Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,348 questions · 1,514 findings · 111 reviews · All outcomes

No studies found 287 · 19%GRADE not reported 823 · 54.4%Very low 243 · 16.1%Low 104 · 6.9%Moderate 49 · 3.2%High 8 · 0.5%

Placebo vs Silver diamine fluoride

Oral health-related quality of life · Children with dental caries

The direct estimate found no statistically significant difference in oral health-related quality of life between placebo and silver diamine fluoride.

2 findings from 1 review

Placebo vs no treatment

Caries increment in permanent teeth · Children or adolescents

The NMR reported an SMD by randomisation year; no GRADE assessment was reported.

1 finding from 1 review

Placebo vs no treatment

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between placebo and no treatment at randomization years 1970 to 1990; certainty was not graded.

1 finding from 1 review

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

Lactobacillus count (pre- vs post-treatment) · Medically healthy individuals (adults and children, 6-60 years)

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

1 finding 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

Placebo (sham irradiation, laser inactive) vs Control (no laser device used)

Maximum pain (verbal rating scale, VRS) · People requiring retreatment of periapical lesions (failed root canal therapy)

Placebo (sham irradiation, laser inactive) led to lower maximum pain (verbal rating scale, VRS) compared with control (no laser device used); GRADE not reported.

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Streptococcus mutans colonization reduction (narrative; no CFU data reported) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines produced a sustained reduction in Streptococcus mutans colonization on teeth in animal models (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

Hall technique vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, the Hall technique had significantly higher treatment success than placebo (OR 163.59; moderate certainty).

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of initial caries around brackets, aesthetic-zone teeth only · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

When only aesthetic-zone teeth (incisors and canines) were considered, two studies reported a significant reduction in initial caries incidence favoring fluoride mouthrinse (ungraded, narrative; no pooled estimate).

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Salivary / secretory IgA (SIgA) antibody response (immunogenicity) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines, particularly via mucosal (intranasal) routes, elicited increased salivary/secretory IgA responses in the animal studies (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

Inactivated-bacteria tablets vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Improved caries prognosis via restored oral microbiota · Patients after dental filling

Adjuvant postbiotics after dental filling improve caries prognosis by restoring the oral microbiota in one RCT (ungraded).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    14 days · Clinical; salivary/plaque sampling
    One RCT reported that adjuvant postbiotic tablets after dental filling improved caries prognosis by restoring oral microbiota diversity, structure and function and reducing potentially pathogenic bacteria (Liu 2024);…
    1 study
    GRADE not reported

Atraumatic restorative treatment vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, ART had significantly higher treatment success than placebo (OR 16.18).

1 finding from 1 review

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Serum IgG antibody response (immunogenicity) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

Anticaries vaccines elicited increased serum IgG antibody responses across the animal studies (ungraded narrative synthesis; no pooled estimate).

1 finding from 1 review

Conventional restoration vs placebo

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 6 months, conventional restorations had significantly higher treatment success than placebo (OR 44.66).

1 finding from 1 review

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).

1 finding from 1 review

Postbiotic products (postbiotic toothpaste; heat-killed/postbiotic oral lozenges; inactivated-bacteria tablets) vs Placebo, fluoride toothpaste, or standard post-filling care (varies by trial)

Streptococcus mutans count · Humans at risk of dental caries (children aged 6-12 years; adults with dental caries)

Postbiotic products reduce salivary S. mutans counts in human trials, though not always significantly (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Daily for 14 days to 4 weeks · Clinical; salivary/plaque sampling
    Three RCTs reported reduced salivary S. mutans counts after postbiotic intervention; the reduction was statistically significant in Lin 2022 but non-significant in Basir 2022; no pooled estimate.
    3 studies
    GRADE not reported

Anticaries vaccine or antibody (DNA, recombinant protein, nanoparticle-adjuvanted, live-vector, plant-based, or passive IgY immunization) targeting S. mutans vs Control (unvaccinated / empty vector / PBS / placebo animals)

Development of >=1 new carious lesion (caries incidence) · Animal caries models (mice, rats, hamsters) challenged/colonized with Streptococcus mutans; one transgenic-plant antigen-expression system

In preclinical animal models, anticaries vaccines significantly reduced dental caries risk (pooled RR 0.53, 95% CI 0.46 to 0.62; random-effects), but the evidence is ungraded and limited to short-term animal studies.

1 finding from 1 review