Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,890 questions · 3,917 findings · 272 reviews · All outcomes

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 buffering capacity · Patients with drooling (sialorrhea) due to neurological disease

Salivary buffering capacity did not decrease after BoNT; one of two quasi-experimental studies reported a significant increase (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 buffering increase at 1 month; 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The quasi-experimental studies of Tiigimae-Saar found different results concerning the changes in buffering capacity. For the analysis carried out in 2017, no statistically significant change was observed. By contrast,…
    2 studies
    GRADE not reported

MidWest (DENTSPLY; red fluorescence, red/green light and sound signal) 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. 4 datasets, 356 tooth sites.
    4 studies
    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: Multiple sites 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: Smooth or secondary-caries surfaces (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)

Sensitivity · 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

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: Proximal surfaces (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: Occlusal surfaces (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

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 38% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.21, 95% CI 1.12 to 1.3; high certainty).

4 findings from 1 review
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30% SDF solution (applied annually) vs 30% SDF solution (once weekly for 3 weeks)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) probably did not differ from 30% SDF solution (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.13, 95% CI 0.95 to 1.34; moderate certainty).

3 findings from 1 review

30% SDF solution (applied annually) vs Fluoride varnish

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) was more effective than 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.41, 95% CI 1.2 to 1.66; high certainty).

3 findings from 1 review

38% silver diamine fluoride vs 12% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied annually) was more effective than 12% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.27, 95% CI 1.16 to 1.4; high certainty).

4 findings from 1 review
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12% SDF solution (applied annually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

12% SDF solution (applied annually) did not differ from 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 0.94, 95% CI 0.87 to 1.02; high certainty).

4 findings from 1 review
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Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of ibuprofen tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of ibuprofen tablets compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs Fluoride varnish

Arrest of dentine caries · Preschool children with active dentine caries in primary teeth (mean age 3.4-4.0 years)

Silver diamine fluoride was about 2.5 times more likely than sodium fluoride to arrest dentine caries surfaces at 18 months (pooled OR 2.51, 95% CI 1.25 to 5.10; 2 RCTs), although between-study heterogeneity was high (I2=90.3%); certainty of evidence was not formally graded.

2 findings from 1 review

30% SDF solution (once weekly for 3 weeks) vs Fluoride varnish

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (once weekly for 3 weeks) probably did not differ from 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 0.97, 95% CI 0.8 to 1.18; moderate certainty).

3 findings from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Patient-reported pain intensity (sum of pain intensity difference (SPID) and sum of pain percussion intensity difference (SPPID)) · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis
1 finding from 1 review
  • Antibiotic use for irreversible pulpitis 2019 · Cochrane All outcomes
    7 days
    Corresponding risk (Antibiotics): The in between-group differences (median +/- IQR) in SPID for the penicillin group were 6.0 +/- 10.5, and for placebo 6.0 +/- 9.5. The SPPID for the penicillin group was 3.5 +/- 7.5…
    1 study · 40 participants
    Low

CPP-ACP vs Pre-treatment (baseline, same group)

Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients (mainly children) with white spot lesions (WSL)

Compared with baseline, CPP-ACP significantly improved white spot lesions on QLF (SMD -0.43, 95% CI -0.79 to -0.07; ungraded).

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of paracetamol (acetaminophen) with codeine (Tylenol) tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of paracetamol (acetaminophen) with codeine (Tylenol)… compared with placebo plus analgesic (low certainty).

1 finding from 1 review