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Objectives Dentists have redefined dental diseases and treatment needs, leading to changes in several common procedures, including caries diagnosis. The current approach prioritizes early intervention to prevent cavities using non-operative methods such as professionally applied fluoride and resin infiltration. As a result, the focus has shifted from operative to non-operative or preventive treatments, with caries being diagnosed and managed at earlier, non-cavitated stages.However, it remains uncertain whether lowering the diagnostic threshold for caries detection and implementing non-invasive treatments provides a significant health benefit that justifies the additional costs and potential risks of unnecessary interventions. To address this issue, we conducted a systematic review to answer the following question: Is the non-invasive treatment of non-cavitated caries lesions effective in preventing cavity formation, the need for restorative treatment, tooth loss or toothache?Method PICO was the following: Population – Adults and children, including permanent and primary teeth, with early, non-cavitated caries lesions; Intervention – Any non-operative (non-invasive) treatment, including infiltrant, fluorides, probiotics, polyols, polyphenols, dietary control, oral hygiene, sealants, chlorhexidine, cariostatic agents, and professional prophylaxis; Comparison – Placebo or no intervention; Outcome – Cavitated caries lesions at the dentin level, restorations, tooth loss, and toothache.A bibliographic search was conducted in major databases up to the year 2020. Two reviewers independently selected randomized controlled trials and extracted the data. In cases of disagreement, a third reviewer was consulted to reach a consensus. Risk of bias was assessed using the RoB2 tool, and the certainty of evidence was evaluated with the GRADE system. We conducted meta-analyses using RevMan.Results A total of 4,108 titles were identified. After removing duplicates and applying exclusion criteria, 19 studies were selected. None of these studies reported the individual risk of developing at least one cavity or requiring a restoration, making it impossible to estimate a pooled relative risk. Ten studies reported data on the mean number of cavitated or restored lesions per individual, enabling meta-analyses of mean differences. Because some studies tested multiple interventions against a placebo or oral hygiene, various comparisons were analyzed. The results of the meta-analyses were consistent, showing statistically significant mean differences ranging from -0.22 to -0.27. In other words, on average, individuals in the non-invasive treatment group had between 0.22 and 0.27 fewer dentin (or filled) carious cavities than those in the placebo or no-treatment groups. However, all meta-analyses showed substantial heterogeneity and the certainty of evidence was low.Conclusions No study has assessed the effectiveness of treatment in preventing toothache or tooth loss, and only a few have examined its impact on avoiding cavities or the need for restorations. Among these, the treatment showed only a modest effect. The included studies generally had a high or unclear risk of bias, and the certainty of evidence in the meta-analyses was low. Before lowering the detection threshold and applying non-invasive treatments to non-cavitated caries, clinical trials are needed to determine whether this approach effectively reduces the risk of cavities, restorations, toothache, or tooth loss. We are currently updating this review.