Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

377 questions · 736 findings · 60 reviews · Dental caries

No studies found 17 · 2.3%GRADE not reported 563 · 76.5%Very low 39 · 5.3%Low 47 · 6.4%Moderate 50 · 6.8%High 20 · 2.7%

Caries distribution assessment (individual, tooth and surface levels) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Caries distribution (individual/tooth/surface level) · European adolescents aged 12–19 years

Caries distribution was skewed at individual, tooth and surface levels and too heterogeneous to meta-analyze (narrative synthesis of 11 studies; not GRADE-rated).

1 finding from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs Single-surface ART with high-viscosity GIC

Restoration survival · Children with decayed primary molar teeth

Multi-surface ART/HVGIC restorations had lower reported survival (49% at 3 years) than single-surface restorations (ungraded).

1 finding from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs Single-surface ART with high-viscosity GIC

Restoration failure · Children (2-9 years) with caries in posterior primary teeth

Multi-surface ART restorations had a high reported mean annual failure rate (17%; ungraded).

1 finding from 1 review

Single-surface ART restoration using high-viscosity glass ionomer vs Multi-surface ART with high-viscosity GIC

Restoration failure · Children (2-9 years) with caries in posterior primary teeth

Single-surface ART restorations had a low reported mean annual failure rate (about 5%; ungraded).

1 finding from 1 review

Single-surface ART restoration using high-viscosity glass ionomer vs Multi-surface ART with high-viscosity GIC

Restoration survival · Children with decayed primary molar teeth

Single-surface ART/HVGIC restorations had high reported survival (86% at 3 years), significantly higher than multi-surface restorations (ungraded).

1 finding from 1 review

Class-I (single-surface) cavity restoration vs Class-II (proximal/multi-surface) cavity restoration

Treatment failure (annual failure rate) by cavity class · Children with carious primary teeth restored in Class-I versus Class-II cavities, no pulp therapy

Class-II restorations failed more than Class-I (annual failure 5-28.9% vs 1.2-14.7% in ART studies); low quality of evidence (ungraded).

1 finding from 1 review

HVGIC bilayer insertion and surface coating protocols vs Alternative HVGIC insertion and surface coating protocols

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; bilayer placement and nanofilled coating were described as improving survival.

1 finding from 1 review

Single-surface ART restoration using high-viscosity glass ionomer vs No comparator

Restoration survival · Permanent posterior teeth with single-surface cavities

Single-surface high-viscosity glass-ionomer ART restorations in permanent teeth had high 2-year survival (93%, 95% CI 89-95%); evidence ungraded.

6 findings from 1 review
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Single-surface ART restoration using high-viscosity glass ionomer vs No comparator

Restoration survival · Primary posterior teeth with single-surface cavities

Single-surface high-viscosity glass-ionomer ART restorations in primary teeth had high 2-year survival (93%, 95% CI 91-94%); evidence ungraded.

3 findings from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs No comparator

Restoration survival · Primary posterior teeth with multiple-surface cavities

Multiple-surface high-viscosity glass-ionomer ART restorations in primary teeth had moderate 2-year survival (62%, 95% CI 51-73%); evidence ungraded.

3 findings from 1 review

Multiple-surface ART restoration using high-viscosity glass ionomer vs No comparator

Restoration survival · Permanent posterior teeth with multiple-surface cavities

Multiple-surface high-viscosity glass-ionomer ART restorations in permanent teeth had high 1-year survival (86%, 95% CI 59-98%); evidence ungraded.

3 findings from 1 review

Resin-based fissure sealant vs Fluoride varnish

DMFS (decayed, missing, filled surfaces) increment, occlusal surfaces · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars

Pit and fissure sealant and fluoride varnish showed no statistically significant difference in DMFS increment at 24 months (SMD -0.13, 95% CI -0.67 to 0.40; I2=92%; not GRADE-rated).

1 finding from 1 review

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

Diagnostic accuracy on surfaces with pit and fissure sealants · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…

The review found no eligible studies for this question.

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) · Pit and fissure sealants
    Pre-specified heterogeneity investigation of surfaces with pit and fissure sealants: no study reported the inclusion of sealants that would allow evaluation of early caries lesions.
    0 studies
    No studies found

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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1.23% APF gel vs CPP-ACP

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)

1.23% APF gel was probably more effective than 10% CPP-ACP paste for arrest or reversal of any-coronal carious lesions (RR 2.19, 95% CI 1.83 to 2.61; moderate certainty).

1 finding from 1 review

38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 38% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.21, 95% CI 1.12 to 1.3; high certainty).

4 findings from 1 review
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30% SDF solution (applied annually) vs 30% SDF solution (once weekly for 3 weeks)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) probably did not differ from 30% SDF solution (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.13, 95% CI 0.95 to 1.34; moderate certainty).

3 findings from 1 review

30% SDF solution (applied annually) vs Fluoride varnish

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) was more effective than 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.41, 95% CI 1.2 to 1.66; high certainty).

3 findings from 1 review

38% silver diamine fluoride vs 12% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied annually) was more effective than 12% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.27, 95% CI 1.16 to 1.4; high certainty).

4 findings from 1 review
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12% SDF solution (applied annually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

12% SDF solution (applied annually) did not differ from 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 0.94, 95% CI 0.87 to 1.02; high certainty).

4 findings from 1 review
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