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What do systematic reviews say?

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Evidence found and GRADE certainty

15 questions · 20 findings · 11 reviews · Dental caries

No studies found 1 · 5%GRADE not reported 18 · 90%Very low 1 · 5%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Higher consumption of snacks / sugar / soft drinks vs Lower consumption

Dental caries · Healthy children and adolescents in the United Arab Emirates

Higher snacking and soft-drink/sugar consumption were associated with more caries in most studies, though one study found no association with sweet-consumption frequency (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal

Pulp exposure rate · Patients with deep carious lesions in permanent (mainly posterior) teeth

Minimally invasive caries removal was associated with a lower mean pulp exposure rate than conventional removal (1.2% vs 8.1%), but the difference was not statistically significant (Wilcoxon, p = 0.068); certainty of evidence was not graded.

1 finding from 1 review

Minimally invasive caries removal (MIT): selective removal to soft dentin, self-limiting chemomechanical removal, or partial/incomplete caries removal vs Conventional caries removal (CT): selective removal to firm dentin, stepwise excavation, or complete caries removal

Treatment success (caries lesion arrest or restoration survival) · Patients with deep carious lesions in permanent (mainly posterior) teeth

Minimally invasive caries removal showed a marginally higher mean restoration success rate than conventional removal (83.6% vs 75.4%), but the difference was not statistically significant (Mann-Whitney U, p > 0.05); certainty of evidence was not graded.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish, placebo)

Adverse effects (tooth staining and other side effects) · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF commonly causes black staining of arrested lesions; only mild, transient adverse events were reported, with no major adverse events (ungraded).

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

Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs placebo or no treatment

Mucosal irritation / oral soft tissue allergic reaction (signs of sensitivity) · Children and adolescents aged 16 years or less
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

Mucosal irritation / oral soft tissue allergic reaction (signs of sensitivity) · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Adverse effects (tooth staining/discoloration, oral soft-tissue signs, adverse symptoms such as nausea/vomiting, enamel etching) · Children and adolescents aged 16 years or less
1 finding from 1 review

Gum chewing (sugar-free) vs Within-subject before/after comparison of soft gum vs hard gum (no no-gum control)

Oral mucosal moisture · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

One small study found that chewing hard (but not soft) gum increased oral mucosal moisture.

1 finding from 1 review

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: effect size (f) for microbial load (log10 CFU) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

The weighted effect size favoured hardness (f=2.62) over colour (f=0.46) for discriminating microbial load, supporting hardness as the more reliable examination (ungraded).

1 finding from 1 review

color contrast: black vs dark brown/light brown/yellow vs hardness contrast: soft vs medium/hard

total microbial load (log10 CFU) · humans with open primary dentine caries

In one study, hardness category differences exceeded color category differences; no meta-analysis was conducted.

1 finding from 1 review

Colour clinical examination (visual shade categorization: yellow, light brown, dark brown, black) vs Hardness clinical examination (tactile texture categorization: soft, medium/leathery, hard)

Discriminant power for caries severity: mean difference in log10 CFU (microbial load) between lesion categories · Patients with dentine carious lesions (deciduous/permanent teeth; children and adults)

For yellow-vs-other colour compared with soft-vs-harder hardness, hardness was significantly the more discriminant test (pooled WMD -3.87, 95% CI -4.46 to -2.87; ungraded).

6 findings from 1 review
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