1 review

Resin-modified glass ionomer fissure sealant vs Fluoride varnish

Progression of dentinal carious lesions into enamel or dentine · Children and adolescents (general population, aged under 20 years)

Resin-modified glass ionomer fissure sealant showed no clear difference in progression of dentinal carious lesions into enamel or dentine compared with fluoride varnish; GRADE not reported.

1 finding from 1 review

Resin-based fissure sealant (visible-light-polymerized) vs Fluoride varnish

Incidence of dentinal carious lesion on treated occlusal surfaces of molars or premolars (yes/no) · Children and adolescents (general population, aged under 20 years)

It is very uncertain whether resin-based fissure sealant (visible-light-polymerized) changes incidence of dentinal carious lesion on treated occlusal surfaces of… compared with fluoride varnish (very low certainty).

2 findings from 1 review

Resin-modified glass ionomer fissure sealant plus oral health education vs Fluoride varnish plus oral health education

Change in DMF increment on occlusal surfaces of first permanent molars · Children and adolescents (general population, aged under 20 years)

Resin-modified glass ionomer fissure sealant plus oral health… showed no clear difference in change in DMF increment on occlusal surfaces of first permanent molars compared with fluoride varnish plus oral health education; GRADE not reported.

2 findings from 1 review

Resin-based fissure sealant vs Fluoride varnish

Change in DMFT (decayed, missing and filled permanent teeth) increment · Children and adolescents (general population, aged under 20 years)

Resin-based fissure sealant led to lower change in DMFT (decayed, missing and filled permanent teeth) increment compared with fluoride varnish; GRADE not reported.

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

Change in DMFS (decayed, missing and filled permanent surfaces) increment · Children and adolescents (general population, aged under 20 years)

Resin-based fissure sealant led to lower change in DMFS (decayed, missing and filled permanent surfaces)… compared with fluoride varnish; GRADE not reported.

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

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

SDF applied once (single application, no re-application) vs Other non/minimally-invasive treatment (ART or silver-fluoride varnish)

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

A single (one-time) SDF application did not significantly arrest caries (pooled ES -0.09, 95% CI -0.48 to 0.29; ungraded).

1 finding from 1 review

Hall technique vs Fluoride varnish

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 12 months, the Hall technique had significantly higher treatment success than sodium fluoride varnish (OR 6.38; moderate certainty).

2 findings from 1 review

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

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