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What do systematic reviews say?

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Evidence found and GRADE certainty

145 questions · 179 findings · 24 reviews

No studies found 27 · 15.1%GRADE not reported 121 · 67.6%Very low 14 · 7.8%Low 3 · 1.7%Moderate 14 · 7.8%High 0 · 0%

Fluoride varnish vs Fluoride toothpaste alone

Proportion of children developing new caries (deciduous) · Children and adolescents aged 16 years or less
1 finding from 1 review

Fluoride varnish vs placebo or no treatment

Proportion of children developing new caries (deciduous) · Children and adolescents aged 16 years or less

Fluoride varnish showed no clear difference in proportion of children developing one or more new caries… compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Fluoride varnish vs placebo or no treatment

Proportion of children developing new caries (permanent) · Children and adolescents aged 16 years or less

Fluoride varnish showed no clear difference in proportion of children developing one or more new caries (permanent… compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

38% silver diamine fluoride vs Glass ionomer cement (GIC) plus fluoride varnish

Caries prevention (preventive fraction, SDF vs GIC+5% fluoride varnish) · intellectually disabled individuals with caries in permanent posterior teeth

SDF had a 45% preventative fraction versus glass ionomer cement plus fluoride varnish; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

Dentine caries in permanent molars (24 months) · Children and adolescents (general population, aged under 20 years)

It is very uncertain whether resin-based fissure sealant plus fluoride varnish changes dentine caries in permanent molars (yes/no) compared with fluoride varnish alone (very low certainty).

1 finding from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence of first permanent molars (FPMs) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

After excluding the high-risk-of-bias study (Bravo 1996), fluoride varnish and fissure sealant did not differ in caries incidence of FPMs and heterogeneity fell to 0% (RR 1.05, 95% CI 0.91 to 1.22; 5 RCTs; ungraded).

3 findings from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence (proportion of enrolled children developing dentin caries, ICDAS 4-6) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

Fluoride varnish and fissure sealant did not differ significantly in the proportion of children developing caries at 2 to 3 years (RR 1.12, 95% CI 0.60 to 2.09; 2 RCTs; ungraded).

1 finding from 1 review

Fluoride varnish vs Fissure sealant (resin-based or glass ionomer)

Caries incidence of occlusal surfaces of first permanent molars · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel…

After excluding Bravo 1996, occlusal caries incidence slightly favored fluoride varnish but was not significant, with heterogeneity falling to 0% (RR 0.98, 95% CI 0.82 to 1.16; 3 RCTs; ungraded).

2 findings from 1 review

Silver diamine fluoride (SDF) plus fluoride varnish vs Sealants plus fluoride varnish (with or without restorations)

Caries arrest · Children and adults (with or without carious lesions)

Silver diamine fluoride (SDF) plus fluoride varnish showed no clear difference in caries arrest compared with sealants plus fluoride varnish (with or without restorations) (low certainty).

1 finding from 1 review

Fluoride varnish vs No fluoride treatment

Dimensional change (size) of early enamel caries lesions · Patients (mainly children) with white spot lesions (WSL)

In one trial, professionally applied sodium fluoride varnish significantly reduced the size of early enamel caries lesions compared with no fluoride treatment; ungraded.

1 finding from 1 review