Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

17 questions · 26 findings · 7 reviews · All outcomes

No studies found 2 · 7.7%GRADE not reported 24 · 92.3%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Psychological intervention (positive reinforcement) vs Alternative psychological intervention (negative reinforcement)

Sucking cessation (long term) · Children with a non-nutritive sucking habit (digit or pacifier)
1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free participants (permanent dentition, D3) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

For low baseline caries experience, the annual decline in caries-free participants ranged 4.3% to 10.2% (9 studies; ungraded).

4 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    4.3% to 10.2%
    9 studies · 4811 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    0.8% to 10.2%
    18 studies · 12017 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: high
    0.8% to 2.2%
    2 studies · 5029 participants
    GRADE not reported
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  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    3.7% to 8.3%
    4 studies · 928 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in DMFT (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFT increment ranged from 0.06 to 0.73 across 14 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    0.24 to 0.73
    6 studies · 16705 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries development in permanent teeth · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFS increment ranged from 0.07 to 1.77 across 26 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    0.07 to 0.53
    8 studies · 3735 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Dental caries: dmfs increment (primary teeth) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmfs increment ranged from -1.0 to 1.0 across 7 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free children (primary dentition, d3) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual decline in the percentage of caries-free children ranged from 3.8% to 12.2% across 6 studies (descriptive range, no pooled estimate; ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries incidence rate (first D3 lesion) per person-year at risk (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the pooled caries incidence rate was 0.11 per person-year at risk (95% CI 0.09 to 0.13; random-effects meta-analysis of 15 studies), i.e., about 11 of every 100 caries-free persons develop dentine caries each year (ungraded).

1 finding from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per person-year at risk · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    Incidence rate (per person-year at risk) 0.11 [0.09, 0.13]
    15 studies · 10768 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in dmft (primary dentition) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmft increment ranged from -0.3 to 0.3 across 4 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Psychological interventions (positive and negative reinforcement) vs no treatment

Sucking cessation (long term) · Children with a non-nutritive sucking habit (digit or pacifier)

Psychological interventions (positive and negative reinforcement) led to higher sucking cessation (long term) compared with no treatment; GRADE not reported.

1 finding from 1 review

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Non-digital gamified oral health interventions (card/board games, storytelling, printed aids)

Long-term behavior change and overall oral health outcomes · Children or adolescents

Digital gamified interventions appear more effective than non-digital alternatives for long-term behavior change and oral health outcomes, 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
    Long-term follow-up (sustained behavior change) · Schools, dental clinics, and mobile-app user-testing environments
    Digital-based interventions were more effective in fostering long-term behavior change compared with nondigital alternatives and consistently outperformed nondigital alternatives in improving oral health outcomes;…
    Studies not reported
    GRADE not reported

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

Quality of life changes or long-term, patient-centred outcomes (e.g. tooth retention) · People with intellectual disabilities (ID), living at home, in day care, in hospital or in a residential care setting; all levels of ID as…

The review found no eligible studies for this question.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower pain intensity (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Muscle palpation pain (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… showed no clear difference in muscle palpation pain (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review
  • Psychosocial interventions for the management of chronic orofacial pain 2011 · Cochrane All outcomes
    Long term (more than 3 months)
    Muscle palpation pain long term (greater than 3 months): 3 studies; results not pooled owing to substantial heterogeneity (I2=64%); insufficient evidence to draw conclusions for any individual intervention. One study…
    3 studies
    GRADE not reported

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Depression (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower depression (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Pain severity - impact: activity interference / disability (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower pain severity - impact: activity interference / disability (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to healthcare workers, with or without the same intervention given to the patients with COVID-19 vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

Hope-based intervention vs Pain education

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.

1 finding from 1 review