Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

36 questions · 46 findings · 21 reviews · Oral Health

No studies found 1 · 2.2%GRADE not reported 26 · 56.5%Very low 12 · 26.1%Low 2 · 4.3%Moderate 5 · 10.9%High 0 · 0%

Unilateral cleft lip and palate (UCLP) vs Bilateral cleft lip and palate (BCLP)

Plaque · Patients with cleft lip and palate (CLP)

Plaque index does not differ significantly between unilateral and bilateral cleft lip and palate (MD -0.13, 95% CI -0.38 to 0.12; ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Plaque · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; low certainty).

1 finding from 1 review

Chlorhexidine mouthwash vs placebo

Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances

Plaque · Adolescents/teenagers undergoing orthodontic treatment

A single study reported lower plaque index with aligners versus fixed appliances in adolescents at 18 months (MD -0.40, 95% CI -0.77 to -0.03; ungraded).

2 findings from 1 review

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) vs Metal-ceramic cantilevered FDPs

Plaque · Adults (18 years or older) needing replacement of one premolar or incisor with a cantilevered fixed dental prosthesis

Metal-free cantilevered FDPs (feldspathic-veneered zirconia) showed no clear difference in plaque index (PI) compared with metal-ceramic cantilevered FDPs; GRADE not reported.

1 finding from 1 review

Periodontal treatment (scaling and root planing, polishing, or surgery), alone or with oral hygiene counselling, antiseptics, or antimicrobials vs no treatment

Plaque index (PI) / oral hygiene · Pregnant women considered to have periodontal disease (gingivitis or periodontitis) after dental examination
1 finding from 1 review

Herbal mouthwash vs placebo

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced some plaque-related indices versus placebo, with low-certainty evidence.

1 finding from 1 review

Cetylpyridinium chloride mouthwash vs Blank control

Plaque · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

CPC mouthwash may reduce plaque-related indexes versus blank control in the short term, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

Fluoride mouthwash vs Blank control

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Long-term fluoride mouthwash showed mixed plaque-index effects, with very low-certainty evidence.

2 findings from 1 review

Herbal mouthwash vs Blank control

Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Herbal mouthwash reduced several plaque-related indices, but certainty is very low.

1 finding from 1 review

Milk-based probiotic vs placebo or control

Plaque index (PI) / oral hygiene · Children and/or adolescents (<18 years) without background systemic disease

In a subgroup analysis, milk-based probiotics reduced the bacterial plaque index more than other presentations (MD -0.10, 95%CI -0.20 to -0.00; p-interaction=0.01); not GRADE-rated.

1 finding from 1 review

Probiotics vs placebo or control

Plaque index (PI) / oral hygiene · Children and/or adolescents (<18 years) without background systemic disease

Probiotics may make little to no difference to the bacterial plaque index versus control (MD 0.21, 95%CI -0.55 to 0.96; very low certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Plaque index (PI) / oral hygiene · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower plaque index (PI) / oral hygiene compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).

6 findings from 1 review
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Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

Plaque index (PI) / oral hygiene · Critically ill patients (adults and children) receiving mechanical ventilation in ICU
1 finding from 1 review

Chlorhexidine mouthwash vs Blank control

Plaque · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce the Plaque Index versus blank control in the short term (WMD -0.70, 95% CI -1.12 to -0.27), but the evidence is very uncertain (very low certainty).

1 finding from 1 review

Electronic cigarette use vs Non-smokers (non-users)

Plaque index (PI) / oral hygiene · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users tend to have a higher plaque index (more biofilm accumulation) than non-smokers (narrative synthesis of systematic reviews; ungraded).

1 finding from 1 review