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%

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

Salivary S. mutans level · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (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 · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
    3 studies
    GRADE not reported

Spectra caries detection device (Air Techniques; blue fluorescence) 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)
    The Spectra caries detection device fits into the blue fluorescence category but no studies provided data for inclusion in the meta-analysis (Markowitz 2015).
    1 study
    GRADE not reported

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: Permanent/mixed dentition (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

Laser fluorescence (LF; DIAGNOdent) vs Reference standard: histology (in vitro studies) or visual-tactile examination (in vivo studies)

Specificity · Adults presenting asymptomatically or suspected of having root caries (in vivo studies); extracted teeth of adults (in vitro studies). 2…
1 finding from 1 review
  • 4 studies (4997 root surfaces) investigated laser fluorescence and reported estimates of sensitivity ranging from 0.50 to 0.81 and specificity ranging from 0.40 to 0.80. 2 studies evaluated tests on in vivo primary…
    4 studies
    Very low

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

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

BoNT injections were not associated with significant changes in oral/salivary pH across three studies (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 · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    Wu et al. did not observe significant differences in participants' oral pH before and after BoNT-A injections between the active and control groups. There were also no statistically significant differences regarding…
    3 studies
    GRADE not reported

Canary System (Quantum Dental Technologies; red fluorescence, scale 0-100) vs Reference standard: histology, enhanced visual examination with or without radiographs, or excavation

Outcome not reported · Children or adults presenting asymptomatically or suspected of having enamel caries (in vivo/clinical studies); extracted teeth of…

The review found no eligible studies for this question.

1 finding from 1 review

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

Sensitivity at fixed upper-quartile specificity 0.90 (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

Combined index test: visual examination + radiograph + DIAGNOdent (Alomari 2015) vs Reference standard: histology

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

All fluorescence-based devices (red, blue, and green fluorescence combined) 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)

Development of >=1 new carious lesion (caries incidence) · Patients with drooling (sialorrhea) due to neurological disease

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

2 findings 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: Single site per tooth (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

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: Radiography 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

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: Enhanced visual examination 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

Blue fluorescence devices (VistaProof, SoproLife, Spectra; wavelength 400-450 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. 3 datasets, 1027 tooth sites.
    3 studies
    GRADE not reported

Quantitative light-induced fluorescence (QLF) 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

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

Sensitivity at fixed median specificity 0.78 (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

Combined index test: visual examination + radiograph + DIAGNOdent (Alomari 2015) vs Reference standard: histology

Specificity 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

Blue fluorescence devices (VistaProof, SoproLife, Spectra; wavelength 400-450 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

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: Primary dentition (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

Fibre-optic transillumination (FOTI, including white light scattering and near infrared) 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