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%

Resin infiltration + 5% NaF varnish vs Sealant

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

Resin infiltration + 5% NaF varnish may not differ from Sealant for arrest or reversal of approximal carious lesions (RR 1.91, 95% CI 0.48 to 7.52; very low certainty).

1 finding from 1 review

Higher JIA disease activity/severity (e.g., high JADAS/activity scores, polyarticular RF-negative subtype, active disease, anti-TNFalpha or cyclosporine medication) vs Lower JIA disease activity / inactive or milder JIA

Prevalence and severity of oral and TMJ diseases/conditions (periodontal status and dental caries) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Some studies suggested greater JIA disease activity/severity (and certain medications) was associated with worse periodontal and caries outcomes, but small samples meant no solid conclusion could be drawn (ungraded).

1 finding from 1 review

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

Dental maturation (tooth calcification) · Children and adolescents with juvenile idiopathic arthritis (JIA)

Evidence on dental maturation was divergent across two studies (one found more advanced maturation in JIA, one found no difference); no clear conclusion (ungraded).

1 finding from 1 review

0.2% NaF mouthrinse + supervised toothbrushing 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)

0.2% NaF mouthrinse + supervised toothbrushing was probably less effective than Sealant + 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.58, 95% CI 0.43 to 0.79; moderate certainty).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pathological mobility · Children with carious vital pulp exposure in primary incisors

Pathological mobility was rare (one tooth in one of four trials) and was not pooled.

1 finding from 1 review

10% CPP-ACP paste 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)

10% CPP-ACP paste may not differ from no treatment for arrest or reversal of any-coronal carious lesions (RR 1.03, 95% CI 0.9 to 1.18; low certainty).

1 finding from 1 review

Chlorhexidine 0.12% mouthrinse vs Pre-treatment (baseline, same group)

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

0.12% chlorhexidine rinse reduced plaque relative to baseline; not GRADE-rated.

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pathological root resorption · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in pathological root resorption between pulpotomy and pulpectomy (RR 1.5, 95% CI 0.56 to 4.04; ungraded).

1 finding from 1 review

CPP-ACP vs No active treatment (control)

Average enamel surface roughness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP markedly reduced enamel surface roughness versus control (SMD -8.21, 95% CI -10.37 to -6.04; ungraded).

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

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

Salvadora persica rinse reduced plaque relative to its own baseline; not GRADE-rated.

1 finding from 1 review

1.23% APF gel vs Fluoride varnish

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 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 1.08, 95% CI 0.83 to 1.4; low certainty).

2 findings from 1 review

Placebo rinse vs Pre-treatment (baseline, same group)

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

Placebo rinse did not significantly change Streptococcus mutans counts relative to baseline; not GRADE-rated.

1 finding from 1 review

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

Physiological stress indicators (heart rate, oxygen saturation) · Children (ages 6-12) receiving pit-and-fissure sealants

Heart rate and oxygen saturation did not differ significantly between laser-plus-acid and acid-etching (ungraded, single study).

1 finding from 1 review

0.2% NaF mouthrinse + supervised toothbrushing vs Fluoride varnish

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

0.2% NaF mouthrinse + supervised toothbrushing may not differ from 5% NaF varnish for arrest or reversal of occlusal carious lesions (RR 0.99, 95% CI 0.84 to 1.15; low certainty).

1 finding from 1 review

Fluoride varnish 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% NaF varnish may not differ from no treatment for arrest or reversal of root carious lesions (RR 2.96, 95% CI 0.27 to 32.26; very 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

The pooled prevalence of dental caries among children and adolescents with type 1 diabetes was 67% (95% CI 0.56 to 0.77), with high heterogeneity (I2=83%); certainty not graded.

1 finding from 1 review

1% chlorhexidine + 1% thymol varnish 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)

1% chlorhexidine + 1% thymol varnish may not differ from 5% NaF varnish for arrest or reversal of root carious lesions (RR 0.57, 95% CI 0.04 to 8.69; 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 with dental caries

Oral-health promotion programs were associated with markedly lower odds of DMFT/S in children (OR 0.19, 95% CI 0.10 to 0.39; ungraded, very high heterogeneity I2=98.5%).

1 finding from 1 review

Fluoride varnish 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)

5% NaF varnish may not differ from no treatment for arrest or reversal of approximal carious lesions (RR 2.29, 95% CI 0.74 to 7.1; very low certainty).

1 finding from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Abscess remedy (AR)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found higher pulpotomy success with MTA than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

1 finding from 1 review