Findings

What do systematic reviews say?

15 questions · 30 findings · 2 reviews · Dental caries

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No studies found 2 · 6.7%GRADE not reported 19 · 63.3%Very low 7 · 23.3%Low 2 · 6.7%Moderate 0 · 0%High 0 · 0%

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 behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Plaque · Children aged 4 to 12 years attending primary school

Primary school-based behavioural intervention (both oral hygiene and… showed no clear difference in plaque indices (permanent and deciduous teeth) compared with no intervention or delayed intervention (non-intervention control;… (low certainty).

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
3 to 15 months
SoF (Plaque indices, follow-up 3 to 15 months): 'All 3 RCTs showed a reduction in plaque in the intervention group compared to control group'; 827 participants (3 RCTs); GRADE low; comment 'Data not suitable for…
3 studies · 827 participants
Low

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
15 months
PF 0.65 [0.12, 1.18]
1 study · 60 participants
Low

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Change in oral health knowledge and skills · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001 reported changes in oral health knowledge and skills: improvement was apparent in both intervention and control groups at the 4-month follow-up (phase one) but greater in the intervention group (34%…
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Changes in dental attendance · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001 found no change in reported dental visits over the course of the programmes, with 97% of children at baseline reporting visiting the dentist every 2 years.
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Behavioural outcomes (reported and/or other measures, e.g. data tracking toothbrushes and collecting food wrappers) · Children aged 4 to 12 years attending primary school

The review found no eligible studies for this question.

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
No other behavioural outcomes (e.g. objective toothbrush tracking or food-wrapper collection) were measured by the four included studies.
0 studies
No studies found

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Adverse events · Children aged 4 to 12 years attending primary school

The review found no eligible studies for this question.

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
No study reported any adverse events.
0 studies
No studies found

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Caries increment, tooth index D(M)FT · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
2 years
PF 0.49
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Frequency of cariogenic food and drink consumption · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001: few children had problems identifying foods containing sugar; only 15% of intervention and 19% of control participants reported routinely consuming sugary snacks on arriving home from school; snacking…
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Frequency of toothbrushing · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001 reported children's brushing frequency: almost all children (99%) at baseline reported twice daily brushing, and this level was maintained across all groups throughout the intervention (in baseline…
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

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