Findings

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Evidence found and GRADE certainty

319 questions · 389 findings · 20 reviews · Dental caries

No studies found 91 · 23.4%GRADE not reported 157 · 40.4%Very low 60 · 15.4%Low 65 · 16.7%Moderate 14 · 3.6%High 2 · 0.5%

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs placebo or no treatment

Caries presence in primary teeth · Pregnant women (for preventing dental caries in the primary teeth of their children)

It is very uncertain whether fluoride supplementation (tablets, drops, lozenges or chewing gum) changes children with caries in the primary teeth at 3 years compared with placebo or no treatment (very low certainty).

2 findings from 1 review

VistaProof (Durr Dental; blue fluorescence, 405 nm) 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 24 / Figure 25; Appendix 5); no summary DOR or sensitivity/specificity point reported numerically in the text. 18 datasets, 2402 tooth sites.
    17 studies
    GRADE not reported

Spectra caries detection device (Air Techniques; blue fluorescence) 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)
    The Spectra caries detection device fits into the blue fluorescence category but no studies provided data for inclusion in the meta-analysis (Markowitz 2015).
    1 study
    GRADE not reported

Xylitol lozenges (4.7 g/day) vs no treatment

Number of children with a caries increment · Children (permanent teeth; baseline 8 to 10 years)

Xylitol lozenges (4.7 g/day) showed no clear difference in number of children with a caries increment compared with no treatment; GRADE not reported.

1 finding from 1 review

Chlorhexidine varnish (10%) vs placebo or no treatment

Elevated mutans streptococci levels (>=4 with caries screen; high vs low) · Children and adolescents below 18 years at study start (included studies: children from birth to 15 years), with mixed, permanent or…

It is very uncertain whether chlorhexidine varnish (10%) changes elevated mutans streptococci levels (>=4 with caries screen; high vs… compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Sensitivity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: sensitivity from 0.61 to 0.98 ... CarieScan Pro: sensitivity from 0.55 to 0.91'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites…
    7 studies
    Very low

Electrical conductance devices (electronic caries monitor (ECM) and/or CarieScan Pro), used as an adjunct to clinical oral examination vs Reference standard (histology, excavation, or enhanced visual examination)

Specificity for detection of enamel caries · Children, adolescents, or adults presenting asymptomatically or suspected of early enamel caries (in vivo), or extracted teeth of…
1 finding from 1 review
  • Electrical conductance for the detection of dental caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    SoF findings (HSROC; no summary operating point reported): 'ECM: specificity from 0.73 to 0.96 ... CarieScan Pro: specificity from 0 to 1.00'. Across all 7 studies (8 datasets), covering 719 tooth surfaces or sites (no…
    7 studies
    Very low

Cessation of water fluoridation (fluoride removed from the water supply) vs Continued fluoridated water

Change in proportion of caries-free children (deciduous or permanent teeth) · People of all ages in a previously fluoridated community (Maupome 2001: children with generally low caries experience)

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Proportion of children not remaining caries-free · Children with primary (deciduous) teeth (younger children)

Fluoride gel (topically applied; operator- or self-applied; any… showed no clear difference in proportion of children not remaining caries-free compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Resin sealant (with or without flossing advice) vs Flossing advice (non-invasive control)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Resin sealant (with or without flossing advice) led to lower caries (lesion) progression (radiographic) compared with flossing advice (non-invasive control); GRADE not reported.

1 finding from 1 review

Glass ionomer sealant (with fluoride gel plus dentifrice) vs Fluoride gel plus fluoride toothpaste/dentifrice (non-invasive control)

Caries (lesion) progression (radiographic) · Dentate children and adults with non-cavitated proximal caries lesions extending into enamel or dentine (not pulp) in primary or permanent…

Glass ionomer sealant (with fluoride gel plus dentifrice) showed no clear difference in caries (lesion) progression (radiographic) compared with fluoride gel plus fluoride toothpaste/dentifrice (non-invasive…; GRADE not reported.

1 finding from 1 review

Analogue (conventional) radiographs vs Digital radiographs (direct within-person / paired comparison); reference standard: histology, excavation, or enhanced visual examination

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

Analogue (conventional) radiographs vs Cone beam computed tomography (CBCT) (direct within-person / paired comparison); reference standard: histology

Diagnostic accuracy: analogue versus CBCT (within-person, not pooled) · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review
  • Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes
    Up to 3 months between index test and reference standard (in vivo studies)
    Direct comparison analogue vs CBCT (within-person): 6 datasets from 3 studies (737 tooth sites or surfaces) provided data, but the results could not be pooled; only individual study results are shown (Figure 21). No…
    3 studies
    GRADE not reported

Cone beam computed tomography (CBCT) vs Digital radiographs (direct within-person / paired comparison); reference standard: histology

Specificity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

Cone beam computed tomography (CBCT) vs Digital radiographs (direct within-person / paired comparison); reference standard: histology

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

Analogue (conventional) radiographs vs Digital radiographs (direct within-person / paired comparison); reference standard: histology, excavation, or enhanced visual examination

Sensitivity for detection and diagnosis of early (enamel) caries · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
2 findings from 1 review

Canary System (Quantum Dental Technologies; red fluorescence, scale 0-100) vs Reference standard: histology, enhanced visual examination with or without radiographs, or excavation

Outcome not reported · Children or adults presenting asymptomatically or suspected of having enamel caries (in vivo/clinical studies); extracted teeth of…

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride-releasing resin-based sealant vs No sealant (control/no treatment)

Development of >=1 new carious lesion (caries incidence) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department, dental hospital, France)
2 findings from 1 review

Glass ionomer-based sealant vs No sealant (control/no treatment)

Development of >=1 new carious lesion (caries incidence) · Children with caries-free primary first molars (with or without caries on other teeth), aged 1-5 years (paediatric clinic/dental school,…

Glass ionomer-based sealant may leads to lower development of >=1 new carious lesion (caries incidence) compared with no sealant (low certainty).

2 findings from 1 review

Fluoride-releasing resin-based sealant vs No sealant (control/no treatment)

Mean caries increment (mean number of new cavitated occlusal lesions) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department, dental hospital, France)
1 finding from 1 review
  • Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
    24 months
    Mean number of new cavitated occlusal lesions 0.23 (SD 0.06) in sealed molars vs 0.29 (SD 0.06) in control molars (Wilcoxon matched-pairs signed-rank test P = 0.42)
    1 study · 85 participants
    GRADE not reported