What do systematic reviews say?

Daily toothbrushing by a dental student vs Twice-weekly or once-weekly toothbrushing by a dental student

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  Daily vs twice-weekly or once-weekly toothbrushing by dental students. Buccal and labial Loe & Silness index, mean 21 days; 80 participants (1 RCT); Low. Brushing daily most likely reduced gingival inflammation more…
  1 study · 80 participants
  Low

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in plaque (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  SMD 0.29 [-0.07, 0.65]
  2 studies · 120 participants
  Low
• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  Assorted plaque indices scale 0-5, 1-4 weeks; 247 participants (4 RCTs); Very Low. Uncertain effect on plaque short term: 2 studies (69 participants) favoured the electric toothbrush; 2 studies (178 participants)…
  4 studies · 247 participants
  Very low

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  Comparison 2.8 (reported; not GRADE-rated). One NRS (Bratel 1991, 23 participants), self-efficacy at 16 months: 10/12 people with ID using the electric toothbrush reported a preference for it, finding it easier to use…
  1 study · 23 participants
  GRADE not reported

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  Electric vs manual toothbrush. Assorted gingival indices scale 0-4, 2-4 weeks; 252 participants (4 RCTs); Low. Four studies showed no significant differences for gingival inflammation short term; data could not be…
  4 studies · 252 participants
  Low

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in gingival inflammation (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (moderate certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD 0.02 [-0.06, 0.09]
  2 studies · 120 participants
  Moderate

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in calculus (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  SMD -0.04 [-0.40, 0.32]
  2 studies · 120 participants
  Low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

It is very uncertain whether oral hygiene training (toothbrushing routine) of people with ID changes plaque (short term) compared with no oral hygiene training of people with ID (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD -0.47 [-0.92, -0.02]
  1 study · 10 participants
  Very low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  Behaviour, attitude and self-efficacy (steps achieved in a toothbrushing routine), 100 days to 19 months; 59 participants (4 NRS); Very Low. Results not in a format for meta-analysis: 3 NRS (56 participants) reported…
  4 studies · 59 participants
  Very low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

It is very uncertain whether oral hygiene training (toothbrushing routine) of people with ID changes gingival inflammation (short term) compared with no oral hygiene training of people with ID (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD -0.28 [-0.90, 0.34]
  1 study · 10 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  Comparison 1.5 (graded in the Effects of interventions text; not tabulated in the SoF). Single-use suction toothbrush vs standard manual toothbrush (both with a chemical agent), 90 days, Ferozali 2007: Total Oral…
  1 study · 22 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  Comparison 1.6 (graded in the Effects of interventions text; not tabulated in the SoF). Bildt 2010, Superbrush vs conventional, 4 months, 18 participants (1 RCT): carer handling of toothbrush MD 0.50 (95% CI -0.35 to…
  1 study · 18 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

It is very uncertain whether special manual toothbrush (self, carer or carer-assisted brushing) changes plaque (short term) compared with conventional manual toothbrush (self, carer or carer-assisted… (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD 0.20 [-0.45, 0.85]
  1 study · 25 participants
  Very low
• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD -0.44 [-0.93, 0.05]
  1 study · 18 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Special manual toothbrush (self, carer or carer-assisted brushing) showed no clear difference in gingival inflammation (short term) compared with conventional manual toothbrush (self, carer or carer-assisted… (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD -0.10 [-0.77, 0.57]
  1 study · 25 participants
  Low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

It is very uncertain whether special manual toothbrush (self, carer or carer-assisted brushing) changes gingival inflammation (medium term) compared with conventional manual toothbrush (self, carer or carer-assisted… (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD -12.40 [-24.31, -0.49]
  1 study · 18 participants
  Very low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower calculus (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -2.00 [-2.64, -1.36]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower gingival pocketing (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.60 [-0.97, -0.23]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower plaque (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.70 [-1.28, -0.12]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… showed no clear difference in gingival bleeding (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.20 [-0.86, 0.46]
  1 study · 304 participants
  Low