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Evidence found and GRADE certainty

199 questions · 351 findings · 38 reviews

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No studies found 0 · 0%GRADE not reported 338 · 96.3%Very low 4 · 1.1%Low 8 · 2.3%Moderate 1 · 0.3%High 0 · 0%

CPP-ACP vs No active treatment (control)

Enamel surface microhardness · Extracted human teeth with early/artificial enamel lesions (in vitro)

In vitro, CPP-ACP increased Vickers microhardness versus control (SMD 1.19, 95% CI 0.72 to 1.66; ungraded).

3 findings from 1 review

Residence in heavily contaminated area (approx. 15-40 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from heavily contaminated areas, individual studies gave conflicting DMFT/dmft differences (some favouring exposed, some non-exposed); the review did not pool them (ungraded).

4 findings from 1 review
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Residence in low-contamination area (approx. 5-15 Ci/km2) vs Residence in non-contaminated (non-exposed) area (<1 Ci/km2)

Dental caries · Children aged 5-7 years (early school-age)

In early school-age children (5-7 y) from a low-contamination area, one study reported higher DMFT/dmft in exposed than non-exposed children; the estimate was not pooled (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

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

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

0.9% silicon tetrafluoride (SiF4) vs Not specified

Remineralisation of white spot lesions · Patients (mainly children) with white spot lesions (WSL)

One trial found professionally applied silicon tetrafluoride did not remineralise white spot lesions; ungraded.

1 finding from 1 review

CO2 laser (carbon dioxide) vs No anticaries intervention (untreated enamel)

Enamel surface / cross-sectional microhardness · Human / bovine enamel specimens under cariogenic challenge (in situ / ex vivo)

CO2 laser irradiation changes enamel microhardness versus untreated enamel (MD 49.55, CI 37.74 to 61.37; ungraded, 3 ex-vivo studies, I2=48%); the forest plot shows higher microhardness in laser-treated enamel, although the review text states the opposite.

1 finding from 1 review

Maternal smoking during pregnancy vs No maternal smoking during pregnancy

Dental caries · children

Maternal smoking during pregnancy was associated with higher odds of dental caries in children (OR 1.78, 95% CI 1.55 to 2.05; ungraded).

2 findings from 1 review · compare the 2 reviews

Erbium:YAG laser vs Untreated / high-speed-handpiece control enamel

Enamel resistance to demineralization (microhardness / lesion depth) · Human enamel adjacent to restorations or in pits and fissures (in situ / ex vivo)

Er:YAG laser showed a mixed and limited effect on enamel resistance to demineralization: feasible for controlling progression around restorations but not preventing caries formation, and ineffective in pits and fissures (ungraded, 2 ex-vivo studies, no pooled estimate).

1 finding from 1 review

CO2 laser combined with fluoride vs Fluorides alone (monotherapy)

Enamel demineralization (QLF ΔF) · Human enamel specimens under cariogenic challenge (in situ / ex vivo)

Evidence on a synergistic effect of combining CO2 laser with fluoride versus fluoride alone is mixed: one ex-vivo study found combined treatment superior while another found no synergy (ungraded, 2 ex-vivo studies, no pooled estimate).

1 finding from 1 review

Low-power CO2 laser irradiation (LLLT, 0.5 to 2 W) vs Placebo (placebo laser or placebo agent) or no treatment

White spot lesion incidence · High caries-risk patients: fixed-orthodontic-appliance patients and children with partially erupted permanent molars

Low-power CO2 laser (LLLT) is associated with a lower incidence of new white spot lesions than placebo (OR 0.21, CI 0.15 to 0.30; ungraded, 3 RCTs, considerable heterogeneity I2=71%).

1 finding from 1 review

Nd:YAG laser vs No anticaries intervention (untreated enamel)

Enamel acid resistance (cross-sectional microhardness) · Human enamel in pits and fissures (in situ / ex vivo)

Nd:YAG laser increased enamel acid resistance versus untreated enamel in pits and fissures (ungraded, 1 ex-vivo study, no pooled estimate).

1 finding from 1 review

Mutans streptococci present in oral samples at baseline vs Mutans streptococci absent in oral samples at baseline

Development of any (cavitated or non-cavitated) carious lesion · Children younger than 6 years with caries-free primary dentition (no cavitated or non-cavitated lesions at baseline)

Preschool children with mutans streptococci at baseline probably have about four times higher odds of developing early childhood caries (OR 4.13; moderate certainty).

10 findings from 1 review
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