What do systematic reviews say?

Self-management (self-administered/self-monitored OHA) vs Professional OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Baab 1986 (time spent brushing, number of oral hygiene aids), Aljafari 2017 (child's dietary habits, self-reported snacking and toothbrushing), Jonsson 2006 (oral self-care habits); measured, not synthesised or…
  3 studies
  GRADE not reported

Enhanced one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Tedesco 1992 reported self-reported brushing and flossing behaviours and self-efficacy (Oral Health Behavior Expectation Scale); measured, not synthesised or GRADE-rated.
  1 study
  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 (Optimised) usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  One study (Bellomo 2005) assessed oral health-related behaviour of residents; 60 residents were interviewed about toothbrushing habits. Use of toothbrushes and the frequency of brushing during the study period were…
  1 study · 60 participants
  GRADE not reported

Personalised one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Ramsay 2018 (oral health behaviour) and Jonsson 2009 (patient-reported health indices: GOHAI and self-rated oral health); measured, not synthesised or GRADE-rated.
  2 studies
  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

Oral hygiene care training of carers vs No training (or a placebo training session) of carers

It is very uncertain whether oral hygiene care training of carers changes behaviour, attitude and self-efficacy of carers (medium term) compared with no training (or a placebo training session) of carers (very low certainty).

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

  Medium term (6 weeks to 12 months)
  MD 0.15 [-0.80, 1.10]
  2 studies · 189 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

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

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