Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,890 questions · 3,917 findings · 272 reviews · Oral Health

No studies found 429 · 11%GRADE not reported 2,657 · 67.8%Very low 512 · 13.1%Low 219 · 5.6%Moderate 80 · 2%High 20 · 0.5%

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard: histology or enhanced visual examination (with or without radiographs)

Outcome not reported · Samples with a low (<15%) prevalence of caries into dentine (d3/D3); target condition = non-cavitated enamel caries.

The review found no eligible studies for this question.

1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    No eligible studies. 'No studies reported the inclusion of a low prevalence (0% to 14%) of d3/D3 of tooth surfaces'; all included studies reported d3/D3 prevalence of 15% or above, so the planned low-prevalence…
    0 studies
    No studies found

Schwarz appliance vs No active treatment (control)

Lower incisors to mandible (position, mm) at 9 months · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Schwarz appliance led to higher lower incisors to mandible (position, mm) at 9 months compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Copper nickel-titanium archwire vs Nickel-titanium archwire

Time to alignment · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Copper nickel-titanium archwire showed no clear difference in time to alignment (days) compared with nickel-titanium archwire; GRADE not reported.

1 finding from 1 review

Active self-ligating brackets vs Passive self-ligating brackets

Amount of crowding (upper anterior crowding) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
1 finding from 1 review
  • Orthodontic treatment for crowded teeth in children 2021 · Cochrane All outcomes
    baseline
    Only baseline upper anterior crowding reported (Pandis 2010a, n=70); evidence of baseline imbalance between groups (P=0.04); no post-treatment between-group crowding estimate reported.
    1 study
    GRADE not reported

Fibre-optic transillumination (FOTI) vs Histological validation (in vitro) or direct visual examination after tooth separation / bioptical cavity preparation (in vivo)

detection of proximal caries · Permanent posterior teeth, proximal surfaces (in vitro extracted teeth and in vivo patients)

For fibre-optic transillumination (FOTI), studies were identified (in vitro N=4, in vivo N=3) but none had sufficiently low risk of bias and adequate reporting to be pooled; no meta-analytic estimate could be derived.

1 finding from 1 review

Transillumination and optical coherence tomography devices (all illumination devices combined: NIR, OCT, and FOTI/DIFOTI) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Oral health knowledge, attitudes and practices assessment vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Mother self-reported oral health behaviours and attitudes · Mothers and caregivers of children in the United Arab Emirates

Mothers and caregivers often had adequate knowledge/attitudes but improper oral-health practices and low dental-service use, associated with education and occupation (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Dental plaque assessment (plaque score/index) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Plaque · Children in the United Arab Emirates (Ajman, Sharjah)

Dental plaque levels were high and associated with frequent snacking and less frequent tooth brushing, and higher plaque was linked to more caries (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Lower lingual arch vs No active treatment (control)

Lower molars to mandible (relationship of lower back teeth to the mandible) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Lower lingual arch led to lower lower molars to mandible at 1 year compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Multistranded stainless steel archwire vs Stainless steel archwire

Amount of crowding (change in mandibular crowding) at 8 weeks · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

It is very uncertain whether multistranded stainless steel archwire changes amount of crowding (change in mandibular crowding) at 8 weeks compared with stainless steel archwire (very low certainty).

1 finding from 1 review

Cervical pull headgear vs Minor interceptive procedures (control)

Lower incisors to mandible (relationship of lower front teeth to the mandible) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Cervical pull headgear showed no clear difference in lower incisors to mandible at 2 years compared with minor interceptive procedures (control); GRADE not reported.

1 finding from 1 review

Self-ligating brackets vs Conventional brackets

Harms (discomfort, periodontal/gingival health, root resorption) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
1 finding from 1 review
  • Orthodontic treatment for crowded teeth in children 2021 · Cochrane All outcomes
    up to 9 months
    No evidence of differences between self-ligating and conventional brackets for discomfort (Atik 2014, Miles 2010), plaque/gingival index and probing depth (Atik 2014), or maxillary incisor root resorption (Aras 2018).…
    3 studies
    GRADE not reported

Electrical conductance (e.g. electronic caries monitor, ECM) vs Reference standard: histology or enhanced visual-tactile examination

Outcome not reported · Adults presenting asymptomatically or suspected of having root caries (in vivo); extracted teeth of adults (in vitro)

The review found no eligible studies for this question.

1 finding from 1 review
  • Electrical conductance was a pre-specified eligible index test but no diagnostic test accuracy study of electrical conductance was included. A study evaluating the electronic caries monitor (ECM) (Wicht 2002) was…
    0 studies
    No studies found

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary Lactobacilli counts · Patients with drooling (sialorrhea) due to neurological disease

Salivary Lactobacilli counts were unchanged in two studies but significantly increased in one study one month after BoNT (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant Lactobacilli increase at 1 month; Wu 2011 and 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    No statistically significant changes in Lactobacilli CFU counts were reported by Wu et al. or by Tiigimae-Saar 2017. However, the 2018 study found that Lactobacilli CFU counts were significantly increased one month…
    3 studies
    GRADE not reported

VistaProof (Durr Dental; blue fluorescence, 405 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Analysed as a separate index test (coupled forest plot and SROC plot, Figure 24 / Figure 25; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 18 datasets, 2402 tooth sites.
    17 studies
    GRADE not reported

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

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Analysed as a separate index test (coupled forest plot and SROC plot, Figure 22 / Figure 23; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 34 datasets, 6842 tooth sites.
    32 studies
    GRADE not reported

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

Diagnostic accuracy (sensitivity and specificity) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Analysed as a separate index test (coupled forest plot and SROC plot, Figure 22 / Figure 23; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 46 datasets, 7316 tooth sites.
    45 studies
    GRADE not reported

Red fluorescence devices (DIAGNOdent, DIAGNOdent pen, MidWest; excitation wavelength >655 nm) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) for detection of early enamel caries (D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary osmolality (hydration level) · Patients with drooling (sialorrhea) due to neurological disease

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

1 finding from 1 review

All fluorescence-based devices (red, blue, and green fluorescence combined) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic odds ratio (DOR) by subgroup: Histology or excavation reference standard (detection of early enamel caries, D1 threshold) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review