What do systematic reviews say?

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
  19 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Integration strategies were generally associated with positive oral health knowledge, attitudes and perceptions among staff and patients (16 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Knowledge/attitudes/perceptions of staff and patients was the second most studied outcome (n=16). Patient and staff perceptions on various aspects of the integration strategy were usually reported as positive.…
  16 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
  15 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
  9 studies
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found

Education vs usual care

• Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
  Lupton 1968: multi-arm study; education arm versus usual care. No usable pain-reduction data reported and could not be combined in meta-analysis (Table 1).
  1 study
  GRADE not reported

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Oral-health-education-only interventions showed at most a marginal effect on tooth-level caries (dmft SMD -0.11, 95% CI -0.21 to -0.00; 2 studies; not GRADE-rated).

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Oral health education only (vs comprehensive intervention)
  SMD -0.11 [-0.21, 0.00]
  2 studies
  GRADE not reported

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Oral-health-education-only interventions did not show a statistically significant effect on surface-level caries (dmfs SMD -0.20, 95% CI -0.43 to 0.03; 2 studies; not GRADE-rated).

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Oral health education only (vs comprehensive intervention)
  SMD -0.20 [-0.43, 0.03]
  2 studies
  GRADE not reported

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Comprehensive interventions produced a small, statistically significant reduction in surface-level caries (dmfs SMD -0.14, 95% CI -0.26 to -0.02; 10 studies; not GRADE-rated).

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
  SMD -0.14 [-0.26, -0.02]
  10 studies
  GRADE not reported

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Comprehensive interventions produced a statistically significant reduction in tooth-level caries (dmft SMD -0.47, 95% CI -0.84 to -0.10; 4 studies; not GRADE-rated), though heterogeneity was very high.

• The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes

  Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
  SMD -0.47 [-0.84, -0.10]
  4 studies
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

Oral health education (advice and training) showed no clear difference in leaving the study early compared with standard care (oral health advice not specifically emphasised beyond… (moderate certainty).

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  RR 1.67 [0.45, 6.24]
  1 study · 50 participants
  Moderate

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

It is very uncertain whether oral health education (advice and training) changes dental state: No clinically important change in plaque index compared with standard care (oral health advice not specifically emphasised beyond… (very low certainty).

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  MD -0.5 [-0.62, -0.38]
  1 study · 40 participants
  Very low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

Educational intervention with information only (theoretical dental health education, no practical training) vs usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  Schou 1989 (114 residents, unclear risk of bias): no difference in the prevalence of denture stomatitis between the groups.
  1 study · 114 participants
  GRADE not reported

Educational intervention with information only (theoretical dental health education, no practical training) vs usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  One study (Schou 1989), at unclear risk of bias and analysing 114 residents, provided insufficient evidence to determine whether denture plaque scores are lower when educating residents or nursing staff without…
  1 study · 114 participants
  GRADE not reported

Educational intervention with information only (theoretical dental health education, no practical training) vs usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  Schou 1989 (114 residents, unclear risk of bias): the number of residents reporting correct denture cleaning habits increased, but not significantly compared to baseline (baseline N = 28; follow-up N = 38).
  1 study · 114 participants
  GRADE not reported