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Evidence found and GRADE certainty

1,966 questions · 3,201 findings · 165 reviews

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No studies found 25 · 0.8%GRADE not reported 2,717 · 84.9%Very low 167 · 5.2%Low 124 · 3.9%Moderate 132 · 4.1%High 36 · 1.1%

Er:YAG laser preparation combined with acid-etching vs Acid-etching (phosphoric acid)

Dental anxiety (subjective and objective scores) · Children (ages 6-12) receiving pit-and-fissure sealants

Er:YAG laser preparation added to acid-etching did not increase children's dental anxiety versus acid-etching alone (P > 0.05; ungraded, single study).

1 finding from 1 review

CPP-ACP vs Placebo paste without CPP-ACP (fluoride toothpaste control)

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

CPP-ACP toothpaste did not differ significantly from placebo paste (fluoride control) for white spot lesion remineralization on QLF (MD 0.08, 95% CI -0.91 to 1.08; ungraded).

1 finding from 1 review

38% SDF + potassium iodide solution (applied annually) vs Fluoride varnish

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF + potassium iodide solution (applied annually) may not differ from 5% NaF varnish for arrest or reversal of root carious lesions (RR 0.8, 95% CI 0.05 to 11.95; very low certainty).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Cost‐effectiveness · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, the cost-effectiveness estimate was extremely imprecise and not significant (OR 0.00, 95% CI 0.00 to 48704.6; ungraded).

1 finding from 1 review

1% chlorhexidine + 1% thymol varnish vs 38% SDF solution (applied annually)

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

1% chlorhexidine + 1% thymol varnish may not differ from 38% SDF solution (applied annually) for arrest or reversal of root carious lesions (RR 0.88, 95% CI 0.14 to 5.6; very low certainty).

1 finding from 1 review

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Caries in primary teeth: dmft (3 years) · Children and adolescents with juvenile idiopathic arthritis (JIA)

There was no significant difference in dental caries of the primary teeth (dmft) between children with JIA and healthy peers (pooled MD -1.16, 95% CI -3.02 to 0.71; 3 cross-sectional studies; very high heterogeneity I2=87.9%; ungraded).

1 finding from 1 review

1% chlorhexidine + 1% thymol varnish vs 5,000-ppm F (1.1% NaF) toothpaste or gel

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

1% chlorhexidine + 1% thymol varnish may not differ from 5,000-ppm F (1.1% NaF) toothpaste or gel for arrest or reversal of root carious lesions (RR 0.64, 95% CI 0.15 to 2.7; very low certainty).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, OHPPs showed no significant effect on DMFT/S (OR 0.29, 95% CI 0.08 to 1.01; ungraded).

1 finding from 1 review

Antimicrobial photodynamic therapy (PDT) vs No photodynamic therapy (untreated negative control)

Microbial reduction (viable count, log CFU/mL) · Patients with dental caries (in vivo cariogenic microorganisms, including children with early childhood caries)

In randomized clinical trials, photodynamic therapy significantly reduced cariogenic microbial counts versus untreated control (SMD -1.16, 95% CI -2.02 to -0.30; 2 trials), but heterogeneity was high (I2=70%) and considered too high to rely on; certainty was not graded.

1 finding from 1 review

Juvenile idiopathic arthritis (JIA) vs Children and adolescents without JIA (healthy peers)

Dental caries in permanent teeth · Children and adolescents with juvenile idiopathic arthritis (JIA)

There was no significant difference in dental caries of the permanent teeth (DMFT) between children/adolescents with JIA and healthy peers (pooled MD -0.08, 95% CI -0.42 to 0.26; 6 cross-sectional studies; no heterogeneity I2=0%; ungraded).

1 finding from 1 review

Sealant + 5% NaF varnish vs no treatment

Arrest or reversal of noncavitated occlusal carious lesions · Children and adults with noncavitated carious lesions on occlusal surfaces (primary and permanent teeth)

Sealant + 5% NaF varnish was probably more effective than no treatment for arrest or reversal of occlusal carious lesions (RR 3.35, 95% CI 2.42 to 4.64; moderate certainty).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Incremental cost‐effectiveness · Children with dental caries

OHPPs were associated with a lower program cost per DMFT/S in about 97 of 100 programs (OR 0.03, 95% CI 0.01 to 0.11; ungraded, very high heterogeneity I2=99%).

1 finding from 1 review

Antimicrobial photodynamic therapy (PDT) vs No photodynamic therapy (untreated negative control)

Microbial reduction (viable count, log CFU/mL) · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

In in vitro studies, photodynamic therapy significantly reduced cariogenic microbial counts versus untreated control (SMD -2.64, 95% CI -4.50 to -0.79; 2 studies; I2=0%); certainty was not graded.

1 finding from 1 review

Resin infiltration + 5% NaF varnish vs Sealants plus fluoride varnish (with or without restorations)

Arrest or reversal of noncavitated occlusal carious lesions · Children and adults with noncavitated carious lesions on occlusal surfaces (primary and permanent teeth)

Resin infiltration + 5% NaF varnish may not differ from Sealant + 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.95, 95% CI 0.75 to 1.21; low certainty).

1 finding from 1 review

Intervention not reported

Dental caries prevalence · Children (<12 years) and adolescents (12-18 years) with type 1 diabetes

Caries prevalence among those with poor metabolic control was 66% (95% CI 0.43 to 0.83); certainty not graded.

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children younger than 6 years (healthy except for dental caries)

In children younger than 6 years, OHPPs were associated with lower odds of DMFT/S (OR 0.14, 95% CI 0.05 to 0.39; ungraded).

1 finding from 1 review

Postnatal passive tobacco exposure (secondhand/household smoke in infancy) vs No passive tobacco exposure (non-exposed children)

Caries presence in primary teeth · Young children with primary (deciduous) dentition (aged 1 to 6 years at study start)

Postnatal (infancy) tobacco exposure is associated with higher odds of caries in primary dentition (pooled OR 1.72, 95% CI 1.45 to 2.05; 13 studies; high heterogeneity I2=83%); certainty not graded.

1 finding from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (often histological; also invasive opening)

All occlusal carious lesions · Permanent molar surfaces in diagnostic accuracy studies (mostly in vitro; clinical)

Pooled specificity for visual detection of all occlusal lesions was 0.770 (95% CI 0.73 to 0.81).

2 findings from 1 review

Radiographic caries detection (bitewing radiography) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Negative LR for detecting advanced proximal caries · Proximal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, the negative lr of radiographic detection for advanced proximal caries was 0.58 (95% CI 0.52 to 0.65) (ungraded).

3 findings from 1 review

Visual caries detection (ICDAS visual/visual-tactile inspection) vs Reference standard (histological validation or cavity/lesion opening; advanced = cavitated/dentin-involved lesions, all = enamel-confined initial lesions also counted)

Specificity for detecting all (initial and advanced) occlusal caries · Occlusal surfaces of permanent molars (demonstrated in 12-14 year-olds; underlying diagnostic accuracy studies, mostly in vitro)

In the conventional (all-studies) meta-analysis, pooled specificity of visual detection for all (initial and advanced) occlusal caries was 75.3% (95% CI 70 to 80) (ungraded).

3 findings from 1 review