Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,066 questions · 3,346 findings · 178 reviews · Dental caries

No studies found 48 · 1.4%GRADE not reported 2,789 · 83.4%Very low 208 · 6.2%Low 129 · 3.9%Moderate 136 · 4.1%High 36 · 1.1%

Laser enamel preparation alone (Er,Cr:YSGG or CO2 laser) vs Acid-etching (phosphoric acid)

Sealant retention rate (completely retained) · Caries-free children to young adults with premolars/molars requiring pit-and-fissure sealants

At 18 months, laser preparation alone did not differ significantly from acid-etching for sealant retention (OR 0.82, 95% CI 0.23 to 2.85; ungraded, single study, high risk of bias).

6 findings from 1 review
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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 0-12 years (studies published 2015 or later)

In studies published from 2015 onward, OHPPs were associated with lower DMFT (OR 0.08, 95% CI 0.01 to 0.53; ungraded).

1 finding from 1 review

38% SDF + potassium iodide solution (applied annually) vs no treatment

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 no treatment for arrest or reversal of root carious lesions (RR 2.36, 95% CI 0.66 to 8.42; very low certainty).

1 finding from 1 review

Fluoride varnish vs Resin infiltration + 5% NaF varnish

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

5% NaF varnish was probably less effective than Resin infiltration + 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.62, 95% CI 0.46 to 0.83; moderate certainty).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Clinical failure · Children with carious vital pulp exposure in primary incisors

Pulpotomy may not differ from pulpectomy for clinical failure; no GRADE rating was reported.

1 finding from 1 review

1.23% APF gel vs no treatment

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel was probably more effective than no treatment for arrest or reversal of any-coronal carious lesions (RR 2.25, 95% CI 2 to 2.53; moderate certainty).

1 finding from 1 review

Learning disability (CLD) vs No learning disability (CNLD)

Dental caries in permanent teeth · Children aged 1-18 years

Across all learning disabilities, meta-analysis found no evidence of a difference in permanent-tooth caries experience (DMFT) between children with and without learning disabilities (SMD -0.43, 95% CI -0.91 to 0.05; 16 studies; certainty not graded).

4 findings from 1 review
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1.23% APF gel vs Sealant

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

1.23% APF gel may not differ from Sealant for arrest or reversal of occlusal carious lesions (RR 1.08, 95% CI 0.82 to 1.41; low certainty).

1 finding from 1 review

5,000-ppm F (1.1% NaF) toothpaste or gel vs no treatment

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)

5,000-ppm F (1.1% NaF) toothpaste or gel may be more effective than no treatment for arrest or reversal of root carious lesions (RR 2.62, 95% CI 1.49 to 4.63; low certainty).

1 finding from 1 review

1.23% APF gel vs Fluoride varnish

Arrest or reversal of noncavitated carious lesions on any coronal surface · Children and adults with noncavitated carious lesions on any coronal surface (primary and permanent teeth)

1.23% APF gel may not differ from 5% NaF varnish for arrest or reversal of any-coronal carious lesions (RR 1.05, 95% CI 0.85 to 1.29; low certainty).

1 finding from 1 review

38% silver diamine fluoride vs 38% SDF + potassium iodide 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)

38% SDF solution (applied annually) may not differ from 38% SDF + potassium iodide solution (applied annually) for arrest or reversal of root carious lesions (RR 0.8, 95% CI 0.25 to 2.61; low certainty).

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts more than placebo (favours Salvadora persica); not GRADE-rated.

1 finding 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

Resin infiltration vs no treatment

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

Resin infiltration may be more effective than no treatment for arrest or reversal of approximal carious lesions (RR 2.11, 95% CI 1.08 to 4.13; low certainty).

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced plaque more than placebo (favours Salvadora persica); certainty not GRADE-rated (Shekelle grade Ia).

1 finding from 1 review

Resin infiltration + 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)

Resin infiltration + 5% NaF varnish was probably more effective than no treatment for arrest or reversal of occlusal carious lesions (RR 3.2, 95% CI 2.24 to 4.56; moderate certainty).

1 finding from 1 review

Fluoride varnish vs Sealant

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

5% NaF varnish may not differ from Sealant for arrest or reversal of occlusal carious lesions (RR 0.99, 95% CI 0.86 to 1.15; low certainty).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Soft tissue pathology · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in soft tissue pathology between pulpotomy and pulpectomy (RR 3.11, 95% CI 0.54 to 17.7; ungraded).

1 finding from 1 review