Caries – Diagnosis, Risk Assessment and Non-Invasive Treatment

SBU’s Conclusions

Main Conclusions

Past caries experience is the single best factor for prediction of future caries (Evidence Grade 1).

It is possible to identify children and adolescents at very low risk of developing caries during the next 2–3 years (Evidence Grade 1). However, it is difficult to determine accurately which individuals are at risk of developing caries.

For caries diagnosis, a combination of visual-tactile and radiographic examination is more reliable than either method used separately (Evidence Grade 3). In general, accuracy in excluding the presence of caries is greater than in confirming its presence (Evidence Grade 3). The likelihood that radiation-induced cancer will develop because of exposure to dental radiography is considered to be very small, but greater than zero. There is inadequate scientific support for complementary diagnostic methods. There are no studies of the cost-effectiveness of the various diagnostic methods.

There is insufficient scientific support for any conclusion as to whether early caries lesions can be treated effectively by non-invasive methods.

Fact box 1 Study Quality and Relevance, Evidence Grade.

Study quality and relevance refers to the scientific quality of a particular study and its ability to reliably address a specific question.
Evidence Grade refers to the total scientific evidence for a conclusion.

Evidence Grade 1 – Strong Scientific Evidence. A conclusion assigned Evidence Grade 1 is supported by at least two studies with high study quality and relevance among the total scientific evidence. If some studies are at variance with the conclusion, the Evidence Grade may be lower.

Evidence Grade 2 – Moderately Strong Scientific Evidence. A conclusion assigned Evidence Grade 2 is supported by at least one study with high study quality and relevance, as well as two studies with medium study quality and relevance, among the total scientific evidence. If some studies are at variance with the conclusion, the Evidence Grade may be lower.

Evidence Grade 3 – Limited Scientific Evidence. A conclusion assigned Evidence Grade is supported by at least two studies with medium study quality and relevance among the total scientific evidence. If some studies are at variance with the conclusion, the Evidence Grade may insufficient or contradictory.

Insufficient Scientific Evidence. If no studies meet the study quality and relevance criteria, the scientific evidence is rated as insufficient to draw any conclusions.

Contradictory Scientific Evidence. If different studies are characterized by equal study quality and relevance but generate conflicting results, the scientific evidence is rated as contradictory and no conclusions can be drawn.