Findings

What do systematic reviews say?

165 questions · 196 findings · 23 reviews

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No studies found 26 · 13.3%GRADE not reported 71 · 36.2%Very low 40 · 20.4%Low 42 · 21.4%Moderate 15 · 7.7%High 2 · 1%

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

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

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).

1 finding from 1 review

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)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

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).

1 finding from 1 review

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

Psychological interventions (including health education) vs usual care

Proportion of participants returning to work in the short term (up to 6 months) · patients with coronary heart disease

It is very uncertain whether psychological interventions (including health education) changes proportion of participants returning to work in the short term (up… compared with usual care (very low certainty).

1 finding from 1 review

Interventions to support return to work for people with coronary heart disease 2019 · Cochrane Headline outcomes only
RR 1.08 [0.84, 1.4]
6 studies · 375 participants
Very low

Psychological interventions (including health education) vs usual care

Proportion of participants returning to work in the medium term (6 months ‐ 1 year) · patients with coronary heart disease

It is very uncertain whether psychological interventions (including health education) changes proportion of participants returning to work in the medium term (6… compared with usual care (very low certainty).

1 finding from 1 review

Interventions to support return to work for people with coronary heart disease 2019 · Cochrane Headline outcomes only
RR 1.24 [0.95, 1.63]
7 studies · 316 participants
Very low

Psychological interventions (including health education) vs usual care

Return to work · patients with coronary heart disease

Psychological interventions (including health education) showed no clear difference in proportion of participants at work in the long term (> 1 to < 5 years) compared with usual care (low certainty).

2 findings from 1 review

Interventions to support return to work for people with coronary heart disease 2019 · Cochrane Headline outcomes only
RR 1.09 [0.88, 1.34]
3 studies · 239 participants
Low
Interventions to support return to work for people with coronary heart disease 2019 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 125 participants
Very low

Community and caregiver oral health education plus media campaign vs Pre-intervention baseline (and sites that discontinued the prevention program)

Reduction in prevalence of baby bottle tooth decay (BBTD) · Alaska Native and American Indian Head Start children

Community and caregiver oral health education was associated with a significant ~25% overall reduction in baby bottle tooth decay among Head Start children (certainty not graded).

1 finding from 1 review

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes
3 to 8 years · Head Start sites in Alaska (1) and the continental US (11); Alaska Native and American Indian communities
Percent reduction in BBTD prevalence 25
1 study
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.32 [-0.46, -0.18]
7 studies · 3339 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Oral hygiene measured by mean gingival scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD 0.12 [-0.32, 0.55]
3 studies · 1573 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 6-8 years, DMFT scores were significantly reduced (SMD -0.11); subgroup not separately GRADE-rated.

8 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 6-8 years
SMD -0.11 [-0.17, -0.04]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · <=3 intervention activities
SMD -0.58 [-1.62, 0.45]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
SMD 0.01 [-0.16, 0.18]
3 studies
GRADE not reported

Show 5 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 8-15 years
SMD -0.41 [-0.50, -0.32]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
SMD -0.49 [-0.79, -0.19]
4 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.33 [-0.56, -0.10]
7 studies · 6766 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.26 [-0.70, 0.18]
5 studies · 3506 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · >3 intervention activities
SMD 0.02 [-0.13, 0.17]
Studies not reported
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Annual increment in DMFS (D3) · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Oral-health-education interventions significantly reduced net increment in DMFS (SMD -1.05); no significant subgroup difference vs other interventions (P=0.74).

5 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: oral health education
SMD -1.05 [-2.03, -0.08]
3 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · WHO health-promoting-schools framework
SMD -0.57 [-1.56, 0.42]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Non-WHO-framework interventions
SMD -1.88 [-3.15, -0.60]
Studies not reported
GRADE not reported

Show 2 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: other (daily tooth brushing)
SMD -1.23 [-1.46, -1.00]
1 study
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -1.09 [-1.91, -0.27]
4 studies · 3755 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
RR 0.70 [0.53, 0.94]
4 studies · 2968 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
RR 0.95 [0.75, 1.21]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
RR 0.58 [0.40, 0.84]
2 studies
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 5-8 years
SMD -0.36 [-0.76, 0.04]
5 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.34 [-0.69, 0.02]
5 studies · 5492 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 9-12 years
SMD -0.20 [-0.44, 0.04]
1 study
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)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

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).

1 finding from 1 review

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)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

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.

1 finding from 1 review

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

Comparison 4: provision of electronic health information with training/education vs no education

Changes to professional behavior ‐ use of EHI · medical residents; allied health personnel; physicians, midwives, nurses

1 finding from 1 review

Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical… 2015 · Cochrane Headline outcomes only
no estimate extracted
183 participants
Low

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Adherence to oral hygiene routines by people with ID or their carers · Children or adolescents

Gamified interventions appear to increase children's engagement and adherence to oral hygiene routines, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
The regular use rate was significantly higher (72.4%) in the gamified mobile health app group than in the nongamified intervention group (48.3%) [Zolfaghari 2021]; quiz-based challenges in mobile apps encouraged higher…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral hygiene behavior (brushing habits, preventive dental visits, dietary choices) · Children or adolescents

Gamified interventions appear to improve oral hygiene behaviors (brushing habits, preventive dental visits) in children, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
A gesture-based motion-capture game enhanced brushing independence and skill retention (P<.001) [Kang 2021]; 58.8% of caregivers reported their children brushed more often when using gamified applications [France…
Studies not reported
GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in primary teeth compared with standard care (very low certainty).

1 finding from 1 review

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
Children assessed at 1-6 yrs
RR 0.73 [0.50, 1.07]
5 studies · 1326 participants
Very low

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in top front four teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in top front four teeth compared with standard care (very low certainty).

1 finding from 1 review

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
Children assessed at 3 yrs · Higher-protein diet trial
RR 0.68 [0.42, 1.10]
1 study · 226 participants
Very low