Randomised Controlled Trials of Caries Care Protocols: A Scoping Review.
INTRODUCTION Caries care protocols (CCPs), commonly known as caries management systems, adopt a patient-centred, hygiene-focused approach to caries prevention. Although individual preventative strategies are well-studied, evidence on their combined efficacy is limited. The aim of this scoping review was to map and evaluate current evidence from clinical studies on the efficacy of CCPs in children and adults. METHODS Primary outcomes were caries incidence (increment), progression and regression, and secondary outcomes were changes in caries risk from baseline to follow-up. Inclusion criteria were randomised controlled trials (RCTs) comparing CCP interventions with control groups receiving only standard preventive care within routine dental services. Titles and abstracts were screened from MEDLINE, Embase, CINAHL and Web of Science databases, and data were extracted from full texts on study setting, methodology and outcomes. Quality was assessed using the Joanna Briggs Institute checklist. RESULTS The three included studies (n = 1186 patients) from Australia, Greece and Colombia showed positive outcomes for CCPs. Risk of bias was moderate in two studies and high in one. Intervention groups in the higher-quality studies showed significantly lower caries increment and progression from baseline, along with a greater reduction in caries risk, compared to control groups. CONCLUSION Limited evidence from two heterogeneous RCTs shows moderate efficacy of CCPs, highlighting the need for more standardised outcomes and reporting to strengthen the evidence base.